Mechanisms underlying the effects of renal denervation in renovascular hypertension

Carlström, Mattias; Braga, Valdir A.

doi:10.1038/s41440-019-0233-7

Cited by 4 publications

(1 citation statement)

References 14 publications

(19 reference statements)

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“…In addition to the brain mechanisms that clearly involves inflammation and ROS accumulation, specially in the RVLM as documented here, we cannot rule out the participation of the renal afferents contributing to the effects induced by augmented Ang-II in the 2K1C model. Actually, recent studies by Nishi et al (2018) and by our group (Carlstrom and Braga, 2019) have documented and discussed, respectively, the important role of the renal afferent in the 2K1C model of hypertension. Authors demonstrated that renal denervation of the ischemic kidney blunts the increase of ROS in brain areas involved in cardiovascular control such as the PVN and the RVLM.…”

Section: Discussionmentioning

confidence: 98%

Central Inhibition of Tumor Necrosis Factor Alpha Reduces Hypertension by Attenuating Oxidative Stress in the Rostral Ventrolateral Medulla in Renovascular Hypertensive Rats

et al. 2019

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Inflammation in the central nervous system is being considered a key player linked to neurogenic hypertension. Using combined in vivo and in vitro approaches, we investigated the effects of central inhibition of TNF-α on blood pressure, sympathetic tone, baroreflex sensitivity, and oxidative stress in the rostral ventrolateral medulla (RVLM) of rats with 2-kidney-1-clip (2K1C) renovascular hypertension. Continuous infusion of pentoxifylline, a TNF-α inhibitor, into the lateral ventricle of the brain for 14 consecutive days reduced blood pressure and improved baroreflex sensitivity in renovascular hypertensive rats. Furthermore, central TNF-α inhibition reduced sympathetic modulation and blunted the increased superoxide accumulation in the RVLM of 2K1C rats. Our findings suggest that TNF-α play an important role in the maintenance of sympathetic vasomotor tone and increased oxidative stress in the RVLM during renovascular hypertension.

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Section: Discussionmentioning

confidence: 98%

Central Inhibition of Tumor Necrosis Factor Alpha Reduces Hypertension by Attenuating Oxidative Stress in the Rostral Ventrolateral Medulla in Renovascular Hypertensive Rats

et al. 2019

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Does renal denervation require cardiovascular outcome-driven data?

Haider,

Wagener,

Iqbal

et al. 2024

Hypertens Res

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Hypertension is a major driver of cardiovascular disease with a prevalence of 32–34% in adults worldwide. This poses a formidable unmet challenge for healthcare systems, highlighting the need for enhanced treatment strategies. Since 2017, eight major sham-controlled randomised controlled trials have examined the effectiveness and safety of renal denervation (RDN) as therapy for BP control. Although most trials demonstrated a reduction in systolic 24-hour/daytime ambulatory BP compared to control groups, open to discussion is whether major adverse cardiovascular events (MACE)-driven RDN trials are necessary or whether the proof of BP reduction as a surrogate for better cardiovascular outcomes is sufficient. We conducted an analysis of the statistical methods used in various trials to assess endpoint definitions and determine the necessity for MACE-driven outcome data. Such comprehensive analysis provides further evidence to confidently conclude that RDN significantly reduces blood pressure compared to sham controls. Importantly, this enables the interpolation of RDN trial endpoints with other studies that report on outcome data, such as pharmacological trials which demonstrate a significant reduction in MACE risk with a decrease in BP. Moreover, limitations associated with directly evaluating outcome data further support the use of BP as a surrogate endpoint. For example, conducting lengthier trials with larger numbers of participants to ensure robust statistical power presents a substantial challenge to evaluating outcome data. Thus, in light of the crucial need to tackle hypertension, there are notable advantages of considering BP as a surrogate for outcome data.

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miR-27a in Extracellular Vesicles: Is It a Novel Modulator of Hypertension?

Carlström

Braga

2019

American Journal of Hypertension

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Mechanisms underlying the effects of renal denervation in renovascular hypertension

Cited by 4 publications

References 14 publications

Central Inhibition of Tumor Necrosis Factor Alpha Reduces Hypertension by Attenuating Oxidative Stress in the Rostral Ventrolateral Medulla in Renovascular Hypertensive Rats

Central Inhibition of Tumor Necrosis Factor Alpha Reduces Hypertension by Attenuating Oxidative Stress in the Rostral Ventrolateral Medulla in Renovascular Hypertensive Rats

Does renal denervation require cardiovascular outcome-driven data?

miR-27a in Extracellular Vesicles: Is It a Novel Modulator of Hypertension?

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