ISSN 2996-8215
International Journal of Cardiology | Vol. 2, No. 1, January 2011 | pp. 1–8
DOI: 10.46882/2011/IJC/000022
Original Research Article
Efficacy of Renal Denervation in Patients with Treatment-Resistant Hypertension: A 12-Month Follow-Up Study
Marcus Thorne¹, Elizabeth Vance¹, Nigel Kirkpatrick²
¹Cardiovascular Research Centre, University of Manchester, Manchester, United Kingdom
²Department of Hypertension, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
Abstract:
Resistant hypertension poses a severe clinical challenge due to its strong correlation with stroke and myocardial infarction. Catheter-based renal denervation (RDN) has emerged as a novel option to disrupt sympathetic overactivity. This study assessed the 12-month efficacy and safety of bilateral RDN in patients with true treatment-resistant hypertension. We enrolled 85 patients taking an average of 4.2 ± 0.8 antihypertensive medications who exhibited a baseline automated office systolic blood pressure (BP) greater than or equal to 160 mmHg. True resistance was confirmed via 24-hour ambulatory blood pressure monitoring (ABPM). Catheter-based radiofrequency ablation of the renal arteries was performed successfully in all patients. The primary endpoint was the change in office and ambulatory systolic BP at 12 months. At 12 months post-procedure, office blood pressure dropped significantly by -28 ± 7 mmHg systolic and -11 ± 4 mmHg diastolic (p < 0.001). More importantly, 24-hour ambulatory systolic BP decreased by -16 ± 5 mmHg (p < 0.01). The treatment response was sustained throughout the study period, with 68.2% of patients classified as responders (systolic reduction greater than or equal to 10 mmHg). Renal artery duplex ultrasound at 12 months showed no evidence of renal artery stenosis or aneurysmal formation in any patient. Renal function, assessed by estimated glomerular filtration rate (eGFR), remained stable (from 78.4 ± 11.2 mL/min/1.73m² to 77.1 ± 10.8 mL/min/1.73m², p = 0.42). Catheter-based renal denervation provides a powerful, sustained reduction in both office and ambulatory blood pressure at 12 months without detrimental effects on renal function or vascular integrity.
Keywords: Resistant hypertension, Renal denervation, Sympathetic nervous system, Ambulatory blood pressure, Catheter ablation
Received: October 10, 2010; Revised: November 22, 2010; Accepted: December 12, 2010; Published: January 18, 2011
Citation: International Journal of Cardiology, 2011, Vol. 2, No. 1, pp. 1–8, DOI: 10.46882/2011/IJC/000022