Renal denervation in moderate treatment-resistant hypertension

Ott C, Mahfoud F, Schmid A, Ditting T, Sobotka PA, Veelken R, Spies A, Ukena C, Laufs U, Uder M, Boehm M, Schmieder R (2013)

Publication Type: Journal article

Publication year: 2013

Journal

Book Volume: 62

Pages Range: 1880-1886

Journal Issue: 20

DOI: 10.1016/j.jacc.2013.06.023

Abstract

Objectives This study sought to investigate the effect of renal denervation (RDN) in patients with treatment-resistant hypertension according to the established definition (Joint National Committee VII and European Society of Hypertension/European Society of Cardiology guidelines), that is, office blood pressure (BP) ≥140/90 mm Hg (with at least three antihypertensive drugs, including a diuretic, in adequate doses) and confirmed by 24-h ambulatory BP monitoring (ABPM). Background RDN emerged as an innovative interventional antihypertensive therapy. However, so far, only patients with severe hypertension (systolic BP ≥160 mm Hg or ≥150 mm Hg for patients with type 2 diabetes) have been investigated. Methods In this study, there were 54 patients with moderate treatment-resistant hypertension (office BP ≥140/90 mm Hg and <160/100 mm Hg and diagnosis confirmed by 24-h ABPM of ≥130/80 mm Hg) who underwent catheter-based RDN using the Symplicity catheter (Medtronic Inc., Mountain View, California). Results Patients were treated with 5.1 ± 1.4 antihypertensive drugs on average. Office BP was significantly reduced by 13/7 mm Hg 6 months after RDN (systolic: 151 ± 6 mm Hg vs. 138 ± 21 mm Hg, p < 0.001; diastolic: 83 ± 11 mm Hg vs. 75 ± 11 mm Hg, p < 0.001). In patients (n = 36) who underwent ABPM 6 months after treatment, there was a reduction in average 24-h ABPM by 14/7 mm Hg (systolic: 150 ± 16 mm Hg vs. 136 ± 16 mm Hg, p < 0.001; diastolic: 83 ± 10 mm Hg vs. 76 ± 10 mm Hg, p < 0.001). In 51% of patients, office BP was controlled below 140/90 mm Hg after RDN. In addition, heart rate decreased from 67 ± 11 to 63 ± 10 beats/min (p = 0.006). Conclusions Our data indicate that RDN may reduce office and 24-h ambulatory BP substantially in patients with moderate treatment-resistant hypertension. (Renal Denervation in Treatment Resistant Hypertension; NCT01687725). © 2013 by the American College of Cardiology Foundation.

Authors with CRIS profile

Involved external institutions

Ohio State University United States (USA) (US) Universitätsklinikum des Saarlandes (UKS) Germany (DE)

How to cite

APA:

Ott, C., Mahfoud, F., Schmid, A., Ditting, T., Sobotka, P.A., Veelken, R.,... Schmieder, R. (2013). Renal denervation in moderate treatment-resistant hypertension. Journal of the American College of Cardiology, 62(20), 1880-1886. https://doi.org/10.1016/j.jacc.2013.06.023

MLA:

Ott, Christian, et al. "Renal denervation in moderate treatment-resistant hypertension." Journal of the American College of Cardiology 62.20 (2013): 1880-1886.

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