Renal Denervation in a Real Life Setting: A Gradual Decrease in Home Blood Pressure

PLoS One. 2016 Sep 15;11(9):e0162251. doi: 10.1371/journal.pone.0162251. eCollection 2016.

Abstract

Objectives: To investigate the blood pressure dynamics after renal denervation through monthly home blood pressure measurements throughout the first 12 months.

Methods: A cohort of 70 patients performed highly standardized monthly home blood pressure monitoring during the first year after denervation according to the European Society of Hypertension guidelines. At baseline and 12 months follow-up, office and ambulatory blood pressure as well as routine physical and laboratory assessment was performed.

Results: Home blood pressure decreased with a rate of 0.53 mmHg/month (95% CI 0.20 to 0.86) systolic and 0.26 mmHg/month (95% CI 0.08 to 0.44) diastolic throughout 12 months of follow-up, while the use of antihypertensive medication remained stable (+0.03 daily defined doses/month, 95% CI -0.01 to 0.08). On average, a 12 month reduction of 8.1 mmHg (95% CI 4.2 to 12.0) was achieved in home systolic blood pressure, 9.3 mmHg (95% CI -14.2 to -4.4) as measured by 24-hour ambulatory blood pressure monitoring and 15.9 mmHg (95% CI -23.8 to -7.9) on office measurements.

Conclusion: Blood pressure reduction after renal denervation occurs as a gradual decrease that extends to at least one-year follow-up. Home monitoring seems a suitable alternative for ambulatory blood pressure monitoring after renal denervation.

MeSH terms

  • Aged
  • Blood Pressure Monitoring, Ambulatory*
  • Blood Pressure*
  • Denervation
  • Female
  • Humans
  • Kidney / innervation*
  • Kidney / physiopathology
  • Male
  • Middle Aged

Grants and funding

RLD and MS are supported by grants from The Netherlands Organisation for Health Research and Development (ZonMw), the Dutch Kidney Foundation and an unrestricted grant from Medtronic (Sympathy trial). MMB is supported by an unrestricted grant from Medtronic (DIASTOLE trial). MLB has obtained grants from non-profit organisations such as The Netherlands Organisation for Health Research and Development (ZonMw) and the Dutch Kidney Foundation for conducting studies into renal denervation. For the remaining authors none were declared. The Dutch National Renal Denervation Registry is partly supported by a grant from the Dutch Kidney Foundation (NCT02482103).