Catheter-based renal denervation for treatment of patients with treatment-resistant hypertension: 36 month results from the SYMPLICITY HTN-2 randomized clinical trial

Esler MD, Boehm M, Sievert H, Rump CL, Schmieder R, Krum H, Mahfoud F, Schlaich MP (2014)

Publication Type: Journal article

Publication year: 2014

Journal

European Heart Journal Oxford University Press

Book Volume: 35

Pages Range: 1752-9

Journal Issue: 26

DOI: 10.1093/eurheartj/ehu209

Abstract

The aim of this study was to determine long-term results of renal artery denervation for treatment of treatment-resistant hypertension in the SYMPLICITY HTN-2 study.SYMPLICITY HTN-2 randomized 106 subjects with treatment-resistant hypertension to renal denervation or medical therapy alone. At 6 months, 37 control subjects crossed over to renal denervation. Office blood pressure measurements, antihypertensive medication use, and safety events were followed every 6 months through 3 years.Follow-up was available at 36 months in 40 of 52 subjects in the initial renal denervation group and at 30 months in 30 of 37 subjects who crossed over and received renal denervation at 6 months. Baseline blood pressure was 184 ± 19/99 ± 16 mmHg in all treated subjects. At 30-month post-procedure, systolic blood pressure decreased 34 mmHg (95% CI: -40, -27, P < 0.01) and diastolic blood pressure decreased 13 mmHg (95% CI: -16, -10, P < 0.01). The systolic and diastolic blood pressure reduction at 36 months for the initial renal denervation group was -33 mmHg (95% CI: -40, -25, P < 0.01) and -14 mmHg (95% CI: -17, -10, P < 0.01), respectively. Procedural complications included one haematoma, and one renal artery dissection before energy delivery that was treated successfully. Later complications included two cases of acute renal failure, which fully resolved, 15 hypertensive events requiring hospitalization, and three deaths.Renal denervation resulted in sustained lowering of blood pressure at 3 years in a selected population of subjects with severe, treatment-resistant hypertension without serious safety concerns.NCT00888433.

Authors with CRIS profile

Roland Schmieder Professur für Innere Medizin (Nephrologie)

Involved external institutions

Monash University AU Australia (AU) Universitätsklinikum des Saarlandes (UKS) DE Germany (DE) Heinrich-Heine-Universität Düsseldorf DE Germany (DE) CardioVasculäres Centrum Frankfurt DE Germany (DE)

How to cite

APA:

Esler, M.D., Boehm, M., Sievert, H., Rump, C.L., Schmieder, R., Krum, H.,... Schlaich, M.P. (2014). Catheter-based renal denervation for treatment of patients with treatment-resistant hypertension: 36 month results from the SYMPLICITY HTN-2 randomized clinical trial. European Heart Journal, 35(26), 1752-9. https://doi.org/10.1093/eurheartj/ehu209

MLA:

Esler, Murray D., et al. "Catheter-based renal denervation for treatment of patients with treatment-resistant hypertension: 36 month results from the SYMPLICITY HTN-2 randomized clinical trial." European Heart Journal 35.26 (2014): 1752-9.

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