Key result
Renal denervation is linked to a sustained ~15 mmHg drop in ambulatory SBP at 10 years.
Why the study?
The study was conducted to examine the efficacy, safety, and long-term outcomes of renal denervation in hypertensive patients for up to 10 years in a real-world setting.
Does catheter-based renal denervation reduce blood pressure long-term in patients with uncontrolled resistant hypertension?
Cohort (n=65)
No
Does catheter-based renal denervation reduce blood pressure long-term in patients with uncontrolled resistant hypertension?
Catheter-based radiofrequency renal denervation safely produces significant and sustained reductions in systolic blood pressure for up to 10 years in patients with resistant hypertension.
Renal denervation may support sustained BP reduction in resistant hypertension; extends observational durability data but remains hypothesis-generating.
This analysis of real-world data examines the efficacy, safety, and long-term outcomes of renal denervation in hypertensive patients for up to 10 years. Sixty-five consecutive patients underwent renal denervation (RDN) (single operator) for uncontrolled resistant hypertension. Efficacy was defined as the interindividual change of office (OBPM) and ambulatory blood pressure monitoring (ABPM) at 1, 6, 12 months, 2-4 and 5-10 years after RDN. Medication changes, renal function, and device generation disparities were analyzed. Of these patients, 42 received RDN with a first-generation device, while 23 underwent the procedure with a second-generation device. Baseline demographics included a predominantly male cohort (57.6%) with an average age of 60.3 years. The mean number of medications at baseline was 4.3. OBPM at baseline was 169.0/87.4 mmHg, and ABPM at baseline was 153.4/88.4 mmHg. Post-procedure, significant reductions in systolic blood pressure (SBP) were observed in both OBPM and ABPM at 1 month (OBPM 147.9/82.8 mmHg; ABPM 141.3/83.0 mmHg [SBP, p < 0.001]), sustained up to 10 years (OBPM 153.1/84.3 mmHg; ABPM 138/80.1 mmHg [SBP, p < 0.001]). After 1 year around half of patients had a controlled OBPM and 24 h ABPM < 135/85 mmHg, which was associated with a higher number of ablation spots (31.5±14.8 vs. 15.5 ± 6.5, p = 0.002) and occurred more often when treated with a second-generation device (2 [12.5%] vs. 7 [77.8%], p = 0.002). Renal function displayed a minor physiological decline over 5-10 years. No major complication occurred. Renal denervation demonstrated sustained significant reductions in systolic OBPM and ABPM up to 10 years post-procedure. Controlled blood pressure at 1 year was associated with a higher number of mean ablated spots and the use of a second-generation device. The procedure exhibited a favorable safety profile, indicating its viability in managing hypertension without significant renal function compromise.
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Brouwers et al. (2024) conducted a cohort in Resistant arterial hypertension (n=65). Renal denervation vs. Baseline (No control group) was evaluated on Change in ambulatory systolic blood pressure at 5-10 years post-procedure (p=<0.001). Renal denervation demonstrated sustained significant reductions in ambulatory systolic blood pressure (from 153.4 to 138.0 mmHg, p<0.001) up to 10 years post-procedure in resistant hypertension.
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