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Ir J Med Sci. 2016 Aug;185(3):635-41. doi: 10.1007/s11845-015-1324-3. Epub 2015 Jun 19.

The effect of renal sympathetic denervation on nocturnal dipping in patients with resistant hypertension; observational data from a tertiary referral centre in the Republic of Ireland.

Author information

1
Department of Cardiology, Galway University Hospital, Galway, Republic of Ireland. stephen_tuohy@hotmail.com.
2
Department of Cardiology, Galway University Hospital, Galway, Republic of Ireland.
3
Department of Nephrology, Galway University Hospital, Galway, Republic of Ireland.
4
Clinical Research Facility, National University of Ireland, Galway, Republic of Ireland.

Abstract

OBJECTIVE:

Renal sympathetic denervation (RSD) is an emerging device based treatment for patients with resistant hypertension. Nocturnal dipping (ND) is defined as a decrease in BP of 10-20 % during sleep, and has been shown to be protective against cardiovascular disease. This study examined the effect of RSD on the 24 h BP profile of patients with resistant hypertension.

METHODS AND RESULTS:

The first 23 consecutive patients with resistant hypertension scheduled for renal denervation in a single centre were included. 24 h ambulatory blood pressure monitors (ABPM) were given to patients pre-procedure and 9 months post-procedure. RSD led to a statistically non-significant reduction in overall 24 h ABPM BP (150/85 ± 12/9 vs. 143/84 ± 15/11 mmHg; P > 0.05) despite a reduction in the number of antihypertensive medications (4.9 ± 1.2 vs. 4.3 ± 1.2; P = 0.001). There were improvements in systolic ND 1.7 ± 8 vs. 5.2 ± 8 %; P < 0.05), diastolic ND (5.2 ± 8 vs. 10.2 ± 9 %; P < 0.05) and mean arterial pressure (MAP) ND (4.2 ± 8 vs. 8.0 ± 8 %; P < 0.05). Non-significant changes in ND status were observed in systolic (17 vs. 43 % of participants; P > 0.05), diastolic (30 vs. 43 % of participants; P > 0.05) and MAP (22 vs. 39 % of participants; P > 0.05) measurements.

CONCLUSIONS:

These data suggest that RSD may lead to an improvement in nocturnal dipping in selected patients with resistant hypertension. This may have cardiovascular benefits even if reduction in BP is not achieved with RSD.

KEYWORDS:

Nocturnal dipping; Renal denervation; Renal sympathetic denervation; Resistant hypertension

PMID:
26089291
DOI:
10.1007/s11845-015-1324-3
[Indexed for MEDLINE]

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