Predictors for success in renal denervation-a single centre retrospective analysis

Abstract

Renal denervation (RDN) is one of the most frequently used invasive methods for the treatment of arterial hypertension. However, recent randomized sham-controlled studies raised concern about the efficacy and predictability of response. We retrospectively analyzed outcomes of patients, who underwent RDN in our hypertension center between November 2010 and April 2014 and report here outcomes twelve months after procedure based on 24-hours ambulatory blood pressure monitoring. We defined ten-mm Hg decrease in office systolic blood pressure (SBP) as a cut-off for response and looked for possible predictors of this response using binary multiple regression analysis. 42 patients were included. Their mean age was 59.6 +/- 9.2 years and 24% were female. Baseline office SBP and diastolic blood pressure (DBP) were 164.1 +/- 20.3 and 91.8 +/- 12.4 mm Hg respectively. Mean 24 h-SBP significantly decreased from 149.8 +/- 13.3 mm Hg to 141.2 +/- 14.6 mm Hg. Mean 24 h-DBP significantly decreased from 83.3 +/- 11.7 mm Hg to 78.8 +/- 11.2 mm Hg. A higher level of mean 24 h-DBP and office DBP was shown to be predictive for response in office BP and a higher level of mean 24 h-DBP for response in 24 h-SBP and 24 h-DBP. Further properly designed randomized trials are warranted to confirm this finding as well as further investigate the role of diabetes mellitus and arterial stiffness in RDN.