Key result
Renal sympathetic denervation reduced resting systolic blood pressure (185 vs 175 mmHg; p=0.04) but did not alter sympathetic nerve activity or blood pressure reactions to mental stress.
Why the study?
The impact of renal denervation on muscle sympathetic nerve activity at rest is controversial, and whether it modifies stress-induced neurocardiovascular changes was unknown.
Does renal sympathetic denervation alter muscle sympathetic nerve activity and blood pressure responses to mental stress in patients with resistant hypertension?
Observational (n=14)
Does renal sympathetic denervation alter muscle sympathetic nerve activity and blood pressure responses to mental stress in patients with resistant hypertension?
Renal denervation lowers resting systolic blood pressure in resistant hypertension but does not alter neurovascular or sympathetic responses to mental stress.
Renal denervation should not yet change practice in resistant hypertension; leaves open sympathetic mechanisms of blood pressure reduction.
Background: The impact of renal denervation (RDN) on muscle sympathetic nerve activity (MSNA) at rest remains controversial. Mental stress (MS) induces transient changes in sympathetic nerve activity, heart rate (HR) and blood pressure (BP). It is not known whether RDN modifies these changes.Purpose: The main objective was to assess the effect of RDN on MSNA and BP alterations during MS.Methods: In 14 patients (11 included in analysis) with resistant hypertension multi-unit MSNA, BP (Finometer ®) and HR were assessed at rest and during forced arithmetics at baseline and 6 months after RDN.Results: Systolic office BP decreased significantly 6 months after RDN (185 ± 29 vs.175 ± 33 mmHG; p = 0.04). No significant changes in MSNA at rest (68 ± 5 vs 73 ± 5 bursts/100hb; p = 0.43) were noted and no significant stress-induced change in group averaged sympathetic activity was found pre- (101 ± 24%; p = 0.9) or post-intervention (108 ± 26%; p = 0.37). Stress was associated with significant increases in mean arterial BP (p < 0.01) and HR (p < 0.01) at baseline, reactions which remained unaltered after intervention. We did not note any correlation between sympathetic nerve activity and BP changes after RDN.Conclusion: Thus, in our group of resistant hypertensives we find no support for the hypothesis that the BP-lowering effect of RDN depends on altered neurovascular responses to stress.
No takes yet. Share an insight, caveat, or question.
Völz et al. (2019) conducted an observational in resistant hypertension (n=14). Renal sympathetic denervation vs. Baseline was evaluated on Muscle sympathetic nerve activity (MSNA) and blood pressure alterations during mental stress. Renal sympathetic denervation reduced resting systolic blood pressure (185 vs 175 mmHg; p=0.04) but did not alter sympathetic nerve activity or blood pressure reactions to mental stress.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: