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Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months

Renal sympathetic hyperactivity is seminal in the maintenance and progression of hypertension. Catheter-based renal sympathetic denervation has been shown to significantly reduce blood pressure (BP) in patients with hypertension. Durability of effect beyond 1 year using this novel technique has neve... Full description

Journal Title: Hypertension (Dallas Tex. 1979), 2011-05, Vol.57 (5), p.911-917
Main Author: Sadowski, Jerzy
Other Authors: Bartus, Krzysztof , Kapelak, Boguslaw , Rocha-Singh, Krishna J , Katholi, Richard E , Witkowski, Adam , Kadziela, Jacek , Januszewicz, Andrzej , Prejbisz, Aleksander , Walton, Anthony S , Sievert, Horst , Id, Dani , Wunderlich, Nina , Whitbourn, Robert , Rump, Lars Christian , Vonend, Oliver , Saleh, Andreas , Thambar, Suku , Nanra, Ranjit , Zeller, Thomas , Erglis, Andrejs , Sagic, Dragan , Boskovic, Srdjan , Brachmann, Johannes , Schmidt, Martin , Wenzel, Ulrich O , Bart, Bradley A , Schmieder, Roland E , Scheinert, Dierk , Boergel, Jan , Straley, Craig , Htn, Symplicity Investigators
Format: Electronic Article Electronic Article
Language: English
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Publisher: United States
ID: ISSN: 0194-911X
Link: https://www.ncbi.nlm.nih.gov/pubmed/21403086
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title: Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months
format: Article
creator:
  • Sadowski, Jerzy
  • Bartus, Krzysztof
  • Kapelak, Boguslaw
  • Rocha-Singh, Krishna J
  • Katholi, Richard E
  • Witkowski, Adam
  • Kadziela, Jacek
  • Januszewicz, Andrzej
  • Prejbisz, Aleksander
  • Walton, Anthony S
  • Sievert, Horst
  • Id, Dani
  • Wunderlich, Nina
  • Whitbourn, Robert
  • Rump, Lars Christian
  • Vonend, Oliver
  • Saleh, Andreas
  • Thambar, Suku
  • Nanra, Ranjit
  • Zeller, Thomas
  • Erglis, Andrejs
  • Sagic, Dragan
  • Boskovic, Srdjan
  • Brachmann, Johannes
  • Schmidt, Martin
  • Wenzel, Ulrich O
  • Bart, Bradley A
  • Schmieder, Roland E
  • Scheinert, Dierk
  • Boergel, Jan
  • Straley, Craig
  • Htn, Symplicity Investigators
subjects:
  • Aged
  • Analysis of Variance
  • blood pressure
  • Blood Pressure - drug effects
  • Blood Pressure - physiology
  • Catheters
  • Female
  • Glomerular Filtration Rate - drug effects
  • Glomerular Filtration Rate - physiology
  • Humans
  • hypertension
  • Hypertension - drug therapy
  • Hypertension - physiopathology
  • Hypertension - surgery
  • Kidney - innervation
  • Kidney - physiopathology
  • Kidney - surgery
  • Male
  • Middle Aged
  • renal sympathetic denervation
  • Sympathectomy - instrumentation
  • Sympathectomy - methods
  • Treatment Outcome
ispartof: Hypertension (Dallas, Tex. 1979), 2011-05, Vol.57 (5), p.911-917
description: Renal sympathetic hyperactivity is seminal in the maintenance and progression of hypertension. Catheter-based renal sympathetic denervation has been shown to significantly reduce blood pressure (BP) in patients with hypertension. Durability of effect beyond 1 year using this novel technique has never been reported. A cohort of 45 patients with resistant hypertension (systolic BP ≥160 mm Hg on ≥3 antihypertension drugs, including a diuretic) has been originally published. Herein, we report longer-term follow-up data on these and a larger group of similar patients subsequently treated with catheter-based renal denervation in a nonrandomized manner. We treated 153 patients with catheter-based renal sympathetic denervation at 19 centers in Australia, Europe, and the United States. Mean age was 57±11 years, 39% were women, 31% were diabetic, and 22% had coronary artery disease. Baseline values included mean office BP of 176/98±17/15 mm Hg, mean of 5 antihypertension medications, and an estimated glomerular filtration rate of 83±20 mL/min per 1.73 m(2). The median time from first to last radiofrequency energy ablation was 38 minutes. The procedure was without complication in 97% of patients (149 of 153). The 4 acute procedural complications included 3 groin pseudoaneurysms and 1 renal artery dissection, all managed without further sequelae. Postprocedure office BPs were reduced by 20/10, 24/11, 25/11, 23/11, 26/14, and 32/14 mm Hg at 1, 3, 6, 12, 18, and 24 months, respectively. In conclusion, in patients with resistant hypertension, catheter-based renal sympathetic denervation results in a substantial reduction in BP sustained out to ≥2 years of follow-up, without significant adverse events.
language: eng
source:
identifier: ISSN: 0194-911X
fulltext: no_fulltext
issn:
  • 0194-911X
  • 1524-4563
url: Link


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titleCatheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months
creatorSadowski, Jerzy ; Bartus, Krzysztof ; Kapelak, Boguslaw ; Rocha-Singh, Krishna J ; Katholi, Richard E ; Witkowski, Adam ; Kadziela, Jacek ; Januszewicz, Andrzej ; Prejbisz, Aleksander ; Walton, Anthony S ; Sievert, Horst ; Id, Dani ; Wunderlich, Nina ; Whitbourn, Robert ; Rump, Lars Christian ; Vonend, Oliver ; Saleh, Andreas ; Thambar, Suku ; Nanra, Ranjit ; Zeller, Thomas ; Erglis, Andrejs ; Sagic, Dragan ; Boskovic, Srdjan ; Brachmann, Johannes ; Schmidt, Martin ; Wenzel, Ulrich O ; Bart, Bradley A ; Schmieder, Roland E ; Scheinert, Dierk ; Boergel, Jan ; Straley, Craig ; Htn, Symplicity Investigators
creatorcontribSadowski, Jerzy ; Bartus, Krzysztof ; Kapelak, Boguslaw ; Rocha-Singh, Krishna J ; Katholi, Richard E ; Witkowski, Adam ; Kadziela, Jacek ; Januszewicz, Andrzej ; Prejbisz, Aleksander ; Walton, Anthony S ; Sievert, Horst ; Id, Dani ; Wunderlich, Nina ; Whitbourn, Robert ; Rump, Lars Christian ; Vonend, Oliver ; Saleh, Andreas ; Thambar, Suku ; Nanra, Ranjit ; Zeller, Thomas ; Erglis, Andrejs ; Sagic, Dragan ; Boskovic, Srdjan ; Brachmann, Johannes ; Schmidt, Martin ; Wenzel, Ulrich O ; Bart, Bradley A ; Schmieder, Roland E ; Scheinert, Dierk ; Boergel, Jan ; Straley, Craig ; Htn, Symplicity Investigators ; Symplicity HTN-1 Investigators
descriptionRenal sympathetic hyperactivity is seminal in the maintenance and progression of hypertension. Catheter-based renal sympathetic denervation has been shown to significantly reduce blood pressure (BP) in patients with hypertension. Durability of effect beyond 1 year using this novel technique has never been reported. A cohort of 45 patients with resistant hypertension (systolic BP ≥160 mm Hg on ≥3 antihypertension drugs, including a diuretic) has been originally published. Herein, we report longer-term follow-up data on these and a larger group of similar patients subsequently treated with catheter-based renal denervation in a nonrandomized manner. We treated 153 patients with catheter-based renal sympathetic denervation at 19 centers in Australia, Europe, and the United States. Mean age was 57±11 years, 39% were women, 31% were diabetic, and 22% had coronary artery disease. Baseline values included mean office BP of 176/98±17/15 mm Hg, mean of 5 antihypertension medications, and an estimated glomerular filtration rate of 83±20 mL/min per 1.73 m(2). The median time from first to last radiofrequency energy ablation was 38 minutes. The procedure was without complication in 97% of patients (149 of 153). The 4 acute procedural complications included 3 groin pseudoaneurysms and 1 renal artery dissection, all managed without further sequelae. Postprocedure office BPs were reduced by 20/10, 24/11, 25/11, 23/11, 26/14, and 32/14 mm Hg at 1, 3, 6, 12, 18, and 24 months, respectively. In conclusion, in patients with resistant hypertension, catheter-based renal sympathetic denervation results in a substantial reduction in BP sustained out to ≥2 years of follow-up, without significant adverse events.
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languageeng
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subjectAged ; Analysis of Variance ; blood pressure ; Blood Pressure - drug effects ; Blood Pressure - physiology ; Catheters ; Female ; Glomerular Filtration Rate - drug effects ; Glomerular Filtration Rate - physiology ; Humans ; hypertension ; Hypertension - drug therapy ; Hypertension - physiopathology ; Hypertension - surgery ; Kidney - innervation ; Kidney - physiopathology ; Kidney - surgery ; Male ; Middle Aged ; renal sympathetic denervation ; Sympathectomy - instrumentation ; Sympathectomy - methods ; Treatment Outcome
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1Bartus, Krzysztof
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6Kadziela, Jacek
7Januszewicz, Andrzej
8Prejbisz, Aleksander
9Walton, Anthony S
10Sievert, Horst
11Id, Dani
12Wunderlich, Nina
13Whitbourn, Robert
14Rump, Lars Christian
15Vonend, Oliver
16Saleh, Andreas
17Thambar, Suku
18Nanra, Ranjit
19Zeller, Thomas
20Erglis, Andrejs
21Sagic, Dragan
22Boskovic, Srdjan
23Brachmann, Johannes
24Schmidt, Martin
25Wenzel, Ulrich O
26Bart, Bradley A
27Schmieder, Roland E
28Scheinert, Dierk
29Boergel, Jan
30Straley, Craig
31Htn, Symplicity Investigators
32Symplicity HTN-1 Investigators
title
0Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months
1Hypertension (Dallas, Tex. 1979)
addtitleHypertension
descriptionRenal sympathetic hyperactivity is seminal in the maintenance and progression of hypertension. Catheter-based renal sympathetic denervation has been shown to significantly reduce blood pressure (BP) in patients with hypertension. Durability of effect beyond 1 year using this novel technique has never been reported. A cohort of 45 patients with resistant hypertension (systolic BP ≥160 mm Hg on ≥3 antihypertension drugs, including a diuretic) has been originally published. Herein, we report longer-term follow-up data on these and a larger group of similar patients subsequently treated with catheter-based renal denervation in a nonrandomized manner. We treated 153 patients with catheter-based renal sympathetic denervation at 19 centers in Australia, Europe, and the United States. Mean age was 57±11 years, 39% were women, 31% were diabetic, and 22% had coronary artery disease. Baseline values included mean office BP of 176/98±17/15 mm Hg, mean of 5 antihypertension medications, and an estimated glomerular filtration rate of 83±20 mL/min per 1.73 m(2). The median time from first to last radiofrequency energy ablation was 38 minutes. The procedure was without complication in 97% of patients (149 of 153). The 4 acute procedural complications included 3 groin pseudoaneurysms and 1 renal artery dissection, all managed without further sequelae. Postprocedure office BPs were reduced by 20/10, 24/11, 25/11, 23/11, 26/14, and 32/14 mm Hg at 1, 3, 6, 12, 18, and 24 months, respectively. In conclusion, in patients with resistant hypertension, catheter-based renal sympathetic denervation results in a substantial reduction in BP sustained out to ≥2 years of follow-up, without significant adverse events.
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8Glomerular Filtration Rate - physiology
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12Hypertension - physiopathology
13Hypertension - surgery
14Kidney - innervation
15Kidney - physiopathology
16Kidney - surgery
17Male
18Middle Aged
19renal sympathetic denervation
20Sympathectomy - instrumentation
21Sympathectomy - methods
22Treatment Outcome
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7Januszewicz, Andrzej
8Prejbisz, Aleksander
9Walton, Anthony S
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11Id, Dani
12Wunderlich, Nina
13Whitbourn, Robert
14Rump, Lars Christian
15Vonend, Oliver
16Saleh, Andreas
17Thambar, Suku
18Nanra, Ranjit
19Zeller, Thomas
20Erglis, Andrejs
21Sagic, Dragan
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24Schmidt, Martin
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titleCatheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months
authorSadowski, Jerzy ; Bartus, Krzysztof ; Kapelak, Boguslaw ; Rocha-Singh, Krishna J ; Katholi, Richard E ; Witkowski, Adam ; Kadziela, Jacek ; Januszewicz, Andrzej ; Prejbisz, Aleksander ; Walton, Anthony S ; Sievert, Horst ; Id, Dani ; Wunderlich, Nina ; Whitbourn, Robert ; Rump, Lars Christian ; Vonend, Oliver ; Saleh, Andreas ; Thambar, Suku ; Nanra, Ranjit ; Zeller, Thomas ; Erglis, Andrejs ; Sagic, Dragan ; Boskovic, Srdjan ; Brachmann, Johannes ; Schmidt, Martin ; Wenzel, Ulrich O ; Bart, Bradley A ; Schmieder, Roland E ; Scheinert, Dierk ; Boergel, Jan ; Straley, Craig ; Htn, Symplicity Investigators
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2blood pressure
3Blood Pressure - drug effects
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7Glomerular Filtration Rate - drug effects
8Glomerular Filtration Rate - physiology
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20Sympathectomy - instrumentation
21Sympathectomy - methods
22Treatment Outcome
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8Prejbisz, Aleksander
9Walton, Anthony S
10Sievert, Horst
11Id, Dani
12Wunderlich, Nina
13Whitbourn, Robert
14Rump, Lars Christian
15Vonend, Oliver
16Saleh, Andreas
17Thambar, Suku
18Nanra, Ranjit
19Zeller, Thomas
20Erglis, Andrejs
21Sagic, Dragan
22Boskovic, Srdjan
23Brachmann, Johannes
24Schmidt, Martin
25Wenzel, Ulrich O
26Bart, Bradley A
27Schmieder, Roland E
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16Saleh, Andreas
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atitleCatheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months
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date2011-05
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issue5
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eissn1524-4563
abstractRenal sympathetic hyperactivity is seminal in the maintenance and progression of hypertension. Catheter-based renal sympathetic denervation has been shown to significantly reduce blood pressure (BP) in patients with hypertension. Durability of effect beyond 1 year using this novel technique has never been reported. A cohort of 45 patients with resistant hypertension (systolic BP ≥160 mm Hg on ≥3 antihypertension drugs, including a diuretic) has been originally published. Herein, we report longer-term follow-up data on these and a larger group of similar patients subsequently treated with catheter-based renal denervation in a nonrandomized manner. We treated 153 patients with catheter-based renal sympathetic denervation at 19 centers in Australia, Europe, and the United States. Mean age was 57±11 years, 39% were women, 31% were diabetic, and 22% had coronary artery disease. Baseline values included mean office BP of 176/98±17/15 mm Hg, mean of 5 antihypertension medications, and an estimated glomerular filtration rate of 83±20 mL/min per 1.73 m(2). The median time from first to last radiofrequency energy ablation was 38 minutes. The procedure was without complication in 97% of patients (149 of 153). The 4 acute procedural complications included 3 groin pseudoaneurysms and 1 renal artery dissection, all managed without further sequelae. Postprocedure office BPs were reduced by 20/10, 24/11, 25/11, 23/11, 26/14, and 32/14 mm Hg at 1, 3, 6, 12, 18, and 24 months, respectively. In conclusion, in patients with resistant hypertension, catheter-based renal sympathetic denervation results in a substantial reduction in BP sustained out to ≥2 years of follow-up, without significant adverse events.
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