Higher baseline office systolic blood pressure was associated with greater 6-month reductions following radiofrequency renal denervation, ranging from 4.2 mmHg at 150 mmHg to 21.0 mmHg at 180 mmHg.
Meta-Analysis (n=3,377)
Yes
Does baseline systolic blood pressure predict the magnitude of blood pressure reduction at 6 months following radiofrequency renal denervation in patients with uncontrolled hypertension?
Higher baseline systolic blood pressure is linearly associated with greater blood pressure reductions at 6 months following radiofrequency renal denervation, allowing for better prediction of treatment response.
BACKGROUND: Renal denervation (RDN) is a guideline-recommended treatment to reduce blood pressure (BP) in patients with uncontrolled hypertension. However, it is unclear if there are patient characteristics that are predictive of greater BP reduction. Baseline systolic blood pressure (SBP) has consistently been identified as an indicator of BP reduction after RDN. AIMS: Our study aimed to quantify the expected SBP change after RDN based on baseline SBP. METHODS: Patients undergoing radiofrequency RDN were pooled from multiple clinical studies, including SPYRAL First-In-Human (n=50), SYMPLICITY HTN-3 (n=364), SYMPLICITY HTN-Japan (n=22), SPYRAL HTN ON-MED (n=206), and the Global SYMPLICITY Registry DEFINE (n=2,735). Office and 24-hour ambulatory BP were measured at baseline and 6 months. Linear regression modelled patient-level 6-month SBP changes against baseline SBP. RESULTS: =0.13 for ASBP). Baseline OSBP of 150, 160, 170, and 180 mmHg were associated with 6-month reductions of 4.2, 9.8, 15.4, and 21.0 mmHg, respectively. CONCLUSIONS: Baseline SBP was associated with 6-month SBP reductions after RDN in hypertensive patients. This relationship provides guidance for shared patient-clinician decision-making about what BP change to expect following radiofrequency RDN based on baseline SBP alone.
Schmieder et al. (Tue,) conducted a meta-analysis in Uncontrolled hypertension (n=3,377). Baseline systolic blood pressure was evaluated on 6-month systolic blood pressure changes. Higher baseline office systolic blood pressure was associated with greater 6-month reductions following radiofrequency renal denervation, ranging from 4.2 mmHg at 150 mmHg to 21.0 mmHg at 180 mmHg.