Renal denervation improves exercise blood pressure: insights from a randomized, sham-controlled trial View Full Text


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Article Info

DATE

2016-01-04

AUTHORS

Karl Fengler, Diana Heinemann, Thomas Okon, Karoline Röhnert, Thomas Stiermaier, Maximilian von Röder, Christian Besler, Ulrike Müller, Robert Höllriegel, Gerhard Schuler, Steffen Desch, Philipp Lurz

ABSTRACT

IntroductionDespite the ongoing debate on the role of renal sympathetic denervation (RSD) in the management of therapy-resistant hypertension, little is known about its possible effects on exercise blood pressure (BP), a known predictor for future cardiovascular events. We sought to evaluate the effect of RSD on exercise BP in a randomized, sham-controlled trial in patients with mild hypertension.Methods and resultsPatients with therapy-resistant mild hypertension (defined by mean daytime systolic BP between 135 and 149 mmHg or mean daytime diastolic BP between 90 and 94 mmHg on 24-h ambulatory BP measurement) were randomized to either radiofrequency-based RSD or a sham procedure. Patients underwent cardiopulmonary exercise testing at baseline and after 6 months. Of the 71 patients randomized, data from cardiopulmonary exercise testing were available for 48 patients (22 in the RSD group, 26 in the sham group). After 6 months, patients undergoing RSD had a significantly lower systolic BP at maximum exercise workload compared to baseline (−14.2 ± 26.1 mmHg, p = 0.009). In contrast, no change was observed in the sham group (0.6 ± 22.9 mmHg, p = 0.45, p = 0.04 for between-group comparison). When analyzing patients with exaggerated baseline exercise BP only, the effect was even more pronounced (RSD vs. sham −29.5 ± 23.4 vs. 0.1 ± 25.3 mmHg, p = 0.008).ConclusionExercise systolic BP values in patients with mild therapy-resistant hypertension are reduced after RSD as compared to a sham-procedure. More... »

PAGES

592-600

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00392-015-0955-8

DOI

http://dx.doi.org/10.1007/s00392-015-0955-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1011081657

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26728060


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33 schema:description IntroductionDespite the ongoing debate on the role of renal sympathetic denervation (RSD) in the management of therapy-resistant hypertension, little is known about its possible effects on exercise blood pressure (BP), a known predictor for future cardiovascular events. We sought to evaluate the effect of RSD on exercise BP in a randomized, sham-controlled trial in patients with mild hypertension.Methods and resultsPatients with therapy-resistant mild hypertension (defined by mean daytime systolic BP between 135 and 149 mmHg or mean daytime diastolic BP between 90 and 94 mmHg on 24-h ambulatory BP measurement) were randomized to either radiofrequency-based RSD or a sham procedure. Patients underwent cardiopulmonary exercise testing at baseline and after 6 months. Of the 71 patients randomized, data from cardiopulmonary exercise testing were available for 48 patients (22 in the RSD group, 26 in the sham group). After 6 months, patients undergoing RSD had a significantly lower systolic BP at maximum exercise workload compared to baseline (−14.2 ± 26.1 mmHg, p = 0.009). In contrast, no change was observed in the sham group (0.6 ± 22.9 mmHg, p = 0.45, p = 0.04 for between-group comparison). When analyzing patients with exaggerated baseline exercise BP only, the effect was even more pronounced (RSD vs. sham −29.5 ± 23.4 vs. 0.1 ± 25.3 mmHg, p = 0.008).ConclusionExercise systolic BP values in patients with mild therapy-resistant hypertension are reduced after RSD as compared to a sham-procedure.
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40 IntroductionDespite
41 ResultsPatients
42 baseline
43 blood pressure
44 cardiopulmonary exercise
45 cardiopulmonary exercise testing
46 cardiovascular events
47 changes
48 contrast
49 data
50 debate
51 denervation
52 effect
53 effect of RDN
54 events
55 exercise
56 exercise blood pressure
57 exercise testing
58 exercise workload
59 future cardiovascular events
60 group
61 hypertension
62 insights
63 lower systolic blood pressure
64 management
65 maximum exercise workload
66 method
67 mild hypertension
68 months
69 ongoing debate
70 patients
71 possible effects
72 predictors
73 pressure
74 procedure
75 renal denervation
76 renal sympathetic denervation
77 role
78 sham group
79 sham procedure
80 sham-controlled trial
81 sympathetic denervation
82 systolic BP values
83 systolic blood pressure
84 testing
85 therapy-resistant hypertension
86 trials
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