title: Health-related quality of life and blood pressure 12 months after renal denervation.
abstract: OBJECTIVE
  To examine the effect of renal denervation (RDN) on blood pressure (BP) and health-related quality of life (QoL) in patients with resistant hypertension, pseudoresistant hypertension due to a white-coat effect and in patients with uncontrolled masked hypertension.
  
  
  METHODS
  Using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), Beck Depression Inventory (BDI) and Spielberger's state and trait anxiety questionnaires, we examined QoL, symptoms of depression and anxiety prior to and 12 months following RDN. BP was assessed from clinic and ambulatory blood pressure monitoring (ABPM) recordings.
  
  
  RESULTS
  Patients with uncontrolled masked hypertension had the highest BDI and anxiety scores among all groups at baseline. Twelve months following RDN clinic and ambulatory BP were reduced only in those patients with resistant hypertension (delta SBP: clinic -16 ± 3 mmHg, ABPMday -8 ± 2 mmHg, ABPMnight -8 ± 2 mmHg, all P < 0.01). Clinic BP was reduced in the pseudoresistant group (-17 ± 6 mmHg, P < 0.01) but was elevated in the uncontrolled masked group (+13 ± 6 mmHg, P = 0.02). In all patients, trait anxiety (P < 0.05), BDI scores (P < 0.05) and the SF-36 mental component summary (MCS) score (P < 0.001) were improved. The improvement in the SF-36 MCS was confined to those patients with resistant hypertension (+4.0 ± 1.1, P < 0.01). The change in clinic BP after RDN was related to the baseline clinic BP (systolic: r = 0.54, P < 0.001; diastolic r = 0.43, P < 0.001), the number of ablations delivered (both clinic and mean day ABPM systolic r = 0.24, P < 0.05) and to the change in SF-36 MCS score (systolic: r = 0.25, P = 0.01; diastolic r = 0.24, P = 0.02).
  
  
  CONCLUSIONS
  These results indicate that in patients with confirmed resistant hypertension, RDN is associated with a reduction in BP and a sustained improvement in mental health-related aspects of QoL.
authors.affiliation: aHuman Neurotransmitters bNeurovascular Hypertension and Kidney Disease cNeuropharmacology Laboratories, Baker IDI Heart and Diabetes Institute dFaculty of Medicine, Nursing and Health Sciences eDepartment of Physiology fPrimary Care Research, Monash University, Melbourne gRoyal Perth Hospital Unit, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
authors.forename: Gavin W
authors.initials: GW
authors.lastname: Lambert
authors.forename: Dagmara
authors.initials: D
authors.lastname: Hering
authors.forename: Petra
authors.initials: P
authors.lastname: Marusic
authors.forename: Alicia
authors.initials: A
authors.lastname: Thorp
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sata
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lee
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Duval
authors.forename: Louise
authors.initials: L
authors.lastname: Hammond
authors.forename: Geoffrey A
authors.initials: GA
authors.lastname: Head
authors.forename: Murray D
authors.initials: MD
authors.lastname: Esler
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Lambert
authors.forename: John B
authors.initials: JB
authors.lastname: Dixon
authors.forename: Arup K
authors.initials: AK
authors.lastname: Dhar
authors.forename: David A
authors.initials: DA
authors.lastname: Barton
authors.forename: Markus P
authors.initials: MP
authors.lastname: Schlaich
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D003714:Denervation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D007668:Kidney / Q000294:innervation* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011788:Quality of Life