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October 1, 2021European Heart JournalOpen Access

Predictors of blood pressure response after renal denervation beyond pretreatment blood pressure

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Why the study?

Pre-treatment blood pressure predicts response after renal denervation, but prior efforts to discover further significant and clinically meaningful predictors of response had failed.

Population

266 patients with resistant hypertension undergoing radiofrequency RDN

Comparison

Responders vs non-responders based on excessive 24h systolic ABP decrease

Design

Two-centre observational cohort study

Follow-up

12 months

Key result

In patients with resistant hypertension undergoing renal denervation, lower baseline HbA1c (beta -0.167, p=0.004) and office heart rate were independent predictors of blood pressure decrease.

Authors

RSRoland E. SchmiederCDChristian DellesLLLucas Lauder

Discussion

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Overview

Pre-treatment BP predicts RDN response; leaves open whether additional predictors meaningfully improve patient selection.

Study Design

Type

Cohort (n=266)

Multicenter

Yes

Structured PICO

P
Population
266 patients with resistant hypertension (mean age 62 years, 34% females) who underwent radiofrequency renal denervation, followed for up to 12 months.
E
Exposure
Radiofrequency renal denervation (RDN) with the Symplicity catheter
O
Outcome
Change in 24-hour systolic ambulatory blood pressure (ABP) after 6 months from pre-treatment valuessurrogate

Main Result

Absolute Event Rate: -23.3% vs 1.4%

p-value: p=<0.001

In patients with resistant hypertension undergoing renal denervation, lower HbA1c and office heart rate are independent predictors of blood pressure response, in addition to pre-treatment blood pressure.

Cite This Study

Schmieder et al. (2021) conducted a cohort in resistant hypertension (n=266). Baseline HbA1c and office heart rate was evaluated on change in 24-hour systolic ambulatory blood pressure after 6 months from pre-treatment values (p=<0.001). In patients with resistant hypertension undergoing renal denervation, lower baseline HbA1c (beta -0.167, p=0.004) and office heart rate were independent predictors of blood pressure decrease.

synapsesocial.com/papers/6a62efad9a2e487662c1b4b3https://doi.org/10.1093/eurheartj/ehab724.2379
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