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Renal sympathetic denervation in patients with treatment-resistant hypertension after witnessed intake of medication before qualifying ambulatory blood pressure
- Source :
- Hypertension (Dallas, Tex. : 1979). 62(3)
- Publication Year :
- 2013
-
Abstract
- 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.
- Subjects :
- Adult
Male
medicine.medical_specialty
Ambulatory blood pressure
medicine.medical_treatment
Blood Pressure
Kidney
Medication Adherence
Internal medicine
Internal Medicine
medicine
Humans
Antihypertensive Agents
Aged
Denervation
business.industry
Blood Pressure Monitoring, Ambulatory
Middle Aged
Combined Modality Therapy
Surgery
Clinical trial
Catheter
Blood pressure
Treatment Outcome
Renal sympathetic denervation
Ambulatory
Hypertension
Retreatment
Cardiology
Female
Diuretic
business
Subjects
Details
- ISSN :
- 15244563
- Volume :
- 62
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Hypertension (Dallas, Tex. : 1979)
- Accession number :
- edsair.doi.dedup.....ff61c8cd905d4667418e10f6573eed53