Effect of Renal Sympathetic Denervation on Glucose Metabolism in Patients With Resistant Hypertension
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- 10 May 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 123 (18), 1940-1946
- https://doi.org/10.1161/circulationaha.110.991869
Abstract
Background—: Hypertension is associated with impaired glucose metabolism and insulin resistance. Chronic activation of the sympathetic nervous system may contribute to either condition. We investigated the effect of catheter-based renal sympathetic denervation on glucose metabolism and blood pressure control in patients with resistant hypertension. Methods and Results—: We enrolled 50 patients with therapy-resistant hypertension. Thirty-seven patients underwent bilateral catheter-based renal denervation, and 13 patients were assigned to a control group. Systolic and diastolic blood pressures, fasting glucose, insulin, C peptide, hemoglobin A 1c , calculated insulin sensitivity (homeostasis model assessment–insulin resistance), and glucose levels during oral glucose tolerance test were measured before and 1 and 3 months after treatment. Mean office blood pressure at baseline was 178/96±3/2 mm Hg. At 1 and 3 months, office blood pressure was reduced by −28/−10 mm Hg ( P P P =0.039). Insulin levels were decreased from 20.8±3.0 to 9.3±2.5 μIU/mL ( P =0.006) and C-peptide levels from 5.3±0.6 to 3.0±0.9 ng/mL ( P =0.002). After 3 months, homeostasis model assessment–insulin resistance decreased from 6.0±0.9 to 2.4±0.8 ( P =0.001). Additionally, mean 2-hour glucose levels during oral glucose tolerance test were reduced significantly by 27 mg/dL ( P =0.012). There were no significant changes in blood pressure or metabolic markers in the control group. Conclusions—: Renal denervation improves glucose metabolism and insulin sensitivity in addition to a significantly reducing blood pressure. However, this improvement appeared to be unrelated to changes in drug treatment. This novel procedure may therefore provide protection in patients with resistant hypertension and metabolic disorders at high cardiovascular risk. Clinical Trial Registration—: URL: http://www.ClinicalTrials.gov . Unique identifiers: NCT00664638 and NCT00888433.This publication has 32 references indexed in Scilit:
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