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Renal artery sympathetic denervation: observations from the UK experience.

Sharp, Andrew S P and Davies, Justin E and Lobo, Melvin D and Bent, Clare L and Mark, Patrick B and Burchell, Amy E and Thackray, Simon D and Martin, Una and McKane, William S and Gerber, Robert T and Wilkinson, James R and Antonios, Tarek F and Doulton, Timothy W and Patterson, Tiffany and Clifford, Piers C and Lindsay, Alistair and Houston, Graeme J and Freedman, Jonathan and Das, Neelan and Belli, Anna M and Faris, Mohamad and Cleveland, Trevor J and Nightingale, Angus K and Hameed, Awais and Mahadevan, Kalaivani and Finegold, Judith A and Mather, Adam N and Levy, Terry and D'Souza, Richard and Riley, Peter and Moss, Jonathan G and Di Mario, Carlo and Redwood, Simon R and Baumbach, Andreas and Caulfield, Mark J and Dasgupta, Indranil (2016) Renal artery sympathetic denervation: observations from the UK experience. Clinical research in cardiology : official journal of the German Cardiac Society, 105 (6). pp. 544-52. ISSN 1861-0692. This article is available to all HEFT staff and students via ASK HEFT Discovery tool http://tinyurl.com/z795c8c using their HEFT Athens Login.

Full text not available from this repository.
Official URL: https://link.springer.com/article/10.1007%2Fs00392...

Abstract

BACKGROUND

Renal denervation (RDN) may lower blood pressure (BP); however, it is unclear whether medication changes may be confounding results. Furthermore, limited data exist on pattern of ambulatory blood pressure (ABP) response-particularly in those prescribed aldosterone antagonists at the time of RDN.

METHODS

We examined all patients treated with RDN for treatment-resistant hypertension in 18 UK centres.

RESULTS

Results from 253 patients treated with five technologies are shown. Pre-procedural mean office BP (OBP) was 185/102 mmHg (SD 26/19; n = 253) and mean daytime ABP was 170/98 mmHg (SD 22/16; n = 186). Median number of antihypertensive drugs was 5.0: 96 % ACEi/ARB; 86 % thiazide/loop diuretic and 55 % aldosterone antagonist. OBP, available in 90 % at 11 months follow-up, was 163/93 mmHg (reduction of 22/9 mmHg). ABP, available in 70 % at 8.5 months follow-up, was 158/91 mmHg (fall of 12/7 mmHg). Mean drug changes post RDN were: 0.36 drugs added, 0.91 withdrawn. Dose changes appeared neutral. Quartile analysis by starting ABP showed mean reductions in systolic ABP after RDN of: 0.4; 6.5; 14.5 and 22.1 mmHg, respectively (p < 0.001 for trend). Use of aldosterone antagonist did not predict response (p > 0.2).

CONCLUSION

In 253 patients treated with RDN, office BP fell by 22/9 mmHg. Ambulatory BP fell by 12/7 mmHg, though little response was seen in the lowermost quartile of starting blood pressure. Fall in BP was not explained by medication changes and aldosterone antagonist use did not affect response.

Item Type: Article
Additional Information: This article is available to all HEFT staff and students via ASK HEFT Discovery tool http://tinyurl.com/z795c8c using their HEFT Athens Login.
Subjects: WJ Urogenital system. Urology
Divisions: Emergency Services > Renal
Related URLs:
Depositing User: Miss Adele Creak
Date Deposited: 08 Mar 2017 13:48
Last Modified: 08 Mar 2017 13:48
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1261

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