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July 4, 2016Journal of Hypertension

Blood pressure reduction at 3 and 6 months follow-up did not differ between the active treatment and the sham control group, though at 1-month follow-up there was a significant difference in daytime DBP of -4.4 mmHg (P = 0.02) in favor of renal denervation.

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Why the study?

Does renal denervation using a single-electrode catheter reduce daytime ambulatory SBP in patients with resistant hypertension?

Population

69 patients with resistant hypertension

Comparison

Renal denervation using a single-electrode… vs Sham control

Design

Editorial, randomized, double-blind, sham-controlled

Follow-up

3 and 6 months

Authors

MSMarkus P. SchlaichCSCarl SchultzSSSharad Shetty

Discussion

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Overview

No sustained BP benefit with single-electrode renal denervation; leaves open whether multielectrode catheters improve outcomes in resistant hypertension.

Structured PICO

Does renal denervation using a single-electrode catheter reduce daytime ambulatory SBP in patients with resistant hypertension?

P
Population
69 patients with resistant hypertension
I
Intervention
Renal denervation using a single-electrode catheter
C
Comparator
Sham control
O
Outcome
Mean change in daytime ambulatory SBP from baseline to 3 monthssurrogate

This editorial highlights that single-electrode renal denervation did not significantly lower blood pressure compared to sham control at 3 and 6 months, emphasizing the need for multielectrode catheters to achieve more complete denervation.

Limitations

  • Observed pill intake prior to ambulatory BP monitoring was not performed
  • No testing for drug metabolites to assess medication adherence
  • Almost half of the patients had changes in antihypertensive medication at 3 and 6 months follow-up
  • No direct evidence to support the claim that a circumferential ablation pattern was achieved
  • Number of ablations likely too low to achieve sufficient denervation

Cite This Study

Schlaich et al. (2016) studied this question.

synapsesocial.com/papers/6a87f0596304c7fd8e4de699https://doi.org/10.1097/hjh.0000000000001016
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Renal denervation: symply trapped by complexity?2014 · 63 citations
  2. 2Renal denervation: are we at a crossroads?2016 · 1 citations
  3. 3The complexity after simplicity: How to proceed with renal denervation in hypertension?2014 · 7 citations
  4. 4Moderator's View: Renal denervation: The jury is still out and the verdict will be more complex than initially envisaged2014 · 1 citations
  5. 5Renal sympathetic denervation: Ashes to ashes or rebirth from the ashes?2018 · 3 citations