Background: Renal denervation (RDN) reduces sympathetic activity and blood pressure (BP) in patients with resistant hypertension. Increased 24-h BP variability is associated with adverse cardiovascular outcomes and related to sympathetic activation. Methods and results: This multicenter study investigated the effect of RDN on BP variability in 84 patients with uncontrolled hypertension (office systolic BP-140 mmHg) despite treatment with greater than three antihypertensive agents. BP variability was assessed by means of standard deviation, coefficient of variation (standard deviation/ mean), and average real variability of 24-h ambulatory SBP at 3-month and 6-month follow-up. RDN significantly reduced office BP by 17/6 mmHg at 3-month and 19/7 mmHg at 6-month follow-up (P<0.001 for all) and 24-h ambulatory BP by 9/5 mmHg (P<0.001/P=0.001) after 3 months and 12/7 mmHg (P<0.001/P<0.001) after 6 months. Standard deviation significantly decreased from 17.1 to 14.9 mmHg (P=0.008) and 15.3 mmHg (P=0.037), consistent with a reduction of coefficient of variation from 0.116 to 0.103 (P=0.035) and 0.104 (P=0.071) and average real variability from 12.3 to 10.9 (P=0.029) and 11.0 (P=0.054) after 3-month and 6-month, respectively. Interestingly, also BP nonresponders (change in office systolic BP<10 mmHg after 6 months) showed a significant reduction of standard deviation after 3 months (P=0.041, n=26) and a borderline significant reduction at 6-month (P=0.057, n=28). Conclusions: RDN reduces office and ambulatory BP and BP variability in patients with resistant hypertension. Improvement in BP variability was also documented in patients characterized as office BP nonresponders after 6 months.
Ewen, S., Dörr, O., Ukena, C., Linz, D., Cremers, B., Laufs, U., et al. (2015). Blood pressure variability after catheter-based renal sympathetic denervation in patients with resistant hypertension. JOURNAL OF HYPERTENSION, 33(12), 2512-2518 [10.1097/HJH.0000000000000751].
Blood pressure variability after catheter-based renal sympathetic denervation in patients with resistant hypertension
Mancia, Giuseppe;
2015
Abstract
Background: Renal denervation (RDN) reduces sympathetic activity and blood pressure (BP) in patients with resistant hypertension. Increased 24-h BP variability is associated with adverse cardiovascular outcomes and related to sympathetic activation. Methods and results: This multicenter study investigated the effect of RDN on BP variability in 84 patients with uncontrolled hypertension (office systolic BP-140 mmHg) despite treatment with greater than three antihypertensive agents. BP variability was assessed by means of standard deviation, coefficient of variation (standard deviation/ mean), and average real variability of 24-h ambulatory SBP at 3-month and 6-month follow-up. RDN significantly reduced office BP by 17/6 mmHg at 3-month and 19/7 mmHg at 6-month follow-up (P<0.001 for all) and 24-h ambulatory BP by 9/5 mmHg (P<0.001/P=0.001) after 3 months and 12/7 mmHg (P<0.001/P<0.001) after 6 months. Standard deviation significantly decreased from 17.1 to 14.9 mmHg (P=0.008) and 15.3 mmHg (P=0.037), consistent with a reduction of coefficient of variation from 0.116 to 0.103 (P=0.035) and 0.104 (P=0.071) and average real variability from 12.3 to 10.9 (P=0.029) and 11.0 (P=0.054) after 3-month and 6-month, respectively. Interestingly, also BP nonresponders (change in office systolic BP<10 mmHg after 6 months) showed a significant reduction of standard deviation after 3 months (P=0.041, n=26) and a borderline significant reduction at 6-month (P=0.057, n=28). Conclusions: RDN reduces office and ambulatory BP and BP variability in patients with resistant hypertension. Improvement in BP variability was also documented in patients characterized as office BP nonresponders after 6 months.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.