Renal Denervation by Ablation with Innovative Technique in Resistant Hypertension

Bortolotto, Luiz Aparecido; Midlej-Brito, Thiago; Pisani, Cristiano; Costa-Hong, Valéria

doi:10.5935/abc.20130194

Cited by 3 publications

(2 citation statements)

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“…Patients with RH have even higher risk of cardiovascular complications than hypertensive patients 10 . It is estimated that 10-20% of people with hypertension are resistant, underscoring the importance of understanding the determinants of this condition [11][12][13] .…”

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Association of the genetic ancestry with resistant hypertension in the ReHOT (Resistant Hypertension Optimal Treatment) randomized study

Bueno

Pereira

Santos

et al. 2020

Sci Rep

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Resistant hypertension (RH) is defined as uncontrolled blood pressure despite treatment with three or more antihypertensive medications, including, if tolerated, a diuretic in adequate doses. it has been widely known that race is associated with blood pressure control. However, intense debate persists as to whether this is solely explained by unadjusted socioeconomical variables or genetic variation. in this scenario, the main aim was to evaluate the association between genetic ancestry and resistant hypertension in a large sample from a multicenter trial of stage ii hypertension, the ReHot study. Samples from 1,358 patients were analyzed, of which 167 were defined as resistant hypertensive. Genetic ancestry was defined using a panel of 192 polymorphic markers. The genetic ancestry was similar in resistant (52.0% European, 36.7% African and 11.3% Amerindian) and nonresistant hypertensive patients (54.0% European, 34.4% African and 11.6% Amerindian) (p > 0.05). However, we observed a statistically suggestive association of African ancestry with resistant hypertension in brown patient group. in conclusion, increased African genetic ancestry was not associated with RH in Brazilian patients from a prospective randomized hypertension clinical trial.likely to be black 8 . Some variables, such as advanced age, increased body mass index, male gender, genetic variants and others chronic diseases were also associated with RH or uncontrolled hypertension [28][29][30][31] .On the other hand, some studies, including the present study, did not find an association of self-reported race/ color with RH. A study with 9,361 hypertensive patients from the US, did not find differences in RH proportions according to race 32 . In addition, a meta-analysis, which analyzed the global prevalence of RH from data of 3.2 million patients, did not observe differences 33 . Some studies have observed genetic variants associated with risk for resistant hypertension 2,34,35 . However, to the best of our knowledge, studies of genetic ancestry and RH are not identified in the literature. Our hypothesis was that an increased proportion of African ancestry might be a risk factor for RH, in the overall group or even in subgroups among self-declared race/color, but this was not confirmed. However, in brown patient group, we identified a statistically suggestive association of African ancestry with resistant hypertension. This statistically suggestive association suggests that the criteria applied to segregate the race/color groups, according Brazilian Institute of Geography and Statistics, are possibly distorting the real distribution and, at least in part, leading a limitation for dividing into homogeneous groups. Thus, further investigations and new hypothesis should be tested to elucidate possible associations.The prevalence and incidence of RH will grow considerably because there is a large number of overweight/ obese individuals 36 . In addition, the cutoff blood pressure criteria for RH was reduced from 140/90 mmHg to < 130/80 mmHg 9 . Thus, prev...

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confidence: 99%

Association of the genetic ancestry with resistant hypertension in the ReHOT (Resistant Hypertension Optimal Treatment) randomized study

Bueno

Pereira

Santos

et al. 2020

Sci Rep

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“…A HR é a pressão arterial não controlada, apesar do tratamento com três ou mais medicamentos anti-hipertensivos, incluindo, se tolerado, um diurético em doses adequadas 53,54 . Pacientes com HR apresentam risco ainda maior de complicações cardiovasculares 48 e estima-se que 10-20% das pessoas com hipertensão são resistentes, ressaltando a importância de compreender os determinantes da doença [55][56][57] .…”

Section: Estudos De Ancestralidade Genéticaunclassified

Avaliações farmacometabolômicas e de ancestralidade genética em pacientes hipertensos de um estudo clínico randomizado

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Catheter-based renal sympathetic nerve denervation on hypertension management outcomes

Singh¹,

Varghese²,

Qureshi³

et al. 2022

WJR

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BACKGROUND Renal sympathetic denervation (RSD) provides a minimally invasive interventional treatment modality for patients with resistant hypertension. However, the post-operative outcomes remain a key area of investigation since its earliest clinical trials. AIM To evaluate patient outcomes after RSD intervention among peer-reviewed patient cases. METHODS A systematic review of literature on MEDLINE, Google Scholar, and the Cochrane Database of Systematic Reviews for RSD case studies to assess post-operative hypertension readings and medical management. RESULTS Among 51 RSD cases, the post-operative RSD patients report an apparent reduction with a mean number of 3.1 antihypertensive medications. The mean systolic arterial blood pressure 1 year following RSD was 136.0 mmHg (95%CI: 118.7-153.3). CONCLUSION The apparent improvements in office systolic blood pressure after 12 month post-operative RSD can support the therapeutic potential of this intervention for blood pressure reduction. Additional studies which utilized a uniform methodology for blood pressure measurement can further support the findings of this systematic review.

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Renal Denervation by Ablation with Innovative Technique in Resistant Hypertension

Cited by 3 publications

References 11 publications

Association of the genetic ancestry with resistant hypertension in the ReHOT (Resistant Hypertension Optimal Treatment) randomized study

Association of the genetic ancestry with resistant hypertension in the ReHOT (Resistant Hypertension Optimal Treatment) randomized study

Avaliações farmacometabolômicas e de ancestralidade genética em pacientes hipertensos de um estudo clínico randomizado

Catheter-based renal sympathetic nerve denervation on hypertension management outcomes

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