Management of resistant hypertension in a multidisciplinary unit of renal denervation: protocol and results
- PMID: 24775818
- DOI: 10.1016/j.rec.2012.09.006
Management of resistant hypertension in a multidisciplinary unit of renal denervation: protocol and results
Abstract
Introduction and objectives: Resistant hypertension is a clinical problem because of its difficult management and increased morbidity and mortality. Catheter-based renal denervation has been demonstrated to improve control in these patients. The results of establishing a multidisciplinary unit for the implementation of renal denervation in the management of resistant hypertension are described.
Methods: A team of nephrologists and cardiologists created a protocol for patient selection, intervention, and follow-up. One hundred and ninety-seven patients with poorly controlled essential hypertension, despite taking 3 or more drugs, were included. The ablation technique previously described was supported by a navigator based on rotational angiography. Blood pressure at baseline and after follow-up was compared using the Wilcoxon test for paired samples.
Results: One hundred and eight patients (55%) with pseudo-resistant hypertension were excluded. The other 89 were given antialdosteronic drugs, to which 60 patients (30%) responded. The remaining 29 patients (15%) were candidates for denervation. Eleven patients, with blood pressure 164/99 mmHg and taking 4.4 antihypertensive drugs, were ablated. After 72 days of follow-up, systolic and diastolic blood pressure fell by 25 mmHg (P=.02) and 10 mmHg (P=.06), respectively. In 10 patients (91%) at least 1 drug was discontinued.
Conclusions: Renal denervation performed by a multidisciplinary team led to an improvement in blood pressure similar to previous studies, with a greater reduction of antihypertensive drugs.
Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.
Comment in
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Comment on the Management of resistant hypertension in a multidisciplinary unit of renal denervation: protocol and results. Response.Rev Esp Cardiol (Engl Ed). 2013 Oct;66(10):830-1. doi: 10.1016/j.rec.2013.06.003. Epub 2013 Aug 6. Rev Esp Cardiol (Engl Ed). 2013. PMID: 24773870 No abstract available.
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Comment on the Management of resistant hypertension in a multidisciplinary unit of renal denervation: protocol and results.Rev Esp Cardiol (Engl Ed). 2013 Oct;66(10):830. doi: 10.1016/j.rec.2013.05.014. Epub 2013 Jul 24. Rev Esp Cardiol (Engl Ed). 2013. PMID: 24773871 No abstract available.
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