engleski

The characteristics of early changes in blood pressure after renal denervation

Renal denervation (RDN) has been shown to reduce office blood pressure (BP) and target organ damage in patients with resistant hypertension (RHpt). We aimed to investigate the characteristics of early changes of BP in RHpt undergoing RDN and the predictors of ambulatory blood pressure monitoring (ABPM) response after RDN in one Hypertension unit in Croatia. From a total of 957 patients in Hypertension unit, during 12 months, only refractory RHpt (105) were included in study, from which 10.4% (12pt) have criteria for RDN (Symplicity TM RDN System, 5F/6F quide catheter, five to seven nerve ablations were performed on each side without any complications) and were followed before and after RDN (age 62 +/- 6 years, 6.7 +/- 1 for number of antihypertensive drug classes included aldosterone use in doses from 50-100 mg, BMI 35 +/- 3 kg/m2, estimated GFR 65 +/- 28 mlmin-11.73m2.). ABPM was measured at baseline and one day after RDN in 12 patients with RH and single renal arteries bilaterally: 9 without special anatomical constellations (group1) and 3 patients with special anatomical constellations (group 2). All 12 patients completed renin at baseline and follow-up and were without changing of medication at six months after RDN. The majority of RHpt (90%) had chronic hypertension (cH) more than 10 years, while 10% had diagnosed hypertension less than one year (nRH). Patients with cH compared to patients nH were older (p < 0.001), had higher BMI (p < 0.001), higher systolic BP and lower estimated GFR (56 +/- 17 vs 79 +/- 13 ml min-1 1.73m-2, p < 0.001). RDN significantly reduced ABPM in group 1 at one day after RDN from max average 224/124mmH before RDN to minimal average 134/77 mmHg after RDN (P < 0.001), and in group 2 from max average 221/130 mmHg before RDN to minimal average 129/80 mmHg after RDN (P < 0.001). Significant reduction in resting baseline renin level was observed in group 1 (P < 0.001) and 2 (P < 0.05) after 1 month follow up. If sufficient renal sympathetic nerve ablation were performed and without changing of medication RDN significantly reduced ABPM one day after RDN.

resistant hypertension, renal sympathetic denervation

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