| Catheter-based renal nerve ablation and centrally generated sympathetic activity in difficult-to-control hypertensive patients: prospective case series. | |
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MedLine Citation:
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PMID: 23045466 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Endovascular renal nerve ablation has been developed to treat resistant hypertension. In addition to lowering efferent renal sympathetic activation, the intervention may attenuate central sympathetic outflow through decreased renal afferent nerve traffic, as evidenced by a recent case report. We tested the hypothesis in 12 nonpreselected patients with difficult-to-control hypertension (aged 45-74 years) admitted for renal nerve ablation. All patients received ≥ 3 antihypertensive medications at full doses, including a diuretic. Electrocardiogram, respiration, brachial and finger arterial blood pressure, and muscle sympathetic nerve activity were recorded before and 3 to 6 months after renal nerve ablation. Heart rate and blood pressure variability were analyzed in the time and frequency domain. Pharmacological baroreflex slopes were determined using the modified Oxford bolus technique. Resting heart rate was 61 ± 3 bpm before and 58 ± 2 bpm after ablation (P = 0.4). Supine blood pressure was 157 ± 7/85 ± 4 mm Hg before and 157 ± 6/85 ± 4 mm Hg after ablation (P = 1.0). Renal nerve ablation did not change resting muscle sympathetic nerve activity (before, 34 ± 2 bursts per minute; after, 32 ± 3 bursts per minute P = 0.6), heart rate variability, or blood pressure variability. Pharmacological baroreflex control of heart rate and muscle sympathetic nerve activity did not change. We conclude that reduced central sympathetic inhibition may be the exception rather than the rule after renal nerve ablation in unselected patients with difficult-to-control arterial hypertension. |
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Authors:
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Julia Brinkmann; Karsten Heusser; Bernhard M Schmidt; Jan Menne; Gunnar Klein; Johann Bauersachs; Hermann Haller; Fred C Sweep; Andre Diedrich; Jens Jordan; Jens Tank |
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Publication Detail:
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Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't Date: 2012-10-08 |
Journal Detail:
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Title: Hypertension Volume: 60 ISSN: 1524-4563 ISO Abbreviation: Hypertension Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-11-15 Completed Date: 2013-02-07 Revised Date: 2013-02-26 |
Medline Journal Info:
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Nlm Unique ID: 7906255 Medline TA: Hypertension Country: United States |
Other Details:
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Languages: eng Pagination: 1485-90 Citation Subset: IM |
Affiliation:
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Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany. |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT01355055 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Antihypertensive Agents / pharmacology, therapeutic use Blood Pressure / drug effects, physiology* Catheter Ablation* Female Heart Rate / drug effects, physiology Humans Hypertension / drug therapy, physiopathology, surgery* Kidney / innervation*, physiopathology Male Middle Aged Prospective Studies Sympathectomy* Sympathetic Nervous System / physiopathology, surgery* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents |
| Comments/Corrections | |
Comment In:
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Hypertension. 2013 Feb;61(2):e8
[PMID:
23213193
]
Hypertension. 2013 Feb;61(2):e9-10 Hypertension. 2013 Feb;61(2):e13 [PMID: 23248152 ] Hypertension. 2013 Feb;61(2):e17 [PMID: 23248153 ] Hypertension. 2013 Feb;61(2):e18 Hypertension. 2012 Dec;60(6):1385-6 [PMID: 23045467 ] Hypertension. 2013 Feb;61(2):e14 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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