Long-term reduction in morning and nighttime blood pressure after renal denervation: 36-month results from SPYRAL HTN-ON MED trial

Kario K, Mahfoud F, Kandzari DE, Townsend RR, Weber MA, Schmieder R, Tsioufis K, Pocock S, Brar S, Hettrick DA, Fahy M, Boehm M (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Hypertension Research Nature Publishing Group: Open Access Hybrid Model Option A

DOI: 10.1038/s41440-022-01042-8

Abstract

Elevated morning and nighttime blood pressures (BP) are associated with increased risk of cardiovascular events such as stroke and myocardial infarction. We compared the long-term changes in morning and nighttime BP in patients with uncontrolled hypertension (office systolic BP between 150 and <180 mmHg/diastolic BP ≥ 90 mmHg; mean ambulatory systolic BP (SBP) between 140 and <170 mmHg; 1–3 prescribed antihypertensive medications). Eighty patients were randomized to RDN or sham control. In patients taking at least 3 antihypertensive medications at 36 months (N = 23 RDN group; N = 23 sham group), the 24 h ambulatory SBP as well as morning (7:00–9:00AM) and nighttime (1:00–6:00AM) ambulatory SBP were significantly lower for the RDN group compared to sham control (24 h SBP: −20.2 vs. −10.2, p = 0.0087; morning SBP: −23.9 vs. −8.0 mmHg, p = 0.029; nighttime SBP: −20.8 vs. −7.2 mmHg, p = 0.0011). At 36 months, 24 h SBP was controlled to <130 mmHg in 40% of RDN patients in the morning compared to 6% for the sham group; P = 0.021 and in 80% of the RDN patients at night compared to 39% in the sham group; P = 0.019. Major adverse events through 36 months were rare in both groups, and there were no renal artery re-interventions or vascular complications. Morning and nighttime SBP were significantly lower in patients prescribed at least 3 antihypertensive medications at 36 months in the SPYRAL HTN-ON MED trial for RDN compared with sham control. The results suggest RDN has significant benefit when the risk of cardiovascular events is highest.

Authors with CRIS profile

Roland Schmieder Professur für Innere Medizin (Nephrologie)

Involved external institutions

Piedmont Healthcare US United States (USA) (US) Medtronic US United States (USA) (US) SUNY Downstate Medical Center US United States (USA) (US) University of Pennsylvania US United States (USA) (US) Universität des Saarlandes (UdS) DE Germany (DE) National and Kapodistrian University of Athens GR Greece (GR) London School of Hygiene and Tropical Medicine GB United Kingdom (GB) Jichi Medical University / 自治医科大学 JP Japan (JP)

How to cite

APA:

Kario, K., Mahfoud, F., Kandzari, D.E., Townsend, R.R., Weber, M.A., Schmieder, R.,... Boehm, M. (2022). Long-term reduction in morning and nighttime blood pressure after renal denervation: 36-month results from SPYRAL HTN-ON MED trial. Hypertension Research. https://doi.org/10.1038/s41440-022-01042-8

MLA:

Kario, Kazuomi, et al. "Long-term reduction in morning and nighttime blood pressure after renal denervation: 36-month results from SPYRAL HTN-ON MED trial." Hypertension Research (2022).

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