Abstract
Renal denervation (RDN) is a new procedure for treatment-resistant hypertensive patients. In order to monitor all procedures undergone in Austria, the Austrian Society of Hypertension established the investigator-initiated Austrian Transcatheter Renal Denervation (TREND) Registry. From April 2011 to September 2014, 407 procedures in 14 Austrian centres were recorded. At baseline, office and mean 24-h ambulatory blood pressure (ABP) were 171/94 and 151/89 mmHg, respectively, and patients were taking a median of 4 antihypertensive medications. Mean 24-h ABP changes after 2–6 weeks, 3, 6 and 12 months were -11/-6, -8/-4, -8/-5 and -10/-6 mmHg (p<0.05 at all measurements), respectively. The periprocedural complication rate was 2.5%. Incidence of long-term complications during follow-up (median 1 year) was 0.5%. Office BP and ABP responses showed only a weak correlation (Pearson coefficient 0.303). Based on the data from the TREND registry, ambulatory blood pressure monitoring in addition to office BP should be used for patient selection as well as for monitoring response to RDN. Furthermore, criteria for optimal patient selection are suggested.
Highlights
With a prevalence of 5–30% in the hypertensive population [1], resistant hypertension (RH) is an important health problem and associated with high risk of cardiovascular events [2]
Based on the data from the Transcatheter Renal Denervation (TREND) registry, ambulatory blood pressure monitoring in addition to office BP should be used for patient selection as well as for monitoring response to Renal denervation (RDN)
The analysis of the investigator-initiated Austrian TREND registry revealed three major findings: First, we observed a significant and sustained BP lowering effect reflected in both office BP readings and ambulatory blood pressure (ABP) monitoring
Summary
With a prevalence of 5–30% in the hypertensive population [1], resistant hypertension (RH) is an important health problem and associated with high risk of cardiovascular events [2]. The Symplicity HTN-1 and -2 studies [5, 6] proved the feasibility of the procedure and showed positive results with a low complication rate They observed BP reductions of 20–30 mmHg. RDN is a class IIb level C indication for treatment of RH by the 2013 ESC/ ESH guidelines on the management of hypertension [1]. The Symplicity HTN-3 study [9] was the first blinded randomized sham-controlled trial of RDN It confirmed safety but could not prove a significant effect of renal denervation on BP over sham procedure with a superiority margin of 5 mmHg. the decline in office BP was not significantly different between both groups after 6 months (RDN group -14±24 mmHg vs sham group -12±26 mmHg) The decline in office BP was not significantly different between both groups after 6 months (RDN group -14±24 mmHg vs. sham group -12±26 mmHg)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
