Predictors of blood pressure response: Obesity is associated with a less pronounced treatment response after renal denervation
Objectives The purpose of this study was to identify predictors of BP response. Background Catheter‐based renal denervation (RDN) causes significant blood pressure (BP) reductions in a large number of patients with resistant hypertension. Methods One hundred one consecutive patients with resistant h...
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Published in | Catheterization and cardiovascular interventions Vol. 87; no. 1; pp. E30 - E38 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Blackwell Publishing Ltd
01.01.2016
Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
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Summary: | Objectives
The purpose of this study was to identify predictors of BP response.
Background
Catheter‐based renal denervation (RDN) causes significant blood pressure (BP) reductions in a large number of patients with resistant hypertension.
Methods
One hundred one consecutive patients with resistant hypertension who underwent RDN with the Symplicity™ catheter were included in this retrospective study. Primary endpoint was the change in office systolic BP after 6 months. Uni‐ and multivariate logistic regression analyses were performed to detect baseline predictors of a significant BP response 6 months after RDN (age, gender, office and ambulatory BP, renal function, body mass index [BMI], diabetes mellitus, antihypertensive medication, number of ablations).
Results
The procedure was technically uneventful in all patients. Mean BP at baseline was 166.6/90.2 ± 22.5/16.4 mmHg and decreased by −14.7 (P < 0.0001)/−5.3 (P < 0.001) ± 22.8/14.1 mm Hg at 6‐month follow‐up. Similarly, paired analysis of 24‐hr‐ambulatory BP measurement (n = 71) showed a significant reduction of mean systolic BP by 6.8 ± 14.4 mm Hg (P < 0.0002). Upon univariate analyses, a higher baseline office systolic BP (P < 0.0001) and lower BMI (P = 0.014) were identified as significant predictors of the magnitude of BP response after 6 months. Importantly, on multivariate analysis, baseline office systolic BP (standardized ß = −0.46; r = −0.47; P < 0.0001) and BMI (standardized ß = 0.21; r = 0.95; P = 0.019) remained significant.
Conclusion
Blood pressure reductions after RDN were more pronounced in patients with higher baseline blood pressure and lower BMI. These findings may have implications regarding patient selection for renal denervation. © 2015 Wiley Periodicals, Inc. |
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Bibliography: | ArticleID:CCD26068 ark:/67375/WNG-SPRQCWJD-Q istex:3273EA426702621A8F18AD971F9BDA7B2920F7D5 Conflict of interest: Dr. Sievert's institution has ownership interest in or has received consulting fees, travel expenses or study honoraries from the following companies: Abbott, Access Closure, AGA, Angiomed, Arstasis, Atritech, Atrium, Avinger, Bard, Boston Scientific, Bridgepoint, Cardiac Dimensions, CardioKinetix, CardioMEMS, Coherex, Contego, CSI, EndoCross, EndoTex, Epitek, Evalve, ev3, FlowCardia, Gore, Guidant, Guided Delivery Systems, Inc., InSeal Medical, Lumen Biomedical, HLT, Kensey Nash, Kyoto Medical, Lifetech, Lutonix, Medinol, Medtronic, NDC, NMT, OAS, Occlutech, Osprey, Ovalis, Pathway, PendraCare, Percardia, pfm Medical, Rox Medical, Sadra, Sorin, Spectranetics, SquareOne, Trireme, Trivascular, Velocimed, Veryan. All other authors have no disclosures. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1522-1946 1522-726X |
DOI: | 10.1002/ccd.26068 |