Renal denervation in resistant hypertension reduced mean daytime SBP by 17.3 mmHg (p<0.01), with greater reductions correlating with higher baseline BP, heart rate, and number of ablations.
Observational (n=33)
No
Does renal denervation reduce systolic blood pressure in patients with resistant hypertension?
Higher baseline blood pressure, higher baseline heart rate, and a greater number of ablations are associated with greater systolic blood pressure reductions 12 months after renal denervation in patients with resistant hypertension.
p-value: p=<0.01
Objective: Response after renal denervation (RDN) is heterogeneous and no predictors of response have been defined. We aimed to assess the response after RDN and to identify potential clinical and procedural factors associated with greater systolic blood pressure (SBP) reduction. Design and method: This was a single-center observational study including 33 patients with resistant hypertension (HTN) who underwent RDN. Baseline clinical, biochemical and ambulatory BP monitoring data were collected. BP was reassessed at 12 months. Response was defined as a reduction greater than 10 mmHg in mean daytime SBP or resolution of hypertension-related symptoms. Pearson correlation analyses and t-tests were used to explore associations between baseline or procedural variables and continuous or categorical BP response. Results: At 12 months, mean daytime systolic blood pressure (SBP) decreased by 17.3 ± 10.1 mmHg and nighttime SBP by 15.1 ± 9.8 mmHg (both p < 0.01). Greater SBP reduction correlated positively with the number of ablations performed (r = 0.398, p = 0.022), baseline SBP (r = 0.516, p = 0.002), baseline diastolic BP (r = 0.437, p = 0.011), and baseline heart rate (r = 0.356, p = 0.045). No significant associations were observed with age, body mass index, renal function or metabolic parameters. Overall, 81.5% of patients were classified as responders. Responders had higher baseline SBP (158 ± 15 vs. 146 ± 14 mmHg) and underwent a greater number of ablations (28 ± 9 vs. 25 ± 8) compared with non-responders, although these differences did not reach statistical significance. No biochemical or echocardiographic variables predicted categorical response. Conclusions: Patients with higher baseline BP and heart rate, as well as those undergoing a greater number of ablations, achieved greater SBP reductions after RDN. Although no single parameter predicted categorical response, these findings highlight the importance of pre-procedural hemodynamic profile and procedural optimization in determining BP outcomes. Further studies are warranted to better characterize non-responders and refine patient selection and procedural strategies for RDN.
Batista et al. (Fri,) conducted a observational in resistant hypertension (n=33). Renal denervation was evaluated on Mean daytime systolic blood pressure (SBP) reduction at 12 months (p=<0.01). Renal denervation in resistant hypertension reduced mean daytime SBP by 17.3 mmHg (p<0.01), with greater reductions correlating with higher baseline BP, heart rate, and number of ablations.