Individual-patient visit-by-visit office and ambulatory blood pressure measurements over 24 months in patients undergoing renal denervation for hypertension

BackgroundRenal denervation (RDN) is a promising treatment option in addition to medical antihypertensive treatment in patients suffering from resistant hypertension. Despite the growing interest in RDN, only few long-term results are published so far.MethodsWe systematically investigated the effects of RDN on ABPM in a consecutive series of patients with resistant hypertension out to 24 months. Office BP measurements and ABPM assessment were offered at 3, 6, 12 and 24 months. The patients with an average systolic BP reduction of more than 10 mm Hg in office BP 6 months after RDN were classified as responders. Additional to this classical responder concept, we categorized response to RDN by an individual-patient visit-by-visit evaluation of office BP and 24-hour-BP, separately.ResultsWe included 32 patients. In 21 patients (65.6%) we found a mean systolic BP reduction > 10 mm Hg in office BP six months after RDN. These patients were classified as responders. In responders, mean office BP dropped from 175.3 ± 15.9/96 ± 14.2 mm Hg to 164.8 ± 24.4/93.2 ± 10.4 mm Hg (p = 0.040/p = 0.323) and mean 24-h BP in ABPM decreased from 146.8 ± 17.0/89.1 ± 11 mm Hg to 136.8 ± 15.0/83.2 ± 10.7 mm Hg after 24 months (p = 0.034/p = 0.014).Additionally, we performed a visit-by-visit evaluation of all patients and results were divided in larger-than-median and smaller-than-median response. By this evaluation, we found a high variation of office BP reductions and the 24-hour BP results demonstrated a significant BP reduction in patients with larger-than-median response, which sustained over the 24 months of follow-up.ConclusionsIn contrast to the observed variation of office BP measurements, ABPM demonstrated a reproducible and sustained significant BP reduction in patients with larger-than-median response to RDN.