Renal denervation safe, effective in lowering office SBP

Renal denervation (RDN) can safely and effectively reduce office systolic blood pressure (OSBP) for up to 36 months after the procedure, a recent South Korea study has found.

Drawing from the Global SYMPLICITY Registry (GSR) Korea, the researchers enrolled 102 patients (mean age 54.9±14.1 years, 69.6 percent men) with uncontrolled hypertension or other conditions characterized by increased sympathetic activity. GSR delivered RDN using a Symplicity Flex catheter. Patients were followed-up for up to 36 months after RDN, during which changes in office BP and antihypertensive medications were assessed.

At baseline, OSBP was 169.8±15.5 mm Hg, while office diastolic BP was 97.0±14.3 mm Hg. Over a mean follow-up duration of 1,045.5±203.5 days, there was a significant and consistent decrease in OSBP. At 6-month follow-up, OSBP dropped by 19.8±17.3 mm Hg, and at 12 months by 26.7±18.5 mm Hg (p<0.001 for both).

The corresponding reduction values at 24 and 36 months were 30.1±21.6 and 32.5±18.8 mm Hg, both statistically significant (p<0.001). No clear changes in the overall use of antihypertensive medications were detected throughout follow-up, though there was a significant decrease in the use of diuretics (p=0.041).

RDN also proved to be a safe procedure, with adverse events infrequently arising throughout the 36-month follow-up period. In particular, there were three cases each of new-onset end-stage renal disease and serum creatinine elevation >50 percent, and two each of stroke, hospitalization for atrial fibrillation, and hospitalization for hypertensive crisis. One death of unknown cause was also recorded.