Effects of renal sympathetic denervation on blood pressure and glycaemic control in patients with true resistant hypertension: results of Polish Renal Denervation Registry (RDN-POL Registry)

Abstract

A b s t r a c t Background and aim:The assessment of percutaneous renal sympathetic denervation (RDN) efficacy in patients with true-resistant hypertension (true-RH) in a newly established net of Polish centres (RDN-POL Registry). Methods and results:Forty-four patients with true-RH (23 men, mean age 52.3 years) with daytime systolic blood pressure (SBP) in ambulatory blood pressure monitoring (ABPM) ≥ 135 mm Hg, on ≥ three antihypertensive agents, including diuretic, underwent RDN and completed 12-month follow-up. Mean reductions of office SBP/diastolic blood pressure were -23.8/-10.0, -12.5/-4.6, and -12.6/-6.1 mm Hg at 3, 6, and 12 months, respectively (all significant except diastolic at 6 months). Diabetes was the only predictor of office SBP reduction at 6 months (OR 9.6, 95% CI 1.4-66.5, p < 0.05). Mean 24-h SBP change was -8.3 mm Hg at 6 months and -4.6 mm Hg at 12 months. Increased 2 h-glucose in oral glucose tolerance test was the only predictor of 24-h SBP reduction at 6 months (OR 1.24 for 10 mg/dL glucose increase, 95% CI 1.04-1.48, p < 0.05). At 12 months, 24-h SBP change predictors were: baseline office SBP (OR 4.93 for 10 mm Hg SBP increment, 95% CI 1.01-24.1, p < 0.05) and 2 h-glucose (OR 1.47, 95% CI 1.08-2.00, p < 0.05). In ABPM responders, significant reduction of 2 h glucose was found as compared to the non-responders (-45.8 vs. -7.7 mg/dL, p < 0.005). Conclusions:The RDN-POL Registry demonstrated moderate blood pressure decrease after RDN. The predictors of blood pressure reduction were diabetes, 2 h-glucose, and baseline office SBP. Analysis of ABPM responders indicates a probable positive impact of RDN on glycaemic control.

Renal artery sympathetic nerve radiofrequency denervation

“…Another study performed on a Polish population is the Polish Renal Denervation registry [28]. In this study at 12-month follow-up the mean 24-h systolic BP change was -8.3 mm Hg at six months and -4.6 mm Hg at 12 months.…”

Denervation of the renal arteries — what next?

“…Finally, we obtained results of the first Polish registry RDN-POL [14]. Forty-four patients with true resistant hypertension (23 men, mean age 52.3 years) with daytime SBP in ABPM ≥ 135 mm Hg, on ≥ 3 antihypertensive agents, including diuretic, underwent RDN and completed 12-month follow-up.…”

Experience of using multielectrode catheter systems to perform radiofrequency renal sympathetic denervation in patients with resistant hypertension: immediate procedural effects

“…Вместе с тем, полученные нами результаты внушают и оптимизм: если уровень глюкозы натощак невысок, даже при наличии СД мы вправе рассчитывать по крайней мере на краткосрочную результативность процедуры. Необходимым мы считаем оценку этой связи в нашей когорте пациентов в более отдаленном периоде, потому как исследователи из Европы сообщают противоречивые результаты: если в польском регистре пациентов RDN-POL [44] более высокий уровень гликемии натощак и наличие в анамнезе СД являлись независимыми предик торами снижения 24-часового АД через 3-12 мес., то в недавнем анализе немецкой базы данных пациентов после РЧ РД, чем ниже было исходное значение гликированного гемоглобина, тем выше была вероятность успеха процедуры спустя 6 мес. [45].…”