title: Efficacy and safety of renal denervation in elderly patients with resistant hypertension.
abstract: BACKGROUND
  Catheter-based renal sympathetic denervation (RD) causes significant blood pressure (BP) reductions in patients with resistant hypertension (rHTN). However, hypertensive elderly patients reportedly have a lower sympathetic tone than younger patients and a BP lowering effect of RD in this population has not yet been demonstrated. The purpose of this study was to assess the efficacy and safety of RD in elderly patients.
  
  
  METHODS
  We reviewed all consecutive patients aged ≥ 75 years (mean: 78 years) with rHTN treated with RD. Twenty-four patients were included in this prospective study. Office and ambulatory BPs were assessed at baseline and 6-months follow-up. Primary endpoint was the change in office systolic BP at 6 months.
  
  
  RESULTS
  Baseline mean office BP was 173/86 ± 21/13 mm Hg. Baseline 24-hr mean ambulatory BP, available in 22 patients, was 158/80 ± 20/13 mm Hg. Baseline creatinine was 1.0 ± 0.18 mg/dl and mean number of antihypertensive agents at baseline 4.3 ± 1.4. No device- or procedure-related adverse events occurred. At 6-months follow-up, the mean office BP decreased by 19/11 ± 29/16 mm Hg (P < 0.01 compared to baseline). Mean systolic 24 hr ambulatory BP, available in 17 patients, decreased by 9/5 ± 13/13 mm Hg. Antihypertensive medications could be reduced in nine patients. Furthermore, renal function was not impaired.
  
  
  CONCLUSIONS
  According to our findings, a similar magnitude of BP reduction as reported in previous trials can be expected in elderly patients. Elderly patients with rHTN should not be excluded from renal denervation.
authors: CardioVascular Center Frankfurt, Frankfurt, Germany.
authors: Ann-Kathrin
authors: AK
authors: Ziegler
authors: CardioVascular Center Frankfurt, Frankfurt, Germany.
authors: Stefan
authors: S
authors: Bertog
authors: CardioVascular Center Frankfurt, Frankfurt, Germany.
authors: Benjamin
authors: B
authors: Kaltenbach
authors: CardioVascular Center Frankfurt, Frankfurt, Germany.
authors: Dani
authors: D
authors: Id
authors: CardioVascular Center Frankfurt, Frankfurt, Germany.
authors: Jennifer
authors: J
authors: Franke
authors: CardioVascular Center Frankfurt, Frankfurt, Germany.
authors: Ilona
authors: I
authors: Hofmann
authors: CardioVascular Center Frankfurt, Frankfurt, Germany.
authors: Laura
authors: L
authors: Vaskelyte
authors: CardioVascular Center Frankfurt, Frankfurt, Germany.
authors: Horst
authors: H
authors: Sievert
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory; D017115:Catheter Ablation / Q000009:adverse effects; D004351:Drug Resistance; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D007668:Kidney / Q000098:blood supply*; D008297:Male; D011446:Prospective Studies; D012077:Renal Artery / Q000294:innervation / Q000601:surgery*; D018570:Risk Assessment; D012307:Risk Factors; D013562:Sympathectomy / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: elderly; renal denervation; resistant hypertension