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Management of resistant hypertension in a multidisciplinary unit of renal denervation: protocol and results.
MedLine Citation:
PMID:  24775818     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
INTRODUCTION AND OBJECTIVES: Resistant hypertension is a clinical problem because of its difficult management and increased morbidity and mortality. Catheter-based renal denervation has been demonstrated to improve control in these patients. The results of establishing a multidisciplinary unit for the implementation of renal denervation in the management of resistant hypertension are described.
METHODS: A team of nephrologists and cardiologists created a protocol for patient selection, intervention, and follow-up. One hundred and ninety-seven patients with poorly controlled essential hypertension, despite taking 3 or more drugs, were included. The ablation technique previously described was supported by a navigator based on rotational angiography. Blood pressure at baseline and after follow-up was compared using the Wilcoxon test for paired samples.
RESULTS: One hundred and eight patients (55%) with pseudo-resistant hypertension were excluded. The other 89 were given antialdosteronic drugs, to which 60 patients (30%) responded. The remaining 29 patients (15%) were candidates for denervation. Eleven patients, with blood pressure 164/99mmHg and taking 4.4 antihypertensive drugs, were ablated. After 72 days of follow-up, systolic and diastolic blood pressure fell by 25 mmHg (P=.02) and 10 mmHg (P=.06), respectively. In 10 patients (91%) at least 1 drug was discontinued.
CONCLUSIONS: Renal denervation performed by a multidisciplinary team led to an improvement in blood pressure similar to previous studies, with a greater reduction of antihypertensive drugs.
Authors:
Adolfo Fontenla; José A García-Donaire; Felipe Hernández; Julián Segura; Ricardo Salgado; César Cerezo; Luis M Ruilope; Fernando Arribas
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Publication Detail:
Type:  Journal Article     Date:  2012-12-11
Journal Detail:
Title:  Revista española de cardiología (English ed.)     Volume:  66     ISSN:  1885-5857     ISO Abbreviation:  Rev Esp Cardiol (Engl Ed)     Publication Date:  2013 May 
Date Detail:
Created Date:  2014-04-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101587954     Medline TA:  Rev Esp Cardiol (Engl Ed)     Country:  Spain    
Other Details:
Languages:  eng     Pagination:  364-70     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.
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