Renal Denervation in Patients With Uncontrolled Hypertension and Confirmed Adherence to Antihypertensive Medications

J Clin Hypertens (Greenwich). 2016 Jun;18(6):565-71. doi: 10.1111/jch.12713. Epub 2015 Oct 5.

Abstract

Renal denervation (RDN) has emerged as a potential device-based treatment for resistant hypertension. The authors present their experience of the use of catheter-based RDN as part of routine clinical care in two specialist hypertension clinics. Thirty-four patients with uncontrolled hypertension underwent RDN. All patients had ambulatory blood pressure (BP) monitoring and directly observed medication administration prior to the procedure to exclude white-coat hypertension and nonadherence, respectively. Overall, there was a significant change in clinic systolic BP of -15.1 mm Hg (95% confidence interval, -23.4 to -6.8; P=.001) and clinic diastolic BP of -6.2 mm Hg (95% confidence interval, -11.5 to -0.9; P=.02) 6 months postprocedure, and a nonsignificant change in daytime ambulatory BP of -5.4/-2.9 mm Hg. Eighteen patients (51.4%) showed a significant reduction in their clinic systolic BP (≥10 mm Hg) and 16 (47%) had a significant reduction in their daytime ambulatory systolic BP (≥5 mm Hg) at 6 months.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antihypertensive Agents / administration & dosage*
  • Blood Pressure / physiology
  • Catheter Ablation / methods*
  • Female
  • Humans
  • Hypertension / drug therapy
  • Hypertension / physiopathology
  • Hypertension / surgery
  • Hypertension / therapy*
  • Kidney / innervation*
  • Kidney / surgery
  • Male
  • Medication Adherence*
  • Middle Aged
  • Prospective Studies
  • Sympathectomy / instrumentation
  • Sympathectomy / methods*
  • Treatment Outcome

Substances

  • Antihypertensive Agents