Long-term effectiveness of radiofrequency renal denervation in patients with resistant arterial hypertension (10-year follow-up results)

Abstract

The aim – to determine the long-term efficacy and safety of renal denervation (RDN) at 10-year follow-up. Materials and methods. We selected 1146 patients with resistant arterial hypertension (RAH) who received 3 or more antihypertensive drugs. 16 patients were selected for renal artery denervation. RDN was performed in 8 patients (0.70 %). 8 patients refused the procedure. The age was 52.13 ± 3.88 years (40–66), the duration of hypertension was 16.75 ± 2.17 (12–25) years. The number of antihypertensive drugs was 5.5 ± 0.18. Office SBP/DBP on optimization of therapy in patients was 156.88/95.00 ± 2.98 mm Hg and heart rate – 68.88 ± 3.28 beats/min. 24SBP/DBP was 149.16 ± 5.40/86.98 ± 5.08 mm Hg. 24HR was 70.12 ± 2.94 beats/min. All patients tolerated the procedure well. Results and discussion. The decrease in office SBP/DBP was –12.59/–10.0 mm Hg; –11.17/–2.57 mm Hg; –20.31/–11.71 mm Hg, –27.71/–13.33 mm Hg and –30.21/–16.67 mm Hg, in the dynamics of 1 month, 12 months, 2 years, 5 years and 10 years, respectively, p 0.05. One patient died of thyroid cancer 2 years later. All other patients are alive and have not had any cardiovascular event or death during 10 years. Conclusion. Long-term results of renal artery denervation showed no cases of cardiovascular events, development of diabetes or cardiovascular death over 10 years. RDN contributed to a reduction in the number of antihypertensive drugs from 5.5 to 3.67 after 10 years of therapy against the background of 100 % achievement of the target BP level.

Keywords

• resistant hypertension
• refractory hypertension
• renal denervation