Impact of renal denervation on 24-hour blood pressure pattern in patients with resistant hypertension

Abstract

Aim. To estimate the dynamics of 24-hour blood pressure pattern in patients with resistant hypertension after renal denervation in comparison with the conservative treatment group.Methods. We enrolled 45 patients (21 men and 24 women, mean age 53 (43-66) years) with resistant hypertension. Renal denervation was performed in 25 patients using Vessix renal denervation system while the conservative treatment group included 20 patients. Monitoring of 24-hour blood pressure pattern was performed before renal denervation and after 1 year of follow-up.Results. Twelve months after renal denervation, patients with resistant hypertension had a significant reduction in office blood pressure (33 and 15 mmHg for systolic and diastolic blood pressure, respectively) and 24-hour average blood pressure (29 and 12 mmHg, for systolic and diastolic blood pressure, respectively). Another beneficial effect of renal denervation was a decrease in systolic blood pressure variability both throughout the day and at night (6 (5-12) and 7 (7-10) mmHg, respectively); however, no changes in diastolic blood pressure variability have been registered. Despite renal denervation did not affect the morning blood pressure surge, morning systolic blood pressure reduced from 174 (130180) mmHg to 156 (130-165) mmHg. After 1 year of follow-up, the proportion of dippers increased from 16 to 44%. In contrast to the patients who underwent renal denervation, there were no significant changes in 24-hour blood pressure pattern in the conservative treatment group.Conclusion. After 1 year of follow-up, renal denervation can be considered as an option superior to conservative treatment in patients with resistant hypertension, as it significantly improved 24-hour blood pressure pattern.