PP.26.20

Abstract

Objective: Renal denervation (RDN) of sympathetic nerves is a promising treatment option in patients with a resistant arterial hypertension (RAH). Since publication of the Simplicity HTN-3 trial, which failed it's primary endpoint, all possible effects of RDN are a matter of debate. Inflammation parameters such as C-reactive protein (CRP) and Interleukin-6 (IL-6) are well known predictors for an increased cardiovascular morbidity and mortality. However only few data on possible effects of RDN on inflammatory parameters are published so far, showing a benefit of RDN. Design and method: Patients with RAH, defined as mean systolic office blood pressure (BP) > 160mmHg despite therapy with at least three different antihypertensive drugs, were treated with a RDN after exclusion of secondary causes of hypertension. Patients were classified as responders if the 24-hour average systolic BP dropped by more than 5mmHg after 6 months. The levels of IL-6 and CRP were evaluated along with ambulatory BP measurements after 3,6,9 and 12 months and were analyzed for the responder group to have a population with evident RDN effect. Results: We included 186 patients with RAH, who were treated with RDN. After 6 months 51.8% were classified as responders. Those had a median systolic/diastolic ambulatory BP drop from 149/91 mmHg at baseline to 130/80 mmHg after 6 months (p < 0.01). Median CRP levels in responders were 0.3[0.1; 0.6]mg/l at baseline and 0.3[0.1; 0.5]mg/l after 12 months of follow-up (p = 0.31). In responders, median IL-6 levels were 4.5[1.6; 6.8]pg/ml at baseline and 4.1[2.5; 5.6]pg/ml after 12 months (p = 0.33). IL-6 and CRP levels had no significant difference at any point in time. Additionally, in responders there was a weak but significant correlation between IL-6 levels and elevated average systolic BP(r2 = 0.37,p = 0.01), and with elevated systolic daytime BP (r2 = 0.36,p = 0.01) and systolic nighttime BP (r2 = 0.37,p = 0.01) at baseline. However, after 6 and 12 months of follow-up, there were no correlations between IL-6 levels and BP. No correlation between CRP levels and BP was found at any time of the Study. Conclusions: By our data we did not observe an effect of RDN on inflammatory parameters in patients with RAH.