Radiofrequency renal denervation significantly reduced office systolic blood pressure at 3 years in both ESC guideline-recommended groups (-20.6 mmHg in group 1 and -18.8 mmHg in group 2, p<0.0001).
Observational (n=2,884)
Yes
Does radiofrequency renal denervation reduce blood pressure similarly in the two ESC guideline-recommended hypertensive patient groups?
Radiofrequency renal denervation provides significant and sustained 3-year blood pressure reductions in both ESC guideline-recommended patient groups.
Absolute Event Rate: -20.6% vs -18.8%
p-value: p=<0.0001
Abstract Background/Introduction Recent ESC guidelines recommend that renal denervation (RDN) should be considered in two groups of hypertensive (HTN) patients: 1) patients with an elevated office systolic or diastolic blood pressure (BP) ≥140/90 mmHg using 3 or more antihypertensive (AH) medications and any cardiovascular disease (CVD) risk or 2) patients with an elevated BP on 3 AH medications and increased CVD risk. The Global SYMPLICITY Registry (GSR) DEFINE is the largest study of its kind evaluating the safety and efficacy of radiofrequency (RF) RDN in a real-world setting. Purpose To compare the 3-year outcomes of RF RDN in the 2 ESC guideline-defined patient groups. Methods Patients were categorized into 2 groups based on the ESC guideline recommendations: 2703 with resistant HTN on ≥3 AH drugs and with any CVD risk (group 1) and 181 with HTN on 3 AH drugs and increase CVD risk (group 2). Office BP, 24-h ambulatory BP, medications, and adverse events were compared between groups at each follow-up. Results Differences in baseline characteristics and 3 year adverse events are shown below. There was no difference in CV death between groups, but rates of all-cause death, stroke and new end stage renal disease were higher in group 2. At 3 years, both groups had similar significant reductions in office systolic BP (p0.0001 for both): -20.6±26.8 mmHg in group 1 and -18.8±29.1 mmHg in group 2. Changes in 24h SBP were -9.6±20.9 and -5.6±18.1 mmHg in groups 1 and 2, respectively. AH medication use increased over time in group 2 (from 1.6±0.6 to 2.4±1.4 at 3y) but was similar in group 1 (from 4.9±1.3 to 4.7±1.6 at 3y). Conclusions RF RDN significantly reduced systolic BP in both ESC-guideline recommended patient groups. Further studies are warranted to understand the impact of RDN on CVD events in patient with uncontrolled HTN and increased CVD risk.Characteristics and 3 year AEs
Mahfoud et al. (Sat,) conducted a observational in Hypertension (n=2,884). Radiofrequency renal denervation in ESC group 1 (resistant HTN on ≥3 drugs) vs. ESC group 2 (HTN on <3 drugs) was evaluated on Change in office systolic blood pressure at 3 years (p=<0.0001). Radiofrequency renal denervation significantly reduced office systolic blood pressure at 3 years in both ESC guideline-recommended groups (-20.6 mmHg in group 1 and -18.8 mmHg in group 2, p<0.0001).