title: Effects of Renal Sympathetic Denervation on Arterial Stiffness and Blood Pressure Control in Resistant Hypertensive Patients: A Single Centre Prospective Study.
abstract: Renal denervation (RD) is an intriguing treatment strategy for resistant hypertension. However, limited data are available about its long time efficacy as well as its effects on intermediate phenotypes like arterial stiffness and carotid IMT. 12 patients (9 males, mean 69 years) with resistant hypertension underwent bilateral RDN (Medtronic System) since April 2012 in Niguarda Ca' Granda Hospital (Milan). Patients were studied before intervention, and at 1, 3, 6 and 12 months after RD. Carotid intima media thickness (Esaote Mylab) and carotid-femoral pulse wave velocity (Complior, Alam medical) were assessed at each step. Compared to baseline, patients showed a marked reduction of office systolic blood pressure at each follow-up step (p < 0.05 versus baseline for all steps) as well as pulse wave velocity (p < 0.01 at 1 year versus baseline). Moreover, reduction in pulse wave velocity was higher than the expected value obtained only considering blood pressure drop. Conversely, no significant effect was observed on diastolic blood pressure as well as carotid intima-media thickness. In our study, renal denervation was a safe and effective procedure. The BP lowering effect was maintained during follow-up and a beneficial effect on arterial stiffness was observed, which implies that this effect can't passively originate from the BP fall but rather from an improvement of arterial mechanical properties, possibly related to a reduced sympathetic arterial drive.
authors.affiliation: Cardiology IV, Cardiovascular "A' De Gasperis" Department, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore 3, 20161, Milan, Italy. bimatteo@gmail.com.|Health Science Department, Milan-Bicocca University, Milan, Italy. bimatteo@gmail.com.
authors.forename: Matteo
authors.initials: M
authors.lastname: Baroni
authors.affiliation: Cardiology IV, Cardiovascular "A' De Gasperis" Department, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore 3, 20161, Milan, Italy.|Health Science Department, Milan-Bicocca University, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Nava
authors.affiliation: Cardiology IV, Cardiovascular "A' De Gasperis" Department, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore 3, 20161, Milan, Italy.|Health Science Department, Milan-Bicocca University, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Giupponi
authors.affiliation: Cardiology IV, Cardiovascular "A' De Gasperis" Department, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore 3, 20161, Milan, Italy.|Health Science Department, Milan-Bicocca University, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Meani
authors.affiliation: Cardiology IV, Cardiovascular "A' De Gasperis" Department, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore 3, 20161, Milan, Italy.|Health Science Department, Milan-Bicocca University, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Panzeri
authors.affiliation: Cardiology IV, Cardiovascular "A' De Gasperis" Department, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore 3, 20161, Milan, Italy.|Health Science Department, Milan-Bicocca University, Milan, Italy.
authors.forename: Marisa
authors.initials: M
authors.lastname: Varrenti
authors.affiliation: Cardiology IV, Cardiovascular "A' De Gasperis" Department, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore 3, 20161, Milan, Italy.|Health Science Department, Milan-Bicocca University, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Maloberti
authors.affiliation: Cardiology I, Cardiovascular "A' De Gasperis" Department, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Soriano
authors.affiliation: Internal Medicine Department, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Antonio Maria
authors.initials: AM
authors.lastname: Agrati
authors.affiliation: Internal Medicine Department, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ferraro
authors.affiliation: Internal Medicine Department, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Colombo
authors.affiliation: Interventional Radiology, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Rampoldi
authors.affiliation: Health Science Department, Milan-Bicocca University, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
authors.affiliation: Cardiology I, Cardiovascular "A' De Gasperis" Department, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Colombo
authors.affiliation: Cardiology I, Cardiovascular "A' De Gasperis" Department, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Klugmann
authors.affiliation: Cardiology IV, Cardiovascular "A' De Gasperis" Department, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore 3, 20161, Milan, Italy.|Health Science Department, Milan-Bicocca University, Milan, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Giannattasio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D059168:Carotid Intima-Media Thickness; D004351:Drug Resistance; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D007558:Italy; D007668:Kidney / Q000294:innervation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D013562:Sympathectomy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D059289:Vascular Stiffness
chemical_list: D000959:Antihypertensive Agents
keywords: Arterial stiffness; Cardiovascular risk; Essential hypertension; Renal sympathetic denervation; Resistant hypertension