Back
Full-text
Journal article

Blood pressure changes after renal denervation at 10 European expert centers.

  • Persu A 1] Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium [2] Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
  • Jin Y Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
  • Azizi M Faculté de Médecine, Université Paris Descartes, Paris, France.
  • Baelen M 1] Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium [2] Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
  • Völz S Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
  • Elvan A Department of Cardiology, Isala Klinieken, Zwolle, The Netherlands.
  • Severino F Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.
  • Rosa J Third Department of Internal Medicine, General Faculty Hospital, Prague, Czech Republic.
  • Adiyaman A Department of Cardiology, Isala Klinieken, Zwolle, The Netherlands.
  • Fadl Elmula FE Department of Cardiology, Ullevål University Hospital, University of Oslo, Oslo, Norway.
  • Taylor A BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
  • Pechère-Bertschi A Hypertension Unit, Geneva University Hospital, Geneva, Switzerland.
  • Wuerzner G Service of Nephrology, Lausanne University Hospital, Lausanne, Switzerland.
  • Jokhaji F Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden.
  • Kahan T Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden.
  • Renkin J Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.
  • Monge M Faculté de Médecine, Université Paris Descartes, Paris, France.
  • Widimský P Third Department of Internal Medicine, General Faculty Hospital, Prague, Czech Republic.
  • Jacobs L Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
  • Burnier M Service of Nephrology, Lausanne University Hospital, Lausanne, Switzerland.
  • Mark PB BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
  • Kjeldsen SE Department of Cardiology, Ullevål University Hospital, University of Oslo, Oslo, Norway.
  • Andersson B Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
  • Sapoval M Faculté de Médecine, Université Paris Descartes, Paris, France.
  • Staessen JA 1] Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium [2] Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
Show more…
  • 2013-09-27
Published in:
  • Journal of human hypertension. - 2014
Antihypertensive Agents
Blood Pressure Monitoring, Ambulatory
Combined Modality Therapy
Denervation
Essential Hypertension
Europe
Female
Humans
Hypertension
Kidney
Male
Middle Aged
Treatment Outcome
English We did a subject-level meta-analysis of the changes (Δ) in blood pressure (BP) observed 3 and 6 months after renal denervation (RDN) at 10 European centers. Recruited patients (n=109; 46.8% women; mean age 58.2 years) had essential hypertension confirmed by ambulatory BP. From baseline to 6 months, treatment score declined slightly from 4.7 to 4.4 drugs per day. Systolic/diastolic BP fell by 17.6/7.1 mm Hg for office BP, and by 5.9/3.5, 6.2/3.4, and 4.4/2.5 mm Hg for 24-h, daytime and nighttime BP (P0.03 for all). In 47 patients with 3- and 6-month ambulatory measurements, systolic BP did not change between these two time points (P0.08). Normalization was a systolic BP of <140 mm Hg on office measurement or <130 mm Hg on 24-h monitoring and improvement was a fall of 10 mm Hg, irrespective of measurement technique. For office BP, at 6 months, normalization, improvement or no decrease occurred in 22.9, 59.6 and 22.9% of patients, respectively; for 24-h BP, these proportions were 14.7, 31.2 and 34.9%, respectively. Higher baseline BP predicted greater BP fall at follow-up; higher baseline serum creatinine was associated with lower probability of improvement of 24-h BP (odds ratio for 20-μmol l(-1) increase, 0.60; P=0.05) and higher probability of experiencing no BP decrease (OR, 1.66; P=0.01). In conclusion, BP responses to RDN include regression-to-the-mean and remain to be consolidated in randomized trials based on ambulatory BP monitoring. For now, RDN should remain the last resort in patients in whom all other ways to control BP failed, and it must be cautiously used in patients with renal impairment.
Language
  • English
Open access status
hybrid
Identifiers
Persistent URL
https://sonar.ch/global/documents/205939
Statistics
Document views: 13 File downloads:
  • fulltext.pdf: 0