| Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months. | |
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MedLine Citation:
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PMID: 21403086 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2011-03-14 |
Journal Detail:
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Title: Hypertension Volume: 57 ISSN: 1524-4563 ISO Abbreviation: Hypertension Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-21 Completed Date: 2011-06-30 Revised Date: 2011-10-21 |
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: 911-7 Citation Subset: IM |
Affiliation:
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Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University/Alfred Hospital, Melbourne, Victoria 3004, Australia. henry.krum@med.monash.edu.au |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Analysis of Variance Blood Pressure / drug effects, physiology* Catheters Female Glomerular Filtration Rate / drug effects, physiology Humans Hypertension / drug therapy, physiopathology, surgery* Kidney / innervation*, physiopathology, surgery Male Middle Aged Sympathectomy / instrumentation, methods* Treatment Outcome |
| Investigator | |
Investigator/Affiliation:
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Henry Krum / ; Neil Barman / ; Markus Schlaich / ; Paul Sobotka / ; Murray Esler / ; Felix Mahfoud / ; Michael Bohm / ; Mark Dunlap / ; Jerzy Sadowski / ; Krzysztof Bartus / ; Boguslaw Kapelak / ; Krishna J Rocha-Singh / ; Richard E Katholi / ; Adam Witkowski / ; Jacek Kadziela / ; Andrzej Januszewicz / ; Aleksander Prejbisz / ; Anthony S Walton / ; Horst Sievert / ; Dani Id / ; Nina Wunderlich / ; Robert Whitbourn / ; Lars Christian Rump / ; Oliver Vonend / ; Andreas Saleh / ; Suku Thambar / ; Ranjit Nanra / ; Thomas Zeller / ; Andrejs Erglis / ; Dragan Sagic / ; Srdjan Boskovic / ; Johannes Brachmann / ; Martin Schmidt / ; Ulrich O Wenzel / ; Bradley A Bart / ; Roland E Schmieder / ; Dierk Scheinert / ; Jan Börgel / ; Craig Straley / |
| Comments/Corrections | |
Comment In:
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Hypertension. 2011 Oct;58(4):e19; author reply e20
[PMID:
21859966
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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