Stručni rad

RENAL DENERVATION AND RESISTANT HYPERTENSION: BACK TO THE FUTURE

INGRID PRKAČIN orcid.org/0000-0002-5830-7131 ; Sveučilište u Zagrebu, Medicinski fakultet, Klinička bolnica Merkur, Klinika za interne bolesti i Klinika za dijabetes, endokrinologiju i bolesti metabolizma Vuk Vrhovac, Zagreb, Hrvatska
BORNA VRHOVEC ; Sveučilište u Zagrebu, Medicinski fakultet, Klinička bolnica Merkur, Klinika za interne bolesti, Zagreb, Hrvatska
ANA LEGOVIĆ ; Sveučilište u Zagrebu, Medicinski fakultet, Klinička bolnica Merkur, Klinika za interne bolesti, Zagreb, Hrvatska
VESNA ĐERMANOVIĆ DOBROTA ; Sveučilište u Zagrebu, Medicinski fakultet, Klinička bolnica Merkur, Klinika za dijabetes, endokrinologiju i bolesti metabolizma Vuk Vrhovac, Zagreb, Hrvatska
TOMISLAV BULUM ; Sveučilište u Zagrebu, Medicinski fakultet, Klinička bolnica Merkur, Klinika za dijabetes, endokrinologiju i bolesti metabolizma Vuk Vrhovac, Zagreb, Hrvatska
VINKO VIDJAK ; Sveučilište u Zagrebu, Medicinski fakultet, Klinička bolnica Merkur, Klinika za dijabetes, endokrinologiju i bolesti metabolizma Vuk Vrhovac i Klinika za radiologiju, Zagreb, Hrvatska

Sažetak

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.

Ključne riječi

resistant hypertension; renal sympathetic denervation

Hrčak ID:

180121

URI

https://hrcak.srce.hr/180121

Datum izdavanja:

6.4.2017.

Podaci na drugim jezicima: hrvatski

Posjeta: 1.066 *