Renal artery sympathetic denervation: observations from the UK experience

Sharp, A. S. P. et al. (2016) Renal artery sympathetic denervation: observations from the UK experience. Clinical Research in Cardiology, 105(6), pp. 544-552. (doi: 10.1007/s00392-015-0959-4) (PMID:26802018)

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Abstract

Background: Renal denervation (RDN) may lower blood pressure (BP); however, it is unclear whether medication changes may be confounding results. Furthermore, limited data exist on pattern of ambulatory blood pressure (ABP) response—particularly in those prescribed aldosterone antagonists at the time of RDN. Methods: We examined all patients treated with RDN for treatment-resistant hypertension in 18 UK centres. Results: Results from 253 patients treated with five technologies are shown. Pre-procedural mean office BP (OBP) was 185/102 mmHg (SD 26/19; n = 253) and mean daytime ABP was 170/98 mmHg (SD 22/16; n = 186). Median number of antihypertensive drugs was 5.0: 96 % ACEi/ARB; 86 % thiazide/loop diuretic and 55 % aldosterone antagonist. OBP, available in 90 % at 11 months follow-up, was 163/93 mmHg (reduction of 22/9 mmHg). ABP, available in 70 % at 8.5 months follow-up, was 158/91 mmHg (fall of 12/7 mmHg). Mean drug changes post RDN were: 0.36 drugs added, 0.91 withdrawn. Dose changes appeared neutral. Quartile analysis by starting ABP showed mean reductions in systolic ABP after RDN of: 0.4; 6.5; 14.5 and 22.1 mmHg, respectively (p < 0.001 for trend). Use of aldosterone antagonist did not predict response (p < 0.2). Conclusion: In 253 patients treated with RDN, office BP fell by 22/9 mmHg. Ambulatory BP fell by 12/7 mmHg, though little response was seen in the lowermost quartile of starting blood pressure. Fall in BP was not explained by medication changes and aldosterone antagonist use did not affect response.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Mark, Dr Patrick
Authors: Sharp, A. S. P., Davies, J. E., Lobo, M. D., Bent, C. L., Mark, P. B., Burchell, A. E., Thackray, S. D., Martin, U., McKane, W. S., Gerber, R. T., Wilkinson, J. R., Antonios, T. F., Doulton, T. W., Patterson, T., Clifford, P. C., Lindsay, A., Houston, G. J., Freedman, J., Das, N., Belli, A. M., Faris, M., Cleveland, T. J., Nightingale, A. K., Hameed, A., Mahadevan, K., Finegold, J. A., Mather, A. N., Levy, T., D'Souza, R., Riley, P., Moss, J. G., Di Mario, C., Redwood, S. R., Baumbach, A., Caulfield, M. J., and Dasgupta, I.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Clinical Research in Cardiology
Publisher:Springer Berlin Heidelberg
ISSN:1861-0684
ISSN (Online):1861-0692
Published Online:22 January 2016
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in Clinical Research in Cardiology 105(6)):544-552
Publisher Policy:Reproduced under a Creative Commons License

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