Health-related quality of life after renal denervation in patients with treatment-resistant hypertension.
Recent studies have demonstrated the effectiveness of radiofrequency ablation of the renal sympathetic nerves in reducing blood pressure (BP) in patients with resistant hypertension. The effect of renal denervation on health-related quality of life (QoL) has not been evaluated. Using the Medical Outcomes Study 36-Item Short-Form Health Survey and Beck Depression Inventory-II, we examined QoL before and 3 months after renal denervation in patients with uncontrolled BP. For baseline comparisons, matched data were extracted from the Australian Diabetes, Obesity, and Lifestyle database. Before renal denervation, patients with resistant hypertension (n = 62) scored significantly worse in 5 of the eight 36-Item Short-Form Health Survey domains and the Mental Component Summary score. Three months after denervation (n = 40), clinic BP was reduced (change in systolic and diastolic BP, -16 ± 4 and -6 ± 2 mm Hg, respectively; P<0.01). The Mental Component Summary score improved (47.6 ± 1.1 versus 52 ± 1; P = 0.001) as a result of increases in the vitality, social function, role emotion, and mental health domains. Beck Depression Inventory scores were also improved, particularly with regard to symptoms of sadness (P = 0.01), tiredness (P<0.001), and libido (P<0.01). The magnitude of BP reduction or BP level achieved at 3 months bore no association to the change in QoL. Renal denervation was without a detrimental effect on any elements of the 36-Item Short-Form Health Survey. These results indicate that patients with severe hypertension resistant to therapy present with a marked reduction in subjective QoL. In this pre- and post-hypothesis generating study, several aspects of QoL were improved after renal denervation; however, this was not directly associated with the magnitude of BP reduction.
Human Neurotransmitters, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia. gavin.lambert@bakeridi.edu.au
Gavin W
GW
Lambert
Dagmara
D
Hering
Murray D
MD
Esler
Petra
P
Marusic
Elisabeth A
EA
Lambert
Stephanie K
SK
Tanamas
Jonathan
J
Shaw
Henry
H
Krum
John B
JB
Dixon
David A
DA
Barton
Markus P
MP
Schlaich
D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D003863:Depression / Q000523:psychology; D004644:Emotions; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000523:psychology / Q000601:surgery*; D007668:Kidney / Q000294:innervation* / Q000601:surgery; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D012919:Social Behavior; D013562:Sympathectomy; D013564:Sympathetic Nervous System / Q000601:surgery*; D016896:Treatment Outcome