Effects of Renal Denervation Documented in the Austrian National Multicentre Renal Denervation Registry

Abstract

Renal denervation (RDN) is a new procedure for treatment-resistant hypertensive patients. In order to monitor all procedures undergone in Austria, the Austrian Society of Hypertension established the investigator-initiated Austrian Transcatheter Renal Denervation (TREND) Registry. From April 2011 to September 2014, 407 procedures in 14 Austrian centres were recorded. At baseline, office and mean 24-h ambulatory blood pressure (ABP) were 171/94 and 151/89 mmHg, respectively, and patients were taking a median of 4 antihypertensive medications. Mean 24-h ABP changes after 2-6 weeks, 3, 6 and 12 months were -11/-6, -8/-4, -8/-5 and -10/-6 mmHg (p<0.05 at all measurements), respectively. The periprocedural complication rate was 2.5%. Incidence of long-term complications during follow-up (median 1 year) was 0.5%. Office BP and ABP responses showed only a weak correlation (Pearson coefficient 0.303). Based on the data from the TREND registry, ambulatory blood pressure monitoring in addition to office BP should be used for patient selection as well as for monitoring response to RDN. Furthermore, criteria for optimal patient selection are suggested.

Fig 1. Mean office BP changes after RDN over 12 months of follow-up.

Error bars represent standard error of means. ^‡ p<0.001.

Fig 2. Mean 24-h BP changes after RDN over 12 months of follow-up.

Error bars represent standard error of means. ^‡ p<0.001.

Fig 3. Correlation between systolic mean 24-h and office BP changes at baseline and 6 months after procedure (n = 154).

Pearson correlation 0.303 (p<0.001).