Key result
Symplicity Spyral renal denervation linked to a ~34 mmHg systolic BP drop regardless of obesity.
Why the study?
Response heterogeneity to renal denervation in resistant hypertension is incompletely understood, and obesity-associated sympathetic overactivity may influence blood pressure response.
Does radiofrequency renal denervation reduce blood pressure in obese and nonobese patients with resistant hypertension?
Cohort (n=50)
No
Does radiofrequency renal denervation reduce blood pressure in obese and nonobese patients with resistant hypertension?
p-value: p=<0.001
Renal denervation significantly reduced blood pressure at 6 months in patients with resistant hypertension, with comparable overall efficacy in both obese and nonobese individuals.
Background: Renal denervation (RDN) has demonstrated blood pressure (BP) – lowering efficacy in resistant hypertension; however, response heterogeneity remains incompletely understood. Obesity is associated with sympathetic overactivity and may influence the BP response to RDN. We evaluated BP changes following Symplicity Spyral RDN in a real-world cohort stratified by obesity status. Methods: We conducted a retrospective single-center cohort study including patients with resistant hypertension who underwent radiofrequency RDN using the Symplicity Spyral system at Sabah Al-Ahmad Cardiac Center in Kuwait between March 2023 and August 2024. BP was assessed at baseline, immediate postprocedure, and at 6 months. The primary outcome was change in systolic and diastolic BP at 6 months and the comparison between obese and nonobese patients. Secondary outcomes included time to achieving BP targets and clinical predictors of target achievement. Results: A total of 50 patients underwent RDN (mean age: 61.7 years); 32 were obese, and 18 were nonobese. In the overall cohort, systolic BP (SBP) decreased from 163.7 ± 24.6 mmHg at baseline to 129.4 ± 13.5 mmHg at 6 months ( P < 0.001), and diastolic BP decreased from 86.7 ± 16.6 mmHg to 75.9 ± 8.2 mmHg ( P = 0.0004). Repeated measures analysis of covariance demonstrated significant SBP changes over time ( P < 0.001) with no overall between-group difference by obesity status; however, a significant time × body mass index category interaction was observed for SBP ( P = 0.038). Kaplan–Meier analysis showed a median time of 2 months to BP target achievement in both the groups. In multivariable logistic regression, dyslipidemia was independently associated with lower odds of BP target achievement (odds ratio: 0.17, 95% confidence interval: 0.03–0.80; P = 0.036). Conclusion: In this real-world cohort, Symplicity Spyral RDN was associated with significant BP reduction at 6 months in both obese and nonobese patients. Obesity status did not appear to diminish overall BP-lowering efficacy, although SBP response trajectory differed over time. In exploratory multivariable analysis, dyslipidemia was associated with lower odds of BP target achievement
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Alansari et al. (2026) conducted a cohort in resistant hypertension (n=50). Symplicity Spyral renal denervation vs. Baseline and nonobese patients was evaluated on Change in systolic and diastolic BP at 6 months and the comparison between obese and nonobese patients (p=<0.001). Symplicity Spyral renal denervation reduced overall systolic blood pressure from 163.7 to 129.4 mmHg at 6 months (P<0.001), with no overall between-group difference by obesity status.
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