Document Detail


Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months.
MedLine Citation:
PMID:  21403086     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Related Documents :
3885756 - Central nervous system cardiovascular effects of bombesin in conscious rats.
22584186 - Achieving your very best.
17976576 - Inducible nitric oxide synthase depresses cardiac contractile function in zucker diabet...
10919856 - Renal interstitial hydrostatic pressure and pressure natriuresis in pregnant rats.
22441346 - Magnitude and return time of the reflected wave: the effects of large artery stiffness ...
22961266 - Defining the characteristic relationship between arterial pressure and cerebral flow.
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2011-03-14
Journal Detail:
Title:  Hypertension     Volume:  57     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-21     Completed Date:  2011-06-30     Revised Date:  2012-05-29    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  911-7     Citation Subset:  IM    
Affiliation:
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
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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:
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:
Auton Neurosci. 2012 Jan 26;166(1-2):1-3   [PMID:  22137183 ]
Hypertension. 2011 Oct;58(4):e19; author reply e20   [PMID:  21859966 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Lost in translation: physicians' struggle with cost-reduction programs.
Next Document:  Cardiovascular outcomes in framingham participants with diabetes: the importance of blood pressure.