Aims Catheter-based renal artery denervation (RDN) has been shown to lower blood pressure (BP) in certain patients with uncontrolled hypertension. Isolated systolic hypertension (ISH) (systolic BP [SBP] ≥140 mmHg and diastolic BP ,90 mmHg), characterized by increased vascular stiffness, is the predominant hypertensive phenotype in elderly patients. This study compared baseline characteristics and SBP change at 6 months between patients with ISH and combined systolic-diastolic hypertension (CH). Methods and results This study pooled data from1103 patients from SYMPLICITY HTN-3 and the Global SYMPLICITY Registry. A total of 429 patients had ISH, and 674 had CH. Patients with ISH were significantly older than those with CH (66 vs. 55 years), had more type 2 diabetes mellitus (52.9 vs. 34.6%), and a lower estimated glomerular filtration rate (71.8 vs. 78.6 mL/min/ 1.73 m2); all P , 0.001. At 6 months, the SBP drop for CH patients was 218.7+23.7 mmHg compared with a reduction of 210.9+21.7 mmHg for ISH patients 27.8 mmHg, 95% confidence interval, CI, 210.5, 25.1, P , 0.001). The change in 24-h SBP at 6 months was 28.8+16.2 mmHg in patients with CH vs. 25.8+15.4 mmHg in ISH (23.0 mmHg, 95% CI 25.4, 20.6, P = 0.015). Presence of ISH at baseline but not age was associated with less pronounced BP changes following the procedure. The strongest predictor of office SBP reduction at 6 months was CH, followed by aldosterone antagonist use and non-use of vasodilators. Conclusion The reduction in BP among patients with ISH following RDNwas less pronounced than the reduction in patientswith CH.
Mahfoud, F., Bakris, G., Bhatt, D., Esler, M., Ewen, S., Fahy, M., et al. (2017). Reduced blood pressure-lowering effect of catheter-based renal denervation in patients with isolated systolic hypertension: Data from SYMPLICITY HTN-3 and the Global SYMPLICITY Registry. EUROPEAN HEART JOURNAL, 38(2), 93-100 [10.1093/eurheartj/ehw325].
Reduced blood pressure-lowering effect of catheter-based renal denervation in patients with isolated systolic hypertension: Data from SYMPLICITY HTN-3 and the Global SYMPLICITY Registry
Mancia, G;
2017
Abstract
Aims Catheter-based renal artery denervation (RDN) has been shown to lower blood pressure (BP) in certain patients with uncontrolled hypertension. Isolated systolic hypertension (ISH) (systolic BP [SBP] ≥140 mmHg and diastolic BP ,90 mmHg), characterized by increased vascular stiffness, is the predominant hypertensive phenotype in elderly patients. This study compared baseline characteristics and SBP change at 6 months between patients with ISH and combined systolic-diastolic hypertension (CH). Methods and results This study pooled data from1103 patients from SYMPLICITY HTN-3 and the Global SYMPLICITY Registry. A total of 429 patients had ISH, and 674 had CH. Patients with ISH were significantly older than those with CH (66 vs. 55 years), had more type 2 diabetes mellitus (52.9 vs. 34.6%), and a lower estimated glomerular filtration rate (71.8 vs. 78.6 mL/min/ 1.73 m2); all P , 0.001. At 6 months, the SBP drop for CH patients was 218.7+23.7 mmHg compared with a reduction of 210.9+21.7 mmHg for ISH patients 27.8 mmHg, 95% confidence interval, CI, 210.5, 25.1, P , 0.001). The change in 24-h SBP at 6 months was 28.8+16.2 mmHg in patients with CH vs. 25.8+15.4 mmHg in ISH (23.0 mmHg, 95% CI 25.4, 20.6, P = 0.015). Presence of ISH at baseline but not age was associated with less pronounced BP changes following the procedure. The strongest predictor of office SBP reduction at 6 months was CH, followed by aldosterone antagonist use and non-use of vasodilators. Conclusion The reduction in BP among patients with ISH following RDNwas less pronounced than the reduction in patientswith CH.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.