title: Individual-patient visit-by-visit office and ambulatory blood pressure measurements over 24months in patients undergoing renal denervation for hypertension.
abstract: BACKGROUND
  Renal denervation (RDN) is a promising treatment option in addition to medical antihypertensive treatment in patients suffering from resistant hypertension. Despite the growing interest in RDN, only few long-term results are published so far.
  
  
  METHODS
  We systematically investigated the effects of RDN on ABPM in a consecutive series of patients with resistant hypertension out to 24 months. Office BP measurements and ABPM assessment were offered at 3, 6, 12 and 24 months. The patients with an average systolic BP reduction of more than 10 mmHg in office BP 6months after RDN were classified as responders. Additional to this classical responder concept, we categorized response to RDN by an individual-patient visit-by-visit evaluation of office BP and 24-hour-BP, separately.
  
  
  RESULTS
  We included 32 patients. In 21 patients (65.6%) we found a mean systolic BP reduction >10 mmHg in office BP six months after RDN. These patients were classified as responders. In responders, mean office BP dropped from 175.3 ± 15.9/96 ± 14.2 mmHg to 164.8 ± 24.4/93.2 ± 10.4 mmHg (p=0.040/p=0.323) and mean 24-h BP in ABPM decreased from 146.8 ± 17.0/89.1 ± 11 mmHg to 136.8 ± 15.0/83.2 ± 10.7 mmHg after 24 months (p=0.034/p=0.014). Additionally, we performed a visit-by-visit evaluation of all patients and results were divided in larger-than-median and smaller-than-median response. By this evaluation, we found a high variation of office BP reductions and the 24-hour BP results demonstrated a significant BP reduction in patients with larger-than-median response, which sustained over the 24 months of follow-up.
  
  
  CONCLUSIONS
  In contrast to the observed variation of office BP measurements, ABPM demonstrated a reproducible and sustained significant BP reduction in patients with larger-than-median response to RDN.
authors.affiliation: 1st Medical Department - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine Linz, Austria. Electronic address: thomas.lambert@akh.linz.at.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lambert
authors.affiliation: 1st Medical Department - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine Linz, Austria.
authors.forename: Verena
authors.initials: V
authors.lastname: Gammer
authors.affiliation: 1st Medical Department - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine Linz, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Nahler
authors.affiliation: 1st Medical Department - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine Linz, Austria.
authors.forename: Hermann
authors.initials: H
authors.lastname: Blessberger
authors.affiliation: 1st Medical Department - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine Linz, Austria.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Kammler
authors.affiliation: 1st Medical Department - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine Linz, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Grund
authors.affiliation: 1st Medical Department - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine Linz, Austria.
authors.forename: Klaus
authors.initials: K
authors.lastname: Kerschner
authors.affiliation: 1st Medical Department - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine Linz, Austria.
authors.forename: Gunda
authors.initials: G
authors.lastname: Buchmayr
authors.affiliation: 1st Medical Department - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine Linz, Austria.
authors.forename: Karim
authors.initials: K
authors.lastname: Saleh
authors.affiliation: 1st Medical Department - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine Linz, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kypta
authors.affiliation: 1st Medical Department - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine Linz, Austria.
authors.forename: Simon
authors.initials: S
authors.lastname: Hönig
authors.affiliation: 1st Medical Department - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine Linz, Austria.
authors.forename: Barbara
authors.initials: B
authors.lastname: Wichert-Schmitt
authors.affiliation: 1st Medical Department - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine Linz, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schwarz
authors.affiliation: 1st Medical Department - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine Linz, Austria.
authors.forename: Kurt
authors.initials: K
authors.lastname: Sihorsch
authors.affiliation: 1st Medical Department - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine Linz, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Reiter
authors.affiliation: 1st Medical Department - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine Linz, Austria.
authors.forename: Clemens
authors.initials: C
authors.lastname: Steinwender
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001317:Austria; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D007668:Kidney / Q000294:innervation*; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D018802:Patient-Centered Care / Q000379:methods*; D015203:Reproducibility of Results; D013562:Sympathectomy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: Ambulatory blood pressure measurements; Renal denervation; Resistant hypertension; Sympathetic nervous system