Renal denervation in resistant hypertension leads to significant improvement in ambulatory daytime systolic blood pressure: a 12- month follow-up audit from a single UK center

2014 ◽  
Vol 8 (4) ◽  
pp. e103-e104
Author(s):  
Fayaz Khan ◽  
Kevin Mohee ◽  
Kenneth Wong ◽  
Jufen Zhang ◽  
Michael S. Cunnington ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Resistant Hypertension ◽  
Renal Denervation

scholarly journals Impact of renal denervation on 24-hour blood pressure pattern in patients with resistant hypertension

2019 ◽  
Vol 4 (4) ◽  
pp. 78-88 ◽  
Author(s):  
T. Yu. Chichkova ◽  
S. E. Mamchur ◽  
M. P. Romanova ◽  
E. A. Khomenko
Keyword(s):  
Blood Pressure ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Resistant Hypertension ◽  
Blood Pressure Variability ◽  
Renal Denervation ◽  
Pressure Pattern

Aim. To estimate the dynamics of 24-hour blood pressure pattern in patients with resistant hypertension after renal denervation in comparison with the conservative treatment group.Methods. We enrolled 45 patients (21 men and 24 women, mean age 53 (43-66) years) with resistant hypertension. Renal denervation was performed in 25 patients using Vessix renal denervation system while the conservative treatment group included 20 patients. Monitoring of 24-hour blood pressure pattern was performed before renal denervation and after 1 year of follow-up.Results. Twelve months after renal denervation, patients with resistant hypertension had a significant reduction in office blood pressure (33 and 15 mmHg for systolic and diastolic blood pressure, respectively) and 24-hour average blood pressure (29 and 12 mmHg, for systolic and diastolic blood pressure, respectively). Another beneficial effect of renal denervation was a decrease in systolic blood pressure variability both throughout the day and at night (6 (5-12) and 7 (7-10) mmHg, respectively); however, no changes in diastolic blood pressure variability have been registered. Despite renal denervation did not affect the morning blood pressure surge, morning systolic blood pressure reduced from 174 (130180) mmHg to 156 (130-165) mmHg. After 1 year of follow-up, the proportion of dippers increased from 16 to 44%. In contrast to the patients who underwent renal denervation, there were no significant changes in 24-hour blood pressure pattern in the conservative treatment group.Conclusion. After 1 year of follow-up, renal denervation can be considered as an option superior to conservative treatment in patients with resistant hypertension, as it significantly improved 24-hour blood pressure pattern.

scholarly journals THE EFFECTS OF TRANSCATHETER RENAL DENERVATION ON BLOOD PRESSURE AND BRAIN STRUCTURAL CHANGES IN RESISTANT HYPERTENSION

2013 ◽  
Vol 19 (3) ◽  
pp. 256-262 ◽  
Author(s):  
N. L. Afanasieva ◽  
S. E. Pekarskiy ◽  
V. F. Mordovin ◽  
G. V. Semke ◽  
T. M. Ripp ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Magnetic Resonance ◽  
Resistant Hypertension ◽  
Renal Denervation ◽  
Single Case ◽  
Blood Pressure Reduction ◽  
Magnetic Resonance Tomography ◽  
Lateral Ventricles ◽  
The Brain

Objective.To study the changes of 24-hour blood pressure parameters and brain structure at follow-up after transcatheter renal denervation in resistant hypertension.Design and methods.We enrolled patients with verified resistant hypertension undergoing an intervention that included 4–8 applications of radiofrequency discharge in both renal arteries using a standard catheter5 F under the controlled temperature regimen (60 С0, 8 Watt, 2-minute application). The efficiency of the intervention was assessed by the office and 24-hour blood pressure decrease within 6 months after intervention. All subjects underwent magnetic resonance tomography («Magnetom-OPEN», «Siemens AG», Germany).Results.By the time of statistical analysis 45 subjects underwent renal denervation, there was not a single case of renal artery damage. At six-month follow-up a significant reduction of office blood pressure (-34,8/-17,2 mmHg; p < 0,00001/0,00001), and mean 24-hour blood pressure (-11,1/-7,1 mmHg; p < 0,001/0,001) was found. No increase of encephalopathy signs by magnetic resonance tomography was found. At the same time there was a reduction of the linear size of lateral ventricles of the brain, subarachnoid space, III ventricle of the brain, liquor volume in the lateral ventricles of the brain.Conclusions.Renal denervation is a safe method resulting in effective blood pressure reduction in resistant hypertension. It is associated with the positive changes of encephalopathy and liquor dynamics according to the magnetic resonance tomography. 

scholarly journals Catheter-based ultrasound renal denervation in patients with resistant hypertension: the randomized, controlled REQUIRE trial

2021 ◽  
Author(s):  
Kazuomi Kario ◽  
Yoshiaki Yokoi ◽  
Keisuke Okamura ◽  
Masahiko Fujihara ◽  
Yukako Ogoyama ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Resistant Hypertension ◽  
Renal Denervation ◽  
Blood Pressure Reduction ◽  
Control Group ◽  
Pressure Reduction ◽  
Sham Control ◽  
Sham Procedure ◽  
Significant Difference

Abstract Renal denervation is a promising new non-pharmacological treatment for resistant hypertension. However, there is a lack of data from Asian patients. The REQUIRE trial investigated the blood pressure-lowering efficacy of renal denervation in treated patients with resistant hypertension from Japan and South Korea. Adults with resistant hypertension (seated office blood pressure ≥150/90 mmHg and 24-hour ambulatory systolic blood pressure ≥140 mmHg) with suitable renal artery anatomy were randomized to ultrasound renal denervation or a sham procedure. The primary endpoint was change from baseline in 24-hour ambulatory systolic blood pressure at 3 months. A total of 143 patients were included (72 renal denervation, 71 sham control). Reduction from baseline in 24-hour ambulatory systolic blood pressure at 3 months was not significantly different between the renal denervation (−6.6 mmHg) and sham control (−6.5 mmHg) groups (difference: −0.1, 95% confidence interval −5.5, 5.3; p = 0.971). Reductions from baseline in home and office systolic blood pressure (differences: –1.8 mmHg [p = 0.488] and −2.0 mmHg [p = 0.511], respectively), and medication load, did not differ significantly between the two groups. The procedure-/device-related major adverse events was not seen. This study did not show a significant difference in ambulatory blood pressure reductions between renal denervation and a sham procedure in treated patients with resistant hypertension. Although blood pressure reduction after renal denervation was similar to other sham-controlled studies, the sham group in this study showed much greater reduction. This unexpected blood pressure reduction in the sham control group highlights study design issues that will be addressed in a new trial. Clinical trial registration NCT02918305 (http://www.clinicaltrials.gov).

scholarly journals Effects of different ablation points of renal denervation on the efficacy of resistant hypertension

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9842
Author(s):  
Hua Zhang ◽  
Ling-Yan Li ◽  
Rong-Xue Xiao ◽  
Ting-Chuan Zhang ◽  
Zong-Jun Liu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Treatment Group ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Resistant Hypertension ◽  
Renal Denervation ◽  
Standard Treatment ◽  
Intensive Treatment Group ◽  
The Mean ◽  
Standard Treatment Group

Objective To explore the blood pressure response to different ablation points of renal denervation (RDN) in patients with resistant hypertension Methods A total of 42 cases with resistant hypertension treated by RDN in our center from 2013 to 2015 were retrospectively analyzed. The patients were divided into two groups according to the different ablation points of RDN: the standard treatment group (spiral ablation from near to proximal, with less than 8 points per artery) and the intensive treatment group (from near to far by spiral ablation, with at least 8 points per artery), with 21 patients in each group. The ablation parameters, including points, impedance, actual wattage, and actual temperature, were recorded intraoperatively. Renal angiography was performed again after RDN. Ambulatory blood pressure (ABP) images were taken for all patients at the baseline and 6 months after operation. Results The mean 24-h blood pressure of the standard treatment group was lower than that of the baseline (24-h systolic blood pressure decreased by 7.4 ± 10.6 mmHg and 24-h diastolic blood pressure decreased by 4.6  ± 6.1 mmHg), and the mean 24-h blood pressure decreased significantly from baseline to 6 months in the intensive treatment group (24–h systolic blood pressure decreased by 27.4 ±  11.4 mmHg, P < 0.0001; 24–h diastolic blood pressure decreased by 10.9 ±  9.6 mmHg, P = 0.005). There was a positive correlation between the decrease of systolic/diastolic 24-hour mean and the number of ablation points used in the procedure. The mean value of systolic and diastolic blood pressure was positively correlated with ablation points at 24-hour (R2 = 0.777 and 0.633 respectively, P < 0.01). There were no adverse events in either group after the operation and during the follow-up. Conclusions RDN could significantly reduce BP in patients with resistant hypertension. Our study showed that the antihypertensive effect appeared to be positively correlated with the number of ablation points.

Sympathetic renal denervation treatment in resistant hypertension: one-year follow-up

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Moiseeva ◽  
A Caraus ◽  
V Moscalu ◽  
N Ciobanu ◽  
M Abras ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Resistant Hypertension ◽  
Pharmacological Treatment ◽  
Renal Denervation ◽  
Blood Pressure Monitoring ◽  
Group Versus ◽  
Total Reduction ◽  
Treatment Regimens ◽  
The Mean

Abstract Aims A comparison influence of renal denervation versus pharmacological treatment with sympathetic nervous system blockers on blood pressure in patients with resistant hypertension. Methods 125 patients with resistant hypertension without comorbidities after a 3-week standardized treatment with Losartan 100 mg, Amlodipine 10 mg and Indapamid 1,5 mg and confirmation of their resistance were randomly assigned into three groups, depending on medication supplemented to previously administered: IM group – selective I1-imidazoline agonist Moxonidine, IIB group – cardioselective beta-blocker Bisoprolol and IIID group – renal artery denervation. Patients were assessed by ambulatory blood pressure monitoring at baseline, 3, 6 and 12 month follow-up. The compliance to drug treatment was confirmed by 8-item Morisky Medication Adherence Scale. Renal denervation was performed with a Symplicity Spyral catheter. Results The mean 24 hour systolic blood pressure (SBP m/24 h) at baseline were 179.0±2.02 mmHg in IM group versus 177.96±2.44 mmHg in IIB group and 176.92±1.97 mmHg in IIID group, p&gt;0.05. Statistically significant dynamics was recorded starting with 3 months of evaluation in all three groups, the group of patients undergoing denervation of the renal arteries demonstrating a net superior effect compared with pharmacological treatment: −6.48±0.81 mmHg in I M group versus −6.2±0.88 mmHg in II B group and −23.28±1.9 mmHg in III D group, p&lt;0.001. The beneficial effect was maintained until the end of the study, when in observational group supplemented with Moxonidine SBP m/24 h were 159.6±1.72 mmHg with a total reduction of −19.9±0.7 mmHg from baseline, in Bisoprolol group −164.08±1.93 mmHg with a reduction of −13.88±1.13 mmHg and 141.76±0.77 mmHg in renal denervation group with a total reduction of −35.16±2.23 mmHg, p&lt;0.001. The mean 24 hour diastolic blood pressure (DBP m/24 h) increased at baseline in all three groups (105.52±1.28 mmHg in IM versus 108.6±1.6 mmHg in IIB and 107.24±0.92 mmHg in IIID, p&gt;0.05) similar to SBP m/24 h noted a significantly reduction at 3 month follow-up: −4.8±0.96 mmHg in IM group versus −3.64±0.47 mmHg in IIB group and −12.08±0.63 mmHg in IIID group, p&lt;0.001. The maximum reduction in DBP m/24 h were registered at 12 month follow-up, a comparative analyses of dynamics between groups showing a presence of statistical difference due to superiority of renal denervation treatment in amelioration of this parameter: −13.68±0.83 mmHg in IM group versus −10.72±0.64 mmHg in IIB group and −20.2±1.28 mmHg in IIID group, p&lt;0.001. Conclusions The application of all three treatment regimens has been shown to be effective in reducing SBP and DBP values m/24 hours in patients with resistant hypertension, with a superior but comparable effect of Moxonidine to Bisoprolol and the absolute superiority of renal denervation treatment versus both pharmacological treatment regimens. Funding Acknowledgement Type of funding source: None

scholarly journals Effect of renal denervation on long-term outcomes in patients with resistant hypertension

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Bo Liang ◽  
Yi Liang ◽  
Rui Li ◽  
Ning Gu
Keyword(s):  
Blood Pressure ◽  
Resistant Hypertension ◽  
Renal Denervation ◽  
Pressure Control ◽  
Treatment Method ◽  
Control Effect ◽  
First Choice ◽  
Long Term Follow Up

AbstractIncreasing studies strongly prove that renal denervation, a minimally invasive surgery, is a promising new non-drug treatment method that can effectively control blood pressure in patients with resistant hypertension, but the evaluation of the long-term blood pressure control effect of renal denervation for resistant hypertension is still lacking. Here, we critically review current long-term follow-up data about the use of renal denervation for RH to comprehensively evaluate the effectiveness of renal denervation for RH, and to provide practical guidance for practitioners who are establishing a renal denervation service. Limited by the current research, many problems need to be solved before renal denervation is applied to RH. In addition, ambulatory blood pressure should be the first choice for the evaluation of blood pressure. Finally, the continuous antihypertensive effect of renal denervation in different renal denervation systems also needs to be strictly compared.

scholarly journals Safety and Efficacy of a New Renal Denervation Catheter in Hypertensive Patients in the Absent of Antihypertensive Medications: A Pilot Study

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Yang Li ◽  
Abdul Qadir Nawabi ◽  
Yi Feng ◽  
Qiming Dai ◽  
Genshan Ma ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Renal Denervation ◽  
Reduce Blood Pressure ◽  
Antihypertensive Medications ◽  
Hypertensive Patients ◽  
Safety And Efficacy ◽  
Renal Artery Denervation

Aim. The aim of present study was to determine the safety and efficacy of a new renal artery denervation system for treatment of hypertensive patients. Methods. Hypertensive patients with mean office systolic blood pressure ≥150mmHg and ≤180mmHg or an average of 24-hour ambulatory systolic blood pressure ≥145mmHg and ≤170mmHg after stopping hypertensive medications for 2 weeks or more were enrolled to undergo renal denervation (RDN) using a new RDN system. Changes in office blood pressure and mean 24-hour ambulatory blood pressure and safety were assessed after 6 months. Results. Fifteen patients underwent RDN and followed up for 6 months. At the 6-month follow-up, office systolic blood pressure decreased 11.5±9.9mmHg (P<0.01) and office diastolic blood pressure decreased 6.9±4.8mmHg (P<0.01); mean 24-hour ambulatory systolic blood pressure decreased 7.5±7.7mmHg (P<0.05) and mean 24-hour diastolic blood pressure decreased 3.3±4.7mmHg (P>0.05) compared to baseline values. There were no serious RDN-related adverse events during follow-up. Conclusion. Our results demonstrate that the new RDN system is safe and could significantly reduce blood pressure in hypertensive patients in the absence of antihypertensive medications. This trial is registered with ChiCTR1800017815.

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