Comparison of Long-Term Outcomes for Responders Versus Non-Responders Following Renal Denervation in Resistant Hypertension.
J Am Heart Assoc
; 10(21): e022429, 2021 11 02.
Article
em En
| MEDLINE
| ID: mdl-34713718
ABSTRACT
Background Recent trial results support the efficacy of renal sympathetic denervation in lowering blood pressure (BP). While BP reduction in general is associated with a clinically meaningful reduction in cardiovascular events and mortality, such a relationship has not been described for patients undergoing renal sympathetic denervation. Methods and Results Clinical events were assessed in patients who underwent renal sympathetic denervation at our center using telephone- and clinical follow-up, interviews with general practitioners, as well as review of hospital databases. Event rates were compared between BP responders (≥5 mm Hg 24-hour ambulatory BP reduction) and non-responders; 296 patients were included. Compared with baseline, 24-hour systolic ambulatory BP was reduced by 8.3±12.2 mm Hg and diastolic BP by 4.8±7.0 mm Hg (P<0.001 for both) after 3 months. One hundred eighty patients were classified as BP responders and 116 as non-responders. During a median follow-up time of 48 months, significantly less major adverse cardiovascular events (cardiovascular death, stroke, myocardial infarction, critical limb ischemia, renal failure) occurred in responders than in non-responders (22 versus 23 events, hazard ratio [HR], 0.53 [95% CI, 0.28 to 0.97], P=0.041). This was consistent after adjustment for potential confounders as well as confirmed by propensity-score matching. A proportional relationship was found between BP reduction after 3 months and frequency of major adverse cardiovascular events (HR, 0.75 [95% CI, 0.58 to 0.97] per 10 mm Hg 24-hour systolic ambulatory BP reduction). Conclusions Based on these observational data, blood pressure response to renal sympathetic denervation is associated with improved long-term clinical outcome.
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Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Isquemia Crônica Crítica de Membro
/
Hipertensão
Limite:
Humans
Idioma:
En
Revista:
J Am Heart Assoc
Ano de publicação:
2021
Tipo de documento:
Article