Denervação simpática renal e qualidade de vida

Abstract

Background: Renal sympathetic denervation (RSD) is a promising strategy in the treatment of resistant hypertension. No studies have assessed the effect of RSD on quality of life in our country, which was the aim of this study. Methods: The EuroQol 5 Dimensions questionnaire (EQ 5D 5L) was chosen to evaluate quality of life in 10 patients undergoing RSD, and it was applied before and 3 months after the procedure. Results: Mean age was 47.3 ± 12 years and 90% of the patients were female. Baseline blood pressure was 187 ± 37.5/104 ± 18.5 mmHg and the number of antihypertensive drugs was 7.6 ± 1.3. Before the procedure, the value assigned to health status was 37.5 ± 22.7, increasing at 3 months to 70.5 ± 20.9 (P = 0.01). In the follow-up, in addition to a decrease in the number of antihypertensive drugs (7.6 ± 1.3 vs. 6 ± 2.2; P = 0.05), a trend towards reduced levels of systolic blood pressure (187 ± 36 mmHg vs 170 ± 44 mmHg; P = 0.10) and diastolic blood pressure (104 ± 18 mmHg vs 98 ± 20 mmHg; P = 0.20) was observed. Health status improvement resulted from a reduction of problems related to mobility, usual activities, pain/discomfort and anxiety/depression. The magnitude of blood pressure reduction was not associated with improved quality in all of the patients. On the other hand, those who had a decrease in the number of antihypertensive drugs reported a better health status. Conclusions: Patients with resistant hypertension have poor health status scores. RSD improved quality of life in most patients. Further studies are required to confirm consistent benefits.

Vivendo mais e melhor: qualidade de vida relacionada saúde

“…The report by Armaganijan et al 7 is a further step both in the study of HRQoL and the performance of renal artery denervation in patients with drug-resistant systemic hypertension in our country. The authors should be congratulated for their initiative in both areas, and certainly further analysis should be undertaken to explore and clarify pending issues.…”

“…In this issue of the Revista Brasileira de Cardiologia Invasiva (Brazilian Journal of Invasive Cardiology) Armaganijan et al 7 report their pioneering experience in the effect of percutaneous renal denervation in the quality of life in patients with chronic hypertension. Evaluating ten patients through the EuroQol tool, it was observed that the magnitude of blood pressure reduction was not associated with better HRQoL, but those who experienced a reduction in the number of antihypertensive drugs reported better health status.…”

“…Another important aspect is the device used for the renal denervation. 7 This information is not available in the manuscript, but it is relevant for the interpretation of the results, as the analysis of a treatment effect on HRQoL cannot be separated from how it is performed and its clinical outcomes.…”