Renal sympathetic denervation did not change mean office and ambulatory blood pressures at 1, 3, and 6 months in patients with true treatment-resistant hypertension.
Observational (n=18)
Does renal denervation reduce blood pressure in patients with true treatment-resistant hypertension confirmed by witnessed medication intake?
In a small cohort of patients with true treatment-resistant hypertension confirmed by witnessed medication intake, renal denervation did not consistently lower mean office or ambulatory blood pressure.
It is unknown whether the decline in blood pressure (BP) after renal denervation (RDN) is caused by denervation itself or concomitantly improved drug adherence. We aimed to investigate the BP lowering effect of RDN in true treatment-resistant hypertension by excluding patients with poor drug adherence. Patients with resistant hypertension (n=18) were referred for a thorough clinical and laboratory work-up. Treatment-resistant hypertension was defined as office systolic BP>140 mm Hg, despite maximally tolerated doses of ≥ 3 antihypertensive drugs, including a diuretic. In addition, ambulatory daytime systolic BP>135 mm Hg was required after witnessed intake of antihypertensive drugs to qualify. RDN (n=6) was performed with Symplicity Catheter System. The mean office and ambulatory BPs remained unchanged at 1, 3, and 6 months in the 6 patients, whereas there was no known change in antihypertensive medication. Two patients, however, had a fall in both office and ambulatory BPs. Our findings question whether BP falls in response to RDN in patients with true treatment-resistant hypertension. Additional research must aim to verify potential BP lowering effect and identify a priori responders to RDN before this invasive method can routinely be applied to patients with drug-resistant hypertension. Clinical Trial Registration- URL: http://www.clinicaltrials.gov. Unique identifier: NCT01673516.
Elmula et al. (Tue,) conducted a observational in Treatment-resistant hypertension (n=18). Renal sympathetic denervation was evaluated on Change in office and ambulatory blood pressure. Renal sympathetic denervation did not change mean office and ambulatory blood pressures at 1, 3, and 6 months in patients with true treatment-resistant hypertension.