Response to Catheter-Based Renal Nerve Ablation and Centrally Generated Sympathetic Activity in Difficult-to-Control Hypertensive Patients: Prospective Case Series

Abstract

Mahfoud et al1 suggest that several aspects in our publication should be clarified. A previous case report showed massive sympathetic vasomotor tone reduction in a patient with treatment-resistant arterial hypertension after renal nerve ablation.2 Our study, albeit small, was sufficiently powered to address our prespecified primary question whether massive sympathetic inhibition is a typical response to catheter-based renal denervation. We strongly believe that the patient population was suitable for our purposes. Our patients showed uncontrolled arterial hypertension despite treatment with an average of 7 antihypertensive medications. Patients in the Symplicity HTN-2 trial were on 5 antihypertensive medications.3 Previous trials reported office blood pressure measurements. In contrast, we assessed supine blood pressure after an ≈1-hour resting period, which cannot be …