Abstract 15204: Ambulatory Blood Pressure and Dipping-Pattern After Catheter-Based Renal Sympathetic Denervation in Patients with Resistant Hypertension
Background Catheter-based renal sympathetic denervation (RD) in patients with resistant hypertension has been shown to reduce sympathetic drive and office blood pressure. Ambulatory blood pressure monitoring (ABPM) is mandatory in every patient with uncontrolled hypertension. Nighttime blood pressure and non-dipping is associated with cardiovascular morbidity and mortality. The influence of RD on ambulatory blood pressure (ABPM) and dipping pattern has not been studied in details.
Methods and Results Eighty patients with resistant hypertension were included in the study. Systolic and diastolic blood pressure (SBP/DBP) as well as ABPM (SBP/DBP average, SBP/DBP daytime, SBP/DBP nighttime, heart rate (HR) average) and dipping-pattern were analyzed prior to, and at 3 and 6 months follow-up. RD reduced office SBP and DBP at 3 and 6 months by 20.9/7.1 mmHg and 25.9/8.3 mmHg (p for all <0.001), respectively. After 3 and 6 months 24-hour average SBP/DBP was reduced by 8.6/4.5 mmHg (p=0.019/0.025) and 11.5/6.5 mmHg (p=0.018/0.022), respectively. Average SBP/DBP were lowered at 3 and 6 months follow-up at daytime by 9.2/5.4 mmHg (p=0.010/0.001) and 11.9/7.1 mmHg (p=0.001/0.001) and at nighttime by 6.2/5.1 mmHg (p=0.002/0.004) and 10.2/5.1 mmHg (p=0.001/0.001), respectively. Renal denervation also reduced maximum SBP by -12.8 mmHg at 3 months and by -14.7 mmHg at 6 months follow-up (p=0.009 and 0.003) whereas maximum DBP was not changed. Six months after RD 21 patients had an improvement in their dipping-pattern.
Conclusion Beside significant reductions in office SBP and DBP, RD also reduced 24-hour average, daytime and nighttime SBP and DBP as well as maximum SBP after 3 and 6 months. RD has the impact to improve dipping-pattern in at least some patients.
- © 2012 by American Heart Association, Inc.