| Title | The effect of renal denervation on arterial stiffness, central blood pressure and heart rate variability in treatment resistant essential hypertension: a substudy of a randomized sham-controlled double-blinded trial (the ReSET trial). | ||
| Author | Peters, Christian Daugaard; Mathiassen, Ole Norling; Vase, Henrik; Bech Norgaard, Jesper; Christensen, Kent Lodberg; Schroeder, Anne Pauline; Rickers, Hans Joachim von Hofe; Opstrup, Ulla Kampmann; Poulsen, Per Logstrup; Langfeldt, Sten; Andersen, Gratien; Hansen, Klavs Wurgler; Botker, Hans Erik; Engholm, Morten; Bertelsen, Jannik Buus; Pedersen, Erling Bjerregaard; Kaltoft, Anne; Buus, Niels Henrik | ||
| Journal | Blood Press | Publication Year/Month | 2017-Dec |
| PMID | 28830251 | PMCID | -N/A- |
| Affiliation + expend | 1.a Department of Renal Medicine , Aarhus University Hospital , Aarhus , Denmark. | ||
OBJECTIVES: To investigate, whether renal denervation (RDN) improves arterial stiffness, central blood pressure (C-BP) and heart rate variability (HRV) in patients with treatment resistant hypertension. METHODS: ReSET was a randomized, sham-controlled, double-blinded trial (NCT01459900). RDN was performed by a single experienced operator using the Medtronic unipolar Symplicity Flex(TM) catheter. C-BP, carotid-femoral pulse wave velocity (PWV), and HRV were obtained at baseline and after six months with the SphygmoCor((R))-device. RESULTS: Fifty-three patients (77% of the ReSET-cohort) were included in this substudy. The groups were similar at baseline (SHAM/RDN): n = 27/n = 26; 78/65% males; age 59 +/- 9/54 +/- 8 years (mean +/- SD); systolic brachial BP 158 +/- 18/154 +/- 17 mmHg; systolic 24-hour ambulatory BP 153 +/- 14/151 +/- 13 mmHg. Changes in PWV (0.1 +/- 1.9 (SHAM) vs. -0.6 +/- 1.3 (RDN) m/s), systolic C-BP (-2 +/- 17 (SHAM) vs. -8 +/- 16 (RDN) mmHg), diastolic C-BP (-2 +/- 9 (SHAM) vs. -5 +/- 9 (RDN) mmHg), and augmentation index (0.7 +/- 7.0 (SHAM) vs. 1.0 +/- 7.4 (RDN) %) were not significantly different after six months. Changes in HRV-parameters were also not significantly different. Baseline HRV or PWV did not predict BP-response after RDN. CONCLUSIONS: In a sham-controlled setting, there were no significant effects of RDN on arterial stiffness, C-BP and HRV. Thus, the idea of BP-independent effects of RDN on large arteries and cardiac autonomic activity is not supported.