In a nutshell
This study examined the effect of renal denervation on blood pressure in patients with moderate resistant hypertension. The authors concluded that renal denervation can significantly reduce blood pressure in patients with moderate resistant hypertension.
Patients with hypertension have a higher resting blood pressure than the body needs. The blood pressure needs to be lowered to avoid cardiovascular complications such as heart attacks, strokes, and heart failure. Resistant hypertension, where blood pressure is consistently higher than 140/90 mm Hg, usually requires treatment with three or more drugs.
Many patients do not respond well to drug therapies. Therefore, alternative non-drug treatment options for are being explored. Renal denervation is a procedure where nerve endings near the kidneys are disrupted with small radio pulses. This procedure is minimally invasive and early results have shown promising results for patients with resistant hypertension. More studies are needed to examine the benefits for patients with moderate resistant hypertension and whether the use of anti-hypertensive medication affect its outcomes.
Methods & findings
40 patients with moderate resistant hypertension who had undergone renal denervation therapy were included in this study. All patients had at least 80% adherence to their medication. Office (single measurement) blood pressure was measured after 5 minutes of rest. Ambulatory blood pressure was measured every 15 minutes during the day and every 30 minutes at night. Readings were taken at the beginning of the study and 6 months after renal denervation therapy.
Average office systolic blood pressure (SBP – pressure when the heart is contracting) significantly decreased by 10 mm Hg. Office diastolic blood pressure (DBP – pressure when the heart is between beats) significantly decreased by 6 mm Hg. Ambulatory SPB significantly decreased by 7 mm Hg after 6 months. Ambulatory DPB significantly decreased by 4 mm Hg after 6 months.
Average heart rate reduced from 65 bpm to 63 bpm at 6 months. However, this difference was not statistically significant. No change in kidney function was observed.
The bottom line
This study concluded that renal denervation can reduce blood pressure levels in patients with moderate resistant hypertension, regardless of adherence to anti-hypertensive medication.
The fine print
Larger studies that compare renal denervation to another treatment or a control group are needed to confirm these findings.
Published By :
Journal of hypertension
Sep 06, 2016