Vol 74, No 9 (2016)
Original articles
Published online: 2016-05-05

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Effects of renal sympathetic denervation on blood pressure and glycaemic control in patients with true resistant hypertension: results of Polish Renal Denervation Registry (RDN-POL Registry)

Jacek Kądziela, Aleksander Prejbisz, Katarzyna Kostka-Jeziorny, Dariusz Dudek, Krzysztof Narkiewicz, Jerzy Sadowski, Andrzej Lekston, Aneta Gziut, Andrzej Więcek, Paweł Buszman, Andrzej Kleinrok, Janusz Kochman, Danuta Czarnecka, Andrzej Januszewicz, Adam Witkowski
Kardiol Pol 2016;74(9):961-968.

Abstract

Background and aim: The assessment of percutaneous renal sympathetic denervation (RDN) efficacy in patients with true-resistant hypertension (true-RH) in a newly established net of Polish centres (RDN-POL Registry).

Methods and results: Forty-four patients with true-RH (23 men, mean age 52.3 years) with daytime systolic blood pressure (SBP) in ambulatory blood pressure monitoring (ABPM) ≥ 135 mm Hg, on ≥ three antihypertensive agents, including diuretic, underwent RDN and completed 12-month follow-up. Mean reductions of office SBP/diastolic blood pressure were –23.8/–10.0, –12.5/–4.6, and –12.6/–6.1 mm Hg at 3, 6, and 12 months, respectively (all significant except diastolic at 6 months). Diabetes was the only predictor of office SBP reduction at 6 months (OR 9.6, 95% CI 1.4–66.5, p < 0.05). Mean 24-h SBP change was –8.3 mm Hg at 6 months and –4.6 mm Hg at 12 months. Increased 2 h-glucose in oral glucose tolerance test was the only predictor of 24-h SBP reduction at 6 months (OR 1.24 for 10 mg/dL glucose increase, 95% CI 1.04–1.48, p < 0.05). At 12 months, 24-h SBP change predictors were: baseline office SBP (OR 4.93 for 10 mm Hg SBP increment, 95% CI 1.01–24.1, p < 0.05) and 2 h-glucose (OR 1.47, 95% CI 1.08–2.00, p < 0.05). In ABPM responders, significant reduction of 2 h glucose was found as compared to the non-responders (–45.8 vs. –7.7 mg/dL, p < 0.005).

Conclusions: The RDN-POL Registry demonstrated moderate blood pressure decrease after RDN. The predictors of blood pressure reduction were diabetes, 2 h-glucose, and baseline office SBP. Analysis of ABPM responders indicates a probable positive impact of RDN on glycaemic control.  




Polish Heart Journal (Kardiologia Polska)