Renal sympathetic denervation lowers systemic vascular resistance in true treatment-resistant hypertension

Autor: Kaja K. Bergo, Anne C. Larstorp, Pavel Hoffmann, Ulla Hjørnholm, Alessandro Cataliotti, Aud Høieggen, Morten Rostrup, Fadl Elmula M. Fadl Elmula
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Blood Pressure, Vol 30, Iss 1, Pp 31-40 (2021)
Druh dokumentu: article
ISSN: 0803-7051
1651-1999
08037051
DOI: 10.1080/08037051.2020.1789446
Popis: Purpose Renal sympathetic denervation (RDN) is again gaining interest as recent well-designed trials have demonstrated reduced ambulatory blood pressure (BP) after RDN. However, the hemodynamic mechanisms have not been elucidated. We aimed for the first time to investigate the effect of RDN on the “Hallmark of Hypertension” namely increased systemic vascular resistance index (SVRI). Materials and methods We investigated SVRI change in patients with true treatment-resistant hypertension randomised to RDN (n = 9) or drug adjusted control (n = 9). Treatment-resistant hypertension was defined as office systolic BP ≥ 140 mmHg despite ≥ 3 antihypertensive drugs including a diuretic. True treatment-resistant hypertension was confirmed prior to inclusion with ambulatory daytime systolic BP ≥ 135 mmHg immediately after witnessed intake of antihypertensive drugs. Hemodynamic variables were recorded with thoracic impedance cardiography at baseline and at three and six months follow-up after RDN. This non-invasive method also guided further tailoring of drug treatment in the control group aiming to normalise hemodynamic variables and BP. Results From three to six months follow-up after RDN, SVRI decreased with a median of −611 dyn*s*m2/cm5 [IQR −949 to −267] (p
Databáze: Directory of Open Access Journals
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