Premium
Predictors of blood pressure response: Obesity is associated with a less pronounced treatment response after renal denervation
Author(s) -
Id Dani,
Bertog Stefan C.,
Ziegler AnnKathrin,
Hornung Marius,
Hofmann Ilona,
Vaskelyte Laura,
Matic Predrag,
Gafoor Sameer,
Sievert Horst
Publication year - 2016
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26068
Subject(s) - medicine , blood pressure , body mass index , ambulatory blood pressure , ambulatory , diabetes mellitus , cardiology , logistic regression , obesity , denervation , renal function , multivariate analysis , univariate analysis , surgery , endocrinology
Objectives 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. Conclusion 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.