Renal denervation in hypertensive patients not on blood pressure lowering drugs

R.L. De Jager, M.F. Sanders, M.L. Bots, M.D. Lobo, S. Ewen, M.M.A. Beeftink, M. Böhm, J. Daemen, O. Dörr, Dagmara Hering, F. Mahfoud, H. Nef, C. Ott, M. Saxena, R.E. Schmieder, Markus Schlaich, W. Spiering, P.A.L. Tonino, W.L. Verloop, E.E. Vink & 4 others E.J. Vonken, M. Voskuil, S.G. Worthley, P.J. Blankestijn

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    Abstract

    © 2016, The Author(s).Introduction: Studies on the blood pressure lowering effect of renal denervation (RDN) in resistant hypertensive patients have produced conflicting results. Change in medication usage during the studies may be responsible for this inconsistency. To eliminate the effect of medication usage on blood pressure we focused on unmedicated hypertensive patients who underwent RDN. Methods and results: Our study reports on a cohort of patients, who were not on blood pressure lowering drugs at baseline and during follow-up, from eight tertiary centers. Data of patients were used when they were treated with RDN and had a baseline office systolic blood pressure (SBP) =140 mmHg and/or 24-h ambulatory SBP =130 mmHg. Our primary outcome was defined as change in office and 24-h SBP at 12 months after RDN, compared to baseline. Fifty-three patients were included. There were three different reasons for not using blood pressure lowering drugs: (1) documented intolerance or allergic reaction (57 %); (2) temporary cessation of medication for study purposes (28 %); and (3) reluctance to take antihypertensive drugs (15 %). Mean change in 24-h SBP was -5.7 mmHg [95 % confidence interval (CI) -11.0 to -0.4; p = 0.04]. Mean change in office SBP was -13.1 mmHg (95 % CI -20.4 to -5.7; p = 0.001). No changes were observed in other variables, such as eGFR, body–mass-index and urinary sodium excretion. Conclusion: This explorative study in hypertensive patients, who are not on blood pressure lowering drugs, suggests that at least in some patients RDN lowers blood pressure.
    Original languageEnglish
    Pages (from-to)755-762
    JournalClinical Research in Cardiology
    Volume105
    Issue number9
    DOIs
    Publication statusPublished - 2016

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    Denervation
    Blood Pressure
    Kidney
    Pharmaceutical Preparations
    Confidence Intervals
    Antihypertensive Agents

    Cite this

    De Jager, R. L., Sanders, M. F., Bots, M. L., Lobo, M. D., Ewen, S., Beeftink, M. M. A., ... Blankestijn, P. J. (2016). Renal denervation in hypertensive patients not on blood pressure lowering drugs. Clinical Research in Cardiology, 105(9), 755-762. https://doi.org/10.1007/s00392-016-0984-y
    De Jager, R.L. ; Sanders, M.F. ; Bots, M.L. ; Lobo, M.D. ; Ewen, S. ; Beeftink, M.M.A. ; Böhm, M. ; Daemen, J. ; Dörr, O. ; Hering, Dagmara ; Mahfoud, F. ; Nef, H. ; Ott, C. ; Saxena, M. ; Schmieder, R.E. ; Schlaich, Markus ; Spiering, W. ; Tonino, P.A.L. ; Verloop, W.L. ; Vink, E.E. ; Vonken, E.J. ; Voskuil, M. ; Worthley, S.G. ; Blankestijn, P.J. / Renal denervation in hypertensive patients not on blood pressure lowering drugs. In: Clinical Research in Cardiology. 2016 ; Vol. 105, No. 9. pp. 755-762.
    @article{a62ba18ab1fc4eb8a201a544e869c678,
    title = "Renal denervation in hypertensive patients not on blood pressure lowering drugs",
    abstract = "{\circledC} 2016, The Author(s).Introduction: Studies on the blood pressure lowering effect of renal denervation (RDN) in resistant hypertensive patients have produced conflicting results. Change in medication usage during the studies may be responsible for this inconsistency. To eliminate the effect of medication usage on blood pressure we focused on unmedicated hypertensive patients who underwent RDN. Methods and results: Our study reports on a cohort of patients, who were not on blood pressure lowering drugs at baseline and during follow-up, from eight tertiary centers. Data of patients were used when they were treated with RDN and had a baseline office systolic blood pressure (SBP) =140 mmHg and/or 24-h ambulatory SBP =130 mmHg. Our primary outcome was defined as change in office and 24-h SBP at 12 months after RDN, compared to baseline. Fifty-three patients were included. There were three different reasons for not using blood pressure lowering drugs: (1) documented intolerance or allergic reaction (57 {\%}); (2) temporary cessation of medication for study purposes (28 {\%}); and (3) reluctance to take antihypertensive drugs (15 {\%}). Mean change in 24-h SBP was -5.7 mmHg [95 {\%} confidence interval (CI) -11.0 to -0.4; p = 0.04]. Mean change in office SBP was -13.1 mmHg (95 {\%} CI -20.4 to -5.7; p = 0.001). No changes were observed in other variables, such as eGFR, body–mass-index and urinary sodium excretion. Conclusion: This explorative study in hypertensive patients, who are not on blood pressure lowering drugs, suggests that at least in some patients RDN lowers blood pressure.",
    author = "{De Jager}, R.L. and M.F. Sanders and M.L. Bots and M.D. Lobo and S. Ewen and M.M.A. Beeftink and M. B{\"o}hm and J. Daemen and O. D{\"o}rr and Dagmara Hering and F. Mahfoud and H. Nef and C. Ott and M. Saxena and R.E. Schmieder and Markus Schlaich and W. Spiering and P.A.L. Tonino and W.L. Verloop and E.E. Vink and E.J. Vonken and M. Voskuil and S.G. Worthley and P.J. Blankestijn",
    year = "2016",
    doi = "10.1007/s00392-016-0984-y",
    language = "English",
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    De Jager, RL, Sanders, MF, Bots, ML, Lobo, MD, Ewen, S, Beeftink, MMA, Böhm, M, Daemen, J, Dörr, O, Hering, D, Mahfoud, F, Nef, H, Ott, C, Saxena, M, Schmieder, RE, Schlaich, M, Spiering, W, Tonino, PAL, Verloop, WL, Vink, EE, Vonken, EJ, Voskuil, M, Worthley, SG & Blankestijn, PJ 2016, 'Renal denervation in hypertensive patients not on blood pressure lowering drugs' Clinical Research in Cardiology, vol. 105, no. 9, pp. 755-762. https://doi.org/10.1007/s00392-016-0984-y

    Renal denervation in hypertensive patients not on blood pressure lowering drugs. / De Jager, R.L.; Sanders, M.F.; Bots, M.L.; Lobo, M.D.; Ewen, S.; Beeftink, M.M.A.; Böhm, M.; Daemen, J.; Dörr, O.; Hering, Dagmara; Mahfoud, F.; Nef, H.; Ott, C.; Saxena, M.; Schmieder, R.E.; Schlaich, Markus; Spiering, W.; Tonino, P.A.L.; Verloop, W.L.; Vink, E.E.; Vonken, E.J.; Voskuil, M.; Worthley, S.G.; Blankestijn, P.J.

    In: Clinical Research in Cardiology, Vol. 105, No. 9, 2016, p. 755-762.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Renal denervation in hypertensive patients not on blood pressure lowering drugs

    AU - De Jager, R.L.

    AU - Sanders, M.F.

    AU - Bots, M.L.

    AU - Lobo, M.D.

    AU - Ewen, S.

    AU - Beeftink, M.M.A.

    AU - Böhm, M.

    AU - Daemen, J.

    AU - Dörr, O.

    AU - Hering, Dagmara

    AU - Mahfoud, F.

    AU - Nef, H.

    AU - Ott, C.

    AU - Saxena, M.

    AU - Schmieder, R.E.

    AU - Schlaich, Markus

    AU - Spiering, W.

    AU - Tonino, P.A.L.

    AU - Verloop, W.L.

    AU - Vink, E.E.

    AU - Vonken, E.J.

    AU - Voskuil, M.

    AU - Worthley, S.G.

    AU - Blankestijn, P.J.

    PY - 2016

    Y1 - 2016

    N2 - © 2016, The Author(s).Introduction: Studies on the blood pressure lowering effect of renal denervation (RDN) in resistant hypertensive patients have produced conflicting results. Change in medication usage during the studies may be responsible for this inconsistency. To eliminate the effect of medication usage on blood pressure we focused on unmedicated hypertensive patients who underwent RDN. Methods and results: Our study reports on a cohort of patients, who were not on blood pressure lowering drugs at baseline and during follow-up, from eight tertiary centers. Data of patients were used when they were treated with RDN and had a baseline office systolic blood pressure (SBP) =140 mmHg and/or 24-h ambulatory SBP =130 mmHg. Our primary outcome was defined as change in office and 24-h SBP at 12 months after RDN, compared to baseline. Fifty-three patients were included. There were three different reasons for not using blood pressure lowering drugs: (1) documented intolerance or allergic reaction (57 %); (2) temporary cessation of medication for study purposes (28 %); and (3) reluctance to take antihypertensive drugs (15 %). Mean change in 24-h SBP was -5.7 mmHg [95 % confidence interval (CI) -11.0 to -0.4; p = 0.04]. Mean change in office SBP was -13.1 mmHg (95 % CI -20.4 to -5.7; p = 0.001). No changes were observed in other variables, such as eGFR, body–mass-index and urinary sodium excretion. Conclusion: This explorative study in hypertensive patients, who are not on blood pressure lowering drugs, suggests that at least in some patients RDN lowers blood pressure.

    AB - © 2016, The Author(s).Introduction: Studies on the blood pressure lowering effect of renal denervation (RDN) in resistant hypertensive patients have produced conflicting results. Change in medication usage during the studies may be responsible for this inconsistency. To eliminate the effect of medication usage on blood pressure we focused on unmedicated hypertensive patients who underwent RDN. Methods and results: Our study reports on a cohort of patients, who were not on blood pressure lowering drugs at baseline and during follow-up, from eight tertiary centers. Data of patients were used when they were treated with RDN and had a baseline office systolic blood pressure (SBP) =140 mmHg and/or 24-h ambulatory SBP =130 mmHg. Our primary outcome was defined as change in office and 24-h SBP at 12 months after RDN, compared to baseline. Fifty-three patients were included. There were three different reasons for not using blood pressure lowering drugs: (1) documented intolerance or allergic reaction (57 %); (2) temporary cessation of medication for study purposes (28 %); and (3) reluctance to take antihypertensive drugs (15 %). Mean change in 24-h SBP was -5.7 mmHg [95 % confidence interval (CI) -11.0 to -0.4; p = 0.04]. Mean change in office SBP was -13.1 mmHg (95 % CI -20.4 to -5.7; p = 0.001). No changes were observed in other variables, such as eGFR, body–mass-index and urinary sodium excretion. Conclusion: This explorative study in hypertensive patients, who are not on blood pressure lowering drugs, suggests that at least in some patients RDN lowers blood pressure.

    U2 - 10.1007/s00392-016-0984-y

    DO - 10.1007/s00392-016-0984-y

    M3 - Article

    VL - 105

    SP - 755

    EP - 762

    JO - Clinical Research in Cardiology

    JF - Clinical Research in Cardiology

    SN - 0300-5860

    IS - 9

    ER -