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Safety and efficacy of renal sympathetic denervation: a 9-year long-term follow-up of 24-hour ambulatory blood pressure measurements.
- Source :
-
Frontiers in cardiovascular medicine [Front Cardiovasc Med] 2023 Jun 19; Vol. 10, pp. 1210801. Date of Electronic Publication: 2023 Jun 19 (Print Publication: 2023). - Publication Year :
- 2023
-
Abstract
- Background: Renal sympathetic denervation (RDN) has been shown to lower arterial blood pressure both in the presence and in the absence of antihypertensive medication in an observation period of up to 3 years. However, long-term results beyond 3 years are scarcely reported.<br />Methods: We performed a long-term follow-up on patients who were previously enrolled in a local renal denervation registry and who underwent radiofrequency RDN with the Symplicity Flex® renal denervation system between 2011 and 2014. The patients were assessed to evaluate their renal function by performing 24-hour ambulatory blood pressure measurement (ABPM), recording their medical history, and conducting laboratory tests.<br />Results: Ambulatory blood pressure readings for 24 h were available for 72 patients at long-term follow-up (FU) [9.3 years (IQR: 8.5-10.1)]. We found a significant reduction of ABP from 150.1/86.1 ± 16.9/12.0 mmHg at baseline to 138.3/77.1 ± 16.5/11.1 mmHg at long-term FU ( P < 0.001 for both systolic and diastolic ABP). The number of antihypertensive medications used by the patients significantly decreased from 5.4 ± 1.5 at baseline to 4.8 ± 1.6 at long-term FU ( P < 0.01). Renal function showed a significant but expected age-associated decrease in the eGFR from 87.8 (IQR: 81.0-100.0) to 72.5 (IQR: 55.8-86.8) ml/min/1.73 m <superscript>2</superscript> ( P < 0.01) in patients with an initial eGFR > 60 ml/min/1.73 m <superscript>2</superscript> , while a non-significant decrease was observed in patients with an initial eGFR < 60 ml/min/1.73 m <superscript>2</superscript> at long-term FU [56.0 (IQR: 40.9-58.4) vs. 39.0 (IQR: 13.5-56.3) ml/min/1.73 m <superscript>2</superscript> ].<br />Conclusions: RDN was accompanied by a long-lasting reduction in blood pressure with a concomitant reduction in antihypertensive medication. No negative effects could be detected, especially with regard to renal function.<br />Competing Interests: AV and AP received consulting fees from Medtronic. AP was a proctor for Medtronic. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.<br /> (© 2023 Vogt, Dutzmann, Nußbaum, Hoyer, Tongers, Schlitt, Sedding and Plehn.)
Details
- Language :
- English
- ISSN :
- 2297-055X
- Volume :
- 10
- Database :
- MEDLINE
- Journal :
- Frontiers in cardiovascular medicine
- Publication Type :
- Academic Journal
- Accession number :
- 37404730
- Full Text :
- https://doi.org/10.3389/fcvm.2023.1210801