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. 2024 Oct 23.
doi: 10.1007/s00392-024-02555-7. Online ahead of print.

Long-term safety and efficacy of endovascular ultrasound renal denervation in resistant hypertension: 8-year results from the ACHIEVE study

Victor J M Zeijen  1 , Sebastian Völz  2 , Thomas Zeller  3 , Felix Mahfoud  4 , Michael Kunz  4 , Karl-Heinz Kuck  5 , Bert Andersson  2 , Tobias Graf  5 , Horst Sievert  6 , Philipp Kahlert  7 , Meital Horesh-Bar  8 , Mattie J Lenzen  1 , Isabella Kardys  1 , Joost Daemen  9
Affiliations

Long-term safety and efficacy of endovascular ultrasound renal denervation in resistant hypertension: 8-year results from the ACHIEVE study

Victor J M Zeijen et al. Clin Res Cardiol. .

Abstract

Background: Ultrasound renal sympathetic denervation (uRDN) reduces blood pressure (BP) in the absence and presence of antihypertensive treatment at 2 months. Beyond 3 years, there is a lack of follow-up data. This study investigated the long-term safety and efficacy of uRDN.

Methods: This prospective observational study recruited patients previously included in the international multicenter ACHIEVE study, with office systolic blood pressure (SBP) ≥160 mmHg, 24 h ambulatory SBP ≥130 mmHg, ≥3 antihypertensive drugs and estimated Glomerular Filtration Rate (eGFR) ≥45 ml/min/1.73m2 undergoing uRDN. The primary efficacy outcome was 24 h ambulatory SBP, adjusted for the number of defined daily dosages (DDD) of antihypertensive drugs. Statistical analyses were performed using linear mixed-effects models and inverse probability weighting.

Results: A total of 27 out of the initially enrolled 96 patients underwent prospective follow-up at a median of 8.2 [7.6-8.9] years. Mean age was 62.6±9.3 years (37.0% female). Preprocedural 24 h ambulatory BP was 151.9/84.1±11.5/11.1 mmHg and the median number of DDDs was 5.0 [4.3-7.0]. At 8 years after uRDN, the change in 24 h ambulatory SBP was -19.5 [95%CI -26.7,-12.4] mmHg (p<0.001). The 8-year change in the number of DDDs was -1.7 [-2.8,-0.6] (p = 0.003). The 8-year decline in eGFR was -8.9 [-13.2,-4.7] ml/min/1.73m2 (p<0.001). Clinical event data were available for all 96 patients (median follow-up 3.5 [1.0-8.0] years). Renal failure occurred in one patient and no cases of renal artery stenosis were detected.

Conclusions: A significant BP reduction was observed up until 8 years following uRDN in parallel to a decrease in drug burden over time, in the absence of procedure-related adverse events.

Keywords: Ambulatory; Antihypertensive agents; Blood pressure monitoring; Glomerular Filtration Rate; Hypertension; Renal artery; Sympathectomy.

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References

    1. Blood Pressure Lowering Treatment Trialists C (2021) Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. Lancet. 397(10285):1625–36 - DOI
    1. Ettehad D, Emdin CA, Kiran A, Anderson SG, Callender T, Emberson J et al (2016) Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet. 387(10022):957–67 - DOI - PubMed
    1. Zeijen VJM, Lafeber M, Versmissen J, Kroon AA, Boersma E, Daemen J (2022) Adequacy of blood pressure control in high-risk hypertensive patients: The DEGREE study. Int J Cardiol. 352:137–43 - DOI - PubMed
    1. Risk Factor Collaboration NCD (2021) Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 398(10304):957–80 - DOI
    1. Sprint Research Group, Lewis CE, Fine LJ, Beddhu S, Cheung AK, Cushman WC et al (2021) Final Report of a Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med. 384(20):1921–30 - DOI

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