title: Effects of renal sympathetic denervation on blood pressure and glycaemic control in patients with true resistant hypertension: results of Polish Renal Denervation Registry (RDN-POL Registry).
abstract: OBJECTIVE
  The assessment of percutaneous renal sympathetic denervation (RDN) efficacy in patients with true-resistant hypertension (true-RH) in a newly established net of Polish centres (RDN-POL Registry).
  
  
  RESULTS
  Forty-four patients with true-RH (23 men, mean age 52.3 years) with daytime systolic blood pressure (SBP) in ambulatory blood pressure monitoring (ABPM) ≥ 135 mm Hg, on ≥ three antihypertensive agents, including diuretic, underwent RDN and completed 12-month follow-up. Mean reductions of office SBP/diastolic blood pressure were -23.8/-10.0, -12.5/-4.6, and -12.6/-6.1 mm Hg at 3, 6, and 12 months, respectively (all significant except diastolic at 6 months). Diabetes was the only predictor of office SBP reduction at 6 months (OR 9.6, 95% CI 1.4-66.5, p < 0.05). Mean 24-h SBP change was -8.3 mm Hg at 6 months and -4.6 mm Hg at 12 months. Increased 2 h-glucose in oral glucose tolerance test was the only predictor of 24-h SBP reduction at 6 months (OR 1.24 for 10 mg/dL glucose increase, 95% CI 1.04-1.48, p < 0.05). At 12 months, 24-h SBP change predictors were: baseline office SBP (OR 4.93 for 10 mm Hg SBP increment, 95% CI 1.01-24.1, p < 0.05) and 2 h-glucose (OR 1.47, 95% CI 1.08-2.00, p < 0.05). In ABPM responders, significant reduction of 2 h glucose was found as compared to the non-responders (-45.8 vs. -7.7 mg/dL, p < 0.005).
  
  
  CONCLUSIONS
  The RDN-POL Registry demonstrated moderate blood pressure decrease after RDN. The predictors of blood pressure reduction were diabetes, 2 h-glucose, and baseline office SBP. Analysis of ABPM responders indicates a probable positive impact of RDN on glycaemic control.
authors.affiliation: Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland. kadziela@ikard.pl.
authors.forename: Jacek
authors.initials: J
authors.lastname: Kądziela
authors.forename: Aleksander
authors.initials: A
authors.lastname: Prejbisz
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kostka-Jeziorny
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Narkiewicz
authors.forename: Jerzy
authors.initials: J
authors.lastname: Sadowski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Lekston
authors.forename: Aneta
authors.initials: A
authors.lastname: Gziut
authors.forename: Andrzej
authors.initials: A
authors.lastname: Więcek
authors.forename: Paweł
authors.initials: P
authors.lastname: Buszman
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kleinrok
authors.forename: Janusz
authors.initials: J
authors.lastname: Kochman
authors.forename: Danuta
authors.initials: D
authors.lastname: Czarnecka
authors.forename: Andrzej
authors.initials: A
authors.lastname: Januszewicz
authors.forename: Adam
authors.initials: A
authors.lastname: Witkowski
mesh_terms: D000328:Adult; D001786:Blood Glucose; D001794:Blood Pressure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011044:Poland; D012042:Registries; D012077:Renal Artery / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013562:Sympathectomy; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose
keywords: diabetes; registry; renal denervation; resistant hypertension; sympathetic nervous system