Differences in the effectiveness of sympathetic radiofrequency denervation of the renal arteries in patients with resistant arterial hypertension and hyperuricemia

Abstract

Objective. To evaluate of differences in the effectiveness of sympathetic radiofrequency denervation (RDN) of renal arteries (RA) in patients with resistant arterial hypertension (RAH) with hyperuricemia (HUA) during 3 years of follow-up. Design and methods. The study included 80 patients with RAH, who were randomized to RDN RA group with medication therapy (MT) and MT group. Groups were comparable in age, gender, duration of hypertension and the number of antihypertensive medications. In 12 months, comparative study was completed, and RDN RA group of patients was examined in 24 and 36 months, results were analyzed depending on the initial level of uric acid (UA). Results. In RDN RA group, compared with MT group, beneficial antihypertensive effect was found both in terms of office blood pressure (BP) and ambulatory BP monitoring (ABPM). After RDN RA, significant decrease in BP persisted for 3 years. Analysis of antihypertensive effect of interventional treatment depending on UA level showed significant decrease in office BP and all indicators of ABPM in patients with normal levels of UA. In HUA patients, only decrease in office BP and mean daily systolic BP was revealed. The majority of patients with favorable response to RDN (“responders” group) showed normal UA (75 % vs. 83,3 %, respectively, at 24, 36 months of follow-up). The creatinine and cystatin C levels in dynamics were slightly increased, but within reference ranges. Conclusions. Obtained data indicated more pronounced clinical efficacy of RDN RA in patients without HUA.