Professional paper

RENAL DENERVATION AND RESISTANT HYPERTENSION: BACK TO THE FUTURE

INGRID PRKAČIN orcid.org/0000-0002-5830-7131 ; University of Zagreb, School of Medicine, Merkur University Hospital, Department of Internal Medicine, and Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, Zagreb, Croatia
BORNA VRHOVEC ; University of Zagreb, School of Medicine, Merkur University Hospital, Department of Internal Medicine, Zagreb, Croatia
ANA LEGOVIĆ ; University of Zagreb, School of Medicine, Merkur University Hospital, Department of Internal Medicine, Zagreb, Croatia
VESNA ĐERMANOVIĆ DOBROTA ; University of Zagreb, School of Medicine, Merkur University Hospital, Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, Zagreb, Croatia
TOMISLAV BULUM ; University of Zagreb, School of Medicine, Merkur University Hospital, Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, Zagreb, Croatia
VINKO VIDJAK ; University of Zagreb, School of Medicine, Merkur University Hospital, Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, and Department of Radiology, Zagreb, Croatia

Abstract

Renal sympathetic denervation (RDN) with radiofrequency (RF) is being used to treat resistant hypertension in seven non-responder patients (62±6 years for age, 5F/2M) despite treatment with >4 different antihypertensive drugs in optimal doses. Prior to diagnosing a patient as having resistant hypertension, we document adherence and exclude white-coat hypertension, inaccurate measurement of blood pressure and secondary causes. Office blood pressure (BP) measurements at 1, 3, 6, 12 and 18 months follow-up visits were compared to baseline. We used STATISTICA 10, 2011 software (Stat Soft Inc., Tulsa, OK, USA). Values are mean SD and considered statistically significant if P <0.001. At baseline, values were 184±21 and 106±26 mmHg for systolic (SBP) and diastolic (DBP), 6.7±1 for number of antihypertensive drug classes. One, 3, 6, 12 and 18 months after RDN, office SBP values were significantly lower (144±13 mmHg, 140±17, 141±15, 139±12 and 135±11 mmHg; P <0.001), with no significant reduction in DBP values at 1, 3, 6, 12 and 18 months after RDN (81±6, 82±9, 79±9, 78±6, and 76±7 mmHg). The number of antihypertensive drug classes before and 6, 12, 18 months after RDN were evaluated. Six months after RDN the number of antihypertensive drug classes required was 6.5±1, after 12 and 18 months was 5.5±1 and 4.5±1. During RDA no complications occurred (the pain during the procedure was well tolerated) and the renal function remained stabile. Renal sympathetic denervation is being a concomitant treatment of drug-resistant hypertension (rHT). The sustained reduction of SBP was observed after the RDN. Patients have benefit the most from procedure after 6-12 months. Further meta-analysis will evaluate the importance of new devices for less pain treatment of RDN.

Keywords

resistant hypertension; renal sympathetic denervation

Hrčak ID:

180121

URI

https://hrcak.srce.hr/180121

Publication date:

6.4.2017.

Article data in other languages: croatian

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