Key result
Radiofrequency denervation of the renal arteries significantly decreased average daily systolic blood pressure at 12 months (P<0.001), with a more pronounced antihypertensive effect in women.
Why the study?
Gender differences in the antihypertensive effect of renal denervation based on office and daily blood pressure measurements in resistant hypertension over 3 years remained to be evaluated.
Does radiofrequency denervation of the renal arteries reduce blood pressure differently in men versus women with resistant arterial hypertension?
RCT (n=80)
stratification randomization
Does radiofrequency denervation of the renal arteries reduce blood pressure differently in men versus women with resistant arterial hypertension?
Radiofrequency renal denervation may offer a more pronounced long-term antihypertensive effect in women than in men with resistant hypertension.
RDN may yield greater long-term BP reduction in women than men with resistant hypertension; extends prior RCTs by identifying sex as a potential effect modifier.
Objective: evaluation of gender differences in the antihypertensive effect after denervation of the renal arteries based on the results of office and daily measurements of blood pressure in resistant arterial hypertension in a 3-year follow-up. Materials and methods: the study involved 80 patients with resistant arterial hypertension (RAH); Patients were divided by stratification randomization into the interventional treatment group, who continue to receive antihypertensive therapy (AHT) (RDN group) and the MT group (patients on drug therapy only. The study groups were comparable in terms of gender, age, duration of hypertension, the number of antihypertensive drugs taken, the presence of For 12 months, a comparative study was conducted between groups, further analysis of the effectiveness of surgical treatment of RDN PA was carried out at control points of 24 and 36 months, in which laboratory and instrumental examinations were performed. Results: according to the office measurement of blood pressure within the RDN and MT study groups, both in men and women, it turned out to be similar. After 12 months of observation between the comparison groups, the women of the group showed a statistically significant negative dynamics of the office SBP (p<0.01) and office DBP (p<0.05) parameters. According to the analysis of average daily, average daily, average night SBP indicators, after 12 months in the RDN group, a decrease was observed in all main parameters (p<0.001). It is worth paying attention to the fact that in the MT group, among the average daily, average daily, average night ABPM indicators after 12 months, no statistically significant changes were detected. When conducting a gender analysis of ABPM indicators using the Friedman test and correcting the p value for multiple comparisons at visits of 24 and 36 months, a statistically significant decrease in the main average daily indicators in women was demonstrated, while in men such changes were not established. Conclusions: the data obtained indicate a more pronounced antihypertensive effect after radiofrequency denervation of the renal arteries in resistant arterial hypertension in women.
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Mikova et al. (2023) conducted an RCT in resistant arterial hypertension (n=80). Radiofrequency denervation of the renal arteries vs. Medical therapy only was evaluated on Office and daily measurements of blood pressure (p=<0.001). Radiofrequency denervation of the renal arteries significantly decreased average daily systolic blood pressure at 12 months (P<0.001), with a more pronounced antihypertensive effect in women.
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