Catheter-Based Renal Sympathetic Denervation for Resistant Hypertension
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- 1 May 2011
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Hypertension
- Vol. 57 (5), 911-917
- https://doi.org/10.1161/hypertensionaha.110.163014
Abstract
Renal sympathetic hyperactivity is seminal in the maintenance and progression of hypertension. Catheter-based renal sympathetic denervation has been shown to significantly reduce blood pressure (BP) in patients with hypertension. Durability of effect beyond 1 year using this novel technique has never been reported. A cohort of 45 patients with resistant hypertension (systolic BP ≥160 mm Hg on ≥3 antihypertension drugs, including a diuretic) has been originally published. Herein, we report longer-term follow-up data on these and a larger group of similar patients subsequently treated with catheter-based renal denervation in a nonrandomized manner. We treated 153 patients with catheter-based renal sympathetic denervation at 19 centers in Australia, Europe, and the United States. Mean age was 57±11 years, 39% were women, 31% were diabetic, and 22% had coronary artery disease. Baseline values included mean office BP of 176/98±17/15 mm Hg, mean of 5 antihypertension medications, and an estimated glomerular filtration rate of 83±20 mL/min per 1.73 m(2). The median time from first to last radiofrequency energy ablation was 38 minutes. The procedure was without complication in 97% of patients (149 of 153). The 4 acute procedural complications included 3 groin pseudoaneurysms and 1 renal artery dissection, all managed without further sequelae. Postprocedure office BPs were reduced by 20/10, 24/11, 25/11, 23/11, 26/14, and 32/14 mm Hg at 1, 3, 6, 12, 18, and 24 months, respectively. In conclusion, in patients with resistant hypertension, catheter-based renal sympathetic denervation results in a substantial reduction in BP sustained out to ≥2 years of follow-up, without significant adverse events.Keywords
This publication has 11 references indexed in Scilit:
- Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trialThe Lancet, 2010
- Heart Disease and Stroke Statistics—2010 UpdateCirculation, 2010
- Renal Sympathetic-Nerve Ablation for Uncontrolled HypertensionThe New England Journal of Medicine, 2009
- Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort studyThe Lancet, 2009
- Resistant Hypertension: An Overview of Evaluation and TreatmentJournal of the American College of Cardiology, 2008
- Global burden of hypertension: analysis of worldwide dataThe Lancet, 2005
- Hypertension Treatment and Control in Five European Countries, Canada, and the United StatesHypertension, 2004
- Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood PressureHypertension, 2003
- Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studiesThe Lancet, 2002
- Preserving renal function in adults with hypertension and diabetes: A consensus approachAmerican Journal of Kidney Diseases, 2000