title: Renal Denervation in Patients With Uncontrolled Hypertension and Confirmed Adherence to Antihypertensive Medications.
abstract: Renal denervation (RDN) has emerged as a potential device-based treatment for resistant hypertension. The authors present their experience of the use of catheter-based RDN as part of routine clinical care in two specialist hypertension clinics. Thirty-four patients with uncontrolled hypertension underwent RDN. All patients had ambulatory blood pressure (BP) monitoring and directly observed medication administration prior to the procedure to exclude white-coat hypertension and nonadherence, respectively. Overall, there was a significant change in clinic systolic BP of -15.1 mm Hg (95% confidence interval, -23.4 to -6.8; P=.001) and clinic diastolic BP of -6.2 mm Hg (95% confidence interval, -11.5 to -0.9; P=.02) 6 months postprocedure, and a nonsignificant change in daytime ambulatory BP of -5.4/-2.9 mm Hg. Eighteen patients (51.4%) showed a significant reduction in their clinic systolic BP (≥10 mm Hg) and 16 (47%) had a significant reduction in their daytime ambulatory systolic BP (≥5 mm Hg) at 6 months.
authors.affiliation: Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: Mohammed Awais
authors.initials: MA
authors.lastname: Hameed
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Pucci
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.|College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
authors.forename: Una
authors.initials: U
authors.lastname: Martin
authors.affiliation: Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Watkin
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Sagar
authors.initials: S
authors.lastname: Doshi
authors.affiliation: Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Freedman
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Riley
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Townend
authors.affiliation: Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Crowe
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Lipkin
authors.affiliation: Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: Indranil
authors.initials: I
authors.lastname: Dasgupta
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000502:physiology; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D007668:Kidney / Q000294:innervation* / Q000601:surgery; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011446:Prospective Studies; D013562:Sympathectomy / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents