title: 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.
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.
  
  
  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.
authors.affiliation: Department of Cardiology, Galway University Hospital, Galway, Republic of Ireland. stephen_tuohy@hotmail.com.
authors.forename: S T
authors.initials: ST
authors.lastname: Tuohy
authors.affiliation: Department of Cardiology, Galway University Hospital, Galway, Republic of Ireland.
authors.forename: S-M G
authors.initials: SG
authors.lastname: Kyvelou
authors.affiliation: Department of Cardiology, Galway University Hospital, Galway, Republic of Ireland.
authors.forename: P J
authors.initials: PJ
authors.lastname: Gleeson
authors.affiliation: Department of Cardiology, Galway University Hospital, Galway, Republic of Ireland.
authors.forename: F B
authors.initials: FB
authors.lastname: Daniels
authors.affiliation: Department of Cardiology, Galway University Hospital, Galway, Republic of Ireland.
authors.forename: L A
authors.initials: LA
authors.lastname: Ryan
authors.affiliation: Department of Nephrology, Galway University Hospital, Galway, Republic of Ireland.
authors.forename: D W
authors.initials: DW
authors.lastname: Lappin
authors.affiliation: Department of Cardiology, Galway University Hospital, Galway, Republic of Ireland.|Clinical Research Facility, National University of Ireland, Galway, Republic of Ireland.
authors.forename: M J
authors.initials: MJ
authors.lastname: O'Donnell
authors.affiliation: Department of Cardiology, Galway University Hospital, Galway, Republic of Ireland.|Clinical Research Facility, National University of Ireland, Galway, Republic of Ireland.
authors.forename: F
authors.initials: F
authors.lastname: Sharif
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007494:Ireland; D007668:Kidney / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D013562:Sympathectomy / Q000379:methods*; D062606:Tertiary Care Centers
chemical_list: D000959:Antihypertensive Agents
keywords: Nocturnal dipping; Renal denervation; Renal sympathetic denervation; Resistant hypertension