Predictors of blood pressure response: Obesity is associated with a less pronounced treatment response after renal denervation

Dani Id, Stefan C. Bertog, Ann Kathrin Ziegler, Marius Hornung, Ilona Hofmann, Laura Vaskelyte, Predrag Matic, Sameer Gafoor, Horst Sievert

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Objectives The purpose of this study was to identify predictors of BP response. Background Catheter-based renal denervation (RDN) causes significant blood pressure (BP) reductions in a large number of patients with resistant hypertension. Methods One hundred one consecutive patients with resistant hypertension who underwent RDN with the Symplicity™ catheter were included in this retrospective study. Primary endpoint was the change in office systolic BP after 6 months. Uni- and multivariate logistic regression analyses were performed to detect baseline predictors of a significant BP response 6 months after RDN (age, gender, office and ambulatory BP, renal function, body mass index [BMI], diabetes mellitus, antihypertensive medication, number of ablations). Results The procedure was technically uneventful in all patients. Mean BP at baseline was 166.6/90.2 ± 22.5/16.4 mmHg and decreased by -14.7 (P < 0.0001)/-5.3 (P < 0.001) ± 22.8/14.1 mm Hg at 6-month follow-up. Similarly, paired analysis of 24-hr-ambulatory BP measurement (n = 71) showed a significant reduction of mean systolic BP by 6.8 ± 14.4 mm Hg (P < 0.0002). Upon univariate analyses, a higher baseline office systolic BP (P < 0.0001) and lower BMI (P = 0.014) were identified as significant predictors of the magnitude of BP response after 6 months. Importantly, on multivariate analysis, baseline office systolic BP (standardized ß = -0.46; r = -0.47; P < 0.0001) and BMI (standardized ß = 0.21; r = 0.95; P = 0.019) remained significant. Conclusion Blood pressure reductions after RDN were more pronounced in patients with higher baseline blood pressure and lower BMI. These findings may have implications regarding patient selection for renal denervation.

Original languageEnglish (US)
Pages (from-to)E30-E38
JournalCatheterization and Cardiovascular Interventions
Volume87
Issue number1
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2015 Wiley Periodicals, Inc.

Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.

Keywords

  • ablation
  • hypertension
  • radiofrequency

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