Key result
Renal denervation significantly reduced mean 24-hour ambulatory blood pressure by 8/5 mmHg and office blood pressure by 20/7 mmHg at 6 months in patients with treatment-resistant hypertension.
Why the study?
Does renal denervation reduce office and ambulatory blood pressure in patients with treatment-resistant hypertension?
Observational (n=407)
Yes
Does renal denervation reduce office and ambulatory blood pressure in patients with treatment-resistant hypertension?
Mean Difference: -8
p-value: p=<0.001
In a real-world national registry, renal denervation safely and significantly reduced both office and ambulatory blood pressure in patients with resistant hypertension, though office and ambulatory responses correlated weakly.
May support renal denervation in resistant hypertension; leaves open need for randomized confirmation before practice change.
Renal denervation (RDN) is a new procedure for treatment-resistant hypertensive patients. In order to monitor all procedures undergone in Austria, the Austrian Society of Hypertension established the investigator-initiated Austrian Transcatheter Renal Denervation (TREND) Registry. From April 2011 to September 2014, 407 procedures in 14 Austrian centres were recorded. At baseline, office and mean 24-h ambulatory blood pressure (ABP) were 171/94 and 151/89 mmHg, respectively, and patients were taking a median of 4 antihypertensive medications. Mean 24-h ABP changes after 2-6 weeks, 3, 6 and 12 months were -11/-6, -8/-4, -8/-5 and -10/-6 mmHg (p<0.05 at all measurements), respectively. The periprocedural complication rate was 2.5%. Incidence of long-term complications during follow-up (median 1 year) was 0.5%. Office BP and ABP responses showed only a weak correlation (Pearson coefficient 0.303). Based on the data from the TREND registry, ambulatory blood pressure monitoring in addition to office BP should be used for patient selection as well as for monitoring response to RDN. Furthermore, criteria for optimal patient selection are suggested.
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Zweiker et al. (2016) conducted an observational in Treatment-resistant hypertension (n=407). Renal denervation vs. Baseline (no control group) was evaluated on Change in mean 24-h ambulatory systolic blood pressure at 6 months (MD -8.0, p=<0.001). Renal denervation significantly reduced mean 24-hour ambulatory blood pressure by 8/5 mmHg and office blood pressure by 20/7 mmHg at 6 months in patients with treatment-resistant hypertension.
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