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Predictors of a reduction in blood pressure after catheter-based renal sympathetic denervation

Session Poster Session 3

Speaker Gintare Neverauskaite Piliponiene

Congress : Acute Cardiovascular Care 2019

  • Topic : interventional cardiology and cardiovascular surgery
  • Sub-topic : Interventional Cardiology - Other
  • Session type : Poster Session
  • FP Number : P823

Authors : G Neverauskaite Piliponiene (Vilnius,LT), A Berukstis (Vilnius,LT), A Laucevicius (Vilnius,LT)

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Authors:
G Neverauskaite Piliponiene1 , A Berukstis2 , A Laucevicius2 , 1Vilnius University, Faculty of Medicine - Vilnius - Lithuania , 2Vilnius University, Clinic of Heart and Vessel Diseases, Institute of Clinical Medicine Faculty of Medicine - Vilnius - Lithuania ,

Citation:

Background/introduction: Renal sympathetic denervation (RSD) is a new method in treatment of resistant hypertension (RH). It is not clear who benefit most from the treatment with catheter-based RSD and why some patients have no changes in their blood pressures after the procedure.
Purpose: To identify predictors for BP variations in RH patients after RSD and evaluate BP changes.
Methods: A prospective cohort study of 73 patients with RH who had RSD performed from 2012 to 2017. Patients’ office and 24-hour blood pressure were measured before the procedure and 1, 3, 6 months after the RSD. Linear mixed model was used to assess predictors for office and 24-hour blood pressure change 6 months after RSD. The model had incorporated factors such as age, sex, body mass index (BMI), number of renal ablations (RA) and baseline BP.
Results: Blood pressure 6 month after procedure dropped from 190/107 ±22/13 to 156/90 ±25/12 mm Hg (p<0.001). 24-hour ambulatory blood pressure at month 6 dropped from 163/97 ±18/14 to 149/90 ±20/10 mm Hg (p<0.001).Predictors for office systolic BP reduction after 6 months were age and baseline systolic BP. More rapid BP reduction was observed in younger patients (<61 vs. >61), by average of -21.95 mm Hg, p=0.0008. Baseline office systolic BP group >210 mm Hg showed more rapid downward over time than group =170 mmHg, by average of -34,11 mm Hg, p<0.0005. The only predictor for diastolic office BP reduction 6 months was baseline BP. Patients diastolic office baseline BP group >115 mm Hg showed a significant greater reduction than BP group =100 mm Hg at baseline, by average of -17.15 mm Hg, p=0.0001. Higher reduction in 24-hour systolic BP after 6 months was noticed for women, by average of -11.34 mm Hg, p=0.0128. Larger 24-hour systolic BP reduction was noticed in younger patients (<61 vs. >61), by average of -20.09 mm Hg, p<0.001. Higher 24-hour baseline systolic BP (>170 mm Hg) showed a greater BP reduction after 6 months as compared with =170 mm Hg baseline 24-hour systolic BP, by average of -16.33 mm Hg, (p=0.0026). Greater 24-hour baseline diastolic BP reduction after 6 months was seen in patients with diastolic BP >100 mm Hg, average -11.78 mm Hg, p=0.0008. Patients aged < 61 sustained a more rapid drop in 24-hour diastolic BP than those aged >61, by average of -11,91 mmHg, (p=0.003).No significant difference in any BP after 6 months was found between patients with a different number of ablations and BMIs.
Conclusions: Based on patient randomisation for the catheter-based RSD procedure, the best results might be expected in patients with higher baseline BP values and younger age. A more considerable reduction in BP among patients under 61 was noticed.



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