PP.26.27

Abstract

Objective: Renal denervation (RDN) is a promising treatment option in addition to medical antihypertensive treatment in patients suffering from resistant hypertension. Despite the growing interest in RDN, only few long-term results are published so far.Design and method: We systematically investigated the effects of RDN on ambulatory blood pressure measurements (ABPM) for 24-hours in a consecutive series of patients with resistant hypertension out to 24 months. Office blood pressure (BP) measurements and ABPM assessment were performed at 3, 6, 12 and 24 months. Patients with an average systolic BP reduction of more than 10 mmHg in office BP 6 months after RDN were classified as responders. Additional to this classical responder concept, we categorized response to RDN by an individual-patient visit-by-visit evaluation of office BP and 24-hour-BP, separately. Results: We included 32 patients. In 21 patients (65.6%) we found a mean systolic BP reduction > 10mmHg in office BP six months after RDN. These patients were classified as responders. In responders, mean office BP dropped from 175.3 ± 15.9/96 ± 14.2 mmHg to 164.8 ± 24.4/93.2 ± 10.4 mmHg (p = 0.040/p = 0.323) and mean 24-hour BP in ABPM decreased from 146.8 ± 17.0/89.1 ± 11 mmHg to 136.8 ± 15.0/83.2 ± 10.7 mmHg after 24 months (p = 0.034/p = 0.014). By the visit-by-visit evaluation, all patients were divided in larger-than-median and smaller-than-median response. Patients with a larger-than-median response had a sustained significant BP reduction, independently at which time-point we have categorized our patients. Conclusions: In contrast to the observed variation of office BP measurements, ABPM demonstrated a reproducible and sustained significant BP reduction in patients with larger-than-median response to RDN.