title: Predictors of blood pressure response: Obesity is associated with a less pronounced treatment response after renal denervation.
abstract: OBJECTIVE
  The purpose of this study was to identify predictors of BP response.
  
  
  BACKGROUND
  Catheter-based renal denervation (RDN) causes significant blood pressure (BP) reductions in a large number of patients with resistant hypertension.
  
  
  METHODS
  One hundred one consecutive patients with resistant hypertension who underwent RDN with the Symplicity™ catheter were included in this retrospective study. Primary endpoint was the change in office systolic BP after 6 months. Uni- and multivariate logistic regression analyses were performed to detect baseline predictors of a significant BP response 6 months after RDN (age, gender, office and ambulatory BP, renal function, body mass index [BMI], diabetes mellitus, antihypertensive medication, number of ablations).
  
  
  RESULTS
  The procedure was technically uneventful in all patients. Mean BP at baseline was 166.6/90.2 ± 22.5/16.4 mmHg and decreased by -14.7 (P < 0.0001)/-5.3 (P < 0.001) ± 22.8/14.1 mm Hg at 6-month follow-up. Similarly, paired analysis of 24-hr-ambulatory BP measurement (n = 71) showed a significant reduction of mean systolic BP by 6.8 ± 14.4 mm Hg (P < 0.0002). Upon univariate analyses, a higher baseline office systolic BP (P < 0.0001) and lower BMI (P = 0.014) were identified as significant predictors of the magnitude of BP response after 6 months. Importantly, on multivariate analysis, baseline office systolic BP (standardized ß = -0.46; r = -0.47; P < 0.0001) and BMI (standardized ß = 0.21; r = 0.95; P = 0.019) remained significant.
  
  
  CONCLUSIONS
  Blood pressure reductions after RDN were more pronounced in patients with higher baseline blood pressure and lower BMI. These findings may have implications regarding patient selection for renal denervation. © 2015 Wiley Periodicals, Inc.
authors.affiliation: CardioVascular Center Frankfurt, Germany.
authors.forename: Dani
authors.initials: D
authors.lastname: Id
authors.affiliation: CardioVascular Center Frankfurt, Germany.|Veterans Affairs Medical Center, Minneapolis, Minnesota, USA.
authors.forename: Stefan C
authors.initials: SC
authors.lastname: Bertog
authors.affiliation: CardioVascular Center Frankfurt, Germany.
authors.forename: Ann-Kathrin
authors.initials: AK
authors.lastname: Ziegler
authors.affiliation: CardioVascular Center Frankfurt, Germany.
authors.forename: Marius
authors.initials: M
authors.lastname: Hornung
authors.affiliation: CardioVascular Center Frankfurt, Germany.
authors.forename: Ilona
authors.initials: I
authors.lastname: Hofmann
authors.affiliation: CardioVascular Center Frankfurt, Germany.
authors.forename: Laura
authors.initials: L
authors.lastname: Vaskelyte
authors.affiliation: CardioVascular Center Frankfurt, Germany.
authors.forename: Predrag
authors.initials: P
authors.lastname: Matic
authors.affiliation: CardioVascular Center Frankfurt, Germany.
authors.forename: Sameer
authors.initials: S
authors.lastname: Gafoor
authors.affiliation: CardioVascular Center Frankfurt, Germany.
authors.forename: Horst
authors.initials: H
authors.lastname: Sievert
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D007668:Kidney / Q000294:innervation*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D012189:Retrospective Studies; D013562:Sympathectomy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
keywords: ablation; hypertension; radiofrequency