eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
3/2018
vol. 14
 
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abstract:
Original paper

Clinical factors predicting blood pressure reduction after catheter-based renal denervation

Krzysztof Bartus, Radosław Litwinowicz, Jerzy Sadowski, Wojciech Zajdel, Maciej Brzeziński, Magdalena Bartus, Paweł Kleczyński, Stanislaw Bartus, Dhanunjaya Lakkireddy, Bogusław Kapelak

Adv Interv Cardiol 2018; 14, 3 (53): 270–275
Online publish date: 2018/09/21
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Introduction
Renal denervation (RD) can lead to a significant and sustained decrease in mean values of arterial blood pressure (BP). However, there is still a subset of patients without a significant BP drop after RD (non-responders).

Aim
To compare characteristics of RD responders to RD non-responders and to identify the clinical predictors of BP reduction.

Material and methods
Thirty-one patients with diagnosed resistant hypertension underwent RD. Three years after RD the analysis of BP reduction was performed in regard to the baseline patient characteristics.

Results
After 3 years’ follow-up a 10% or more reduction of systolic baseline BP was observed in 74% of patients. Ten percent or more reduction of diastolic baseline BP was observed in 71% of patients. Among responders we observed the following risk factors: hypercholesterolemia in 70%, body mass index (BMI) > 30 kg/m2 in 55%, diabetes mellitus in 35%, current smoking in 5%. Comorbidity included coronary artery disease (CAD) in 30%, cardiomyopathy in 10%, chronic obstructive pulmonary disease (COPD) in 10%, renal insufficiency in 10%, and ventricular arrhythmia in 5%. Among non-responders we observed the following risk factors: hypercholesterolemia in 38%, diabetes mellitus type 2 in 38% and BMI > 30 kg/m2 in 86%. Comorbidity included CAD in 50% and cardiomyopathy in 13% of patients.

Conclusions
A 10% reduction of systolic baseline BP was observed in 74% of patients 3 years after renal denervation. Clinical factors like COPD, chronic kidney disease 3a, female sex and hypercholesterolemia increase the chances of effective reduction of BP.

keywords:

hypertension, resistant hypertension, renal denervation

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