Blood Pressure (Nov 2017)

The effect of renal denervation on arterial stiffness, central blood pressure and heart rate variability in treatment resistant essential hypertension: a substudy of a randomized sham-controlled double-blinded trial (the ReSET trial)

  • Christian Daugaard Peters,
  • Ole Norling Mathiassen,
  • Henrik Vase,
  • Jesper Bech Nørgaard,
  • Kent Lodberg Christensen,
  • Anne Pauline Schroeder,
  • Hans Joachim von Hofe Rickers,
  • Ulla Kampmann Opstrup,
  • Per Løgstrup Poulsen,
  • Sten Langfeldt,
  • Gratien Andersen,
  • Klavs Würgler Hansen,
  • Hans Erik Bøtker,
  • Morten Engholm,
  • Jannik Buus Bertelsen,
  • Erling Bjerregaard Pedersen,
  • Anne Kaltoft,
  • Niels Henrik Buus

DOI
https://doi.org/10.1080/08037051.2017.1368368
Journal volume & issue
Vol. 26, no. 6
pp. 366 – 380

Abstract

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Objectives: To investigate, whether renal denervation (RDN) improves arterial stiffness, central blood pressure (C-BP) and heart rate variability (HRV) in patients with treatment resistant hypertension. Methods: ReSET was a randomized, sham-controlled, double-blinded trial (NCT01459900). RDN was performed by a single experienced operator using the Medtronic unipolar Symplicity FlexTM catheter. C-BP, carotid-femoral pulse wave velocity (PWV), and HRV were obtained at baseline and after six months with the SphygmoCor®-device. Results: Fifty-three patients (77% of the ReSET-cohort) were included in this substudy. The groups were similar at baseline (SHAM/RDN): n = 27/n = 26; 78/65% males; age 59 ± 9/54 ± 8 years (mean ± SD); systolic brachial BP 158 ± 18/154 ± 17 mmHg; systolic 24-hour ambulatory BP 153 ± 14/151 ± 13 mmHg. Changes in PWV (0.1 ± 1.9 (SHAM) vs. −0.6 ± 1.3 (RDN) m/s), systolic C-BP (−2 ± 17 (SHAM) vs. −8 ± 16 (RDN) mmHg), diastolic C-BP (−2 ± 9 (SHAM) vs. −5 ± 9 (RDN) mmHg), and augmentation index (0.7 ± 7.0 (SHAM) vs. 1.0 ± 7.4 (RDN) %) were not significantly different after six months. Changes in HRV-parameters were also not significantly different. Baseline HRV or PWV did not predict BP-response after RDN. Conclusions: In a sham-controlled setting, there were no significant effects of RDN on arterial stiffness, C-BP and HRV. Thus, the idea of BP-independent effects of RDN on large arteries and cardiac autonomic activity is not supported.

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