Effects of renal denervation on end organ damage in hypertensive patients

Abstract

Background: Renal denervation (RDN) is believed to reduce sympathetic nerve activity and is a potential treatment for resistant hypertension. The present study investigated the effects of RDN on end organ damage (EOD). Design: The present study was a prospective cohort study (registered as NCT01427049). Methods: Uncontrolled hypertensive patients underwent a work-up prior to and one year after RDN. Cardiac magnetic resonance (CMR) imaging was used to determine left ventricular (LV)-mass; pulse wave analysis and pulse wave velocity (PWV) were used for evaluation of central blood pressure (BP) and arterial stiffness and 24-hour urine was collected for assessment of urinary albumin excretion. The 24-hour ambulatory BP measurement (ABPM) was used to evaluate the effect of RDN on BP. Results: Fifty-four patients gave informed consent for study participation. Mean age was 58±10 years, 50% were male. One year after RDN, mean ABPM decreased by 7±18/5±11mm Hg (p=0.01/p&0.01). In the patients followed-up in a standardised fashion ABPM decreased by 5±18/4±12mm Hg (n=34; p=0.11/p=0.09). Mean body surface area indexed LV-mass decreased by 3.3±11.5 g/m² (corresponding to a 3±11% reduction; p=0.09). PWV increased by 2.9 (-2.2 to 6.1) m/s (p=0.04). Augmentation index corrected for 75 beats per min did not change (median increase 3.0 (-7 to 17) mm Hg; p=0.89). Urinary albumin excretion did not change during follow-up (mean decrease 10±117 mg/ 24 hour; p=0.61). Conclusion: In the current study, we observed a modest effect from renal denervation. Moreover, RDN did not result in a statistical significant effect on end organ damage 12 months after treatment.