Effects of Renal Sympathetic Denervation on Exercise Blood Pressure, Heart Rate, and Capacity in Patients With Resistant Hypertension
Open accessAbstract
Renal denervation reduces office blood pressure in patients with resistant hypertension. This study investigated the effects of renal denervation on blood pressure, heart rate, and chronotropic index at rest, during exercise, and at recovery in 60 patients (renal denervation group=50, control group=10) with resistant hypertension using a standardized bicycle exercise test protocol performed 6 and 12 months after renal denervation. After renal denervation, exercise blood pressure at rest was reduced from 158±3/90±2 to 141±3/84±4 mm Hg ( P <0.001 for systolic blood pressure/ P =0.007 for diastolic blood pressure) after 6 months and 139±3/83±4 mm Hg ( P <0.001/ P =0.022) after 12 months. Exercise blood pressure tended to be lower at all stages of exercise at 6- and 12-month follow-up in patients undergoing renal denervation, although reaching statistical significance only at mild-to-moderate exercise levels (75–100 W). At recovery after 1 minute, blood pressure decreased from 201±4/95±2 to 177±4/88±2 ( P <0.001/ P =0.066) and 188±6/86±2 mm Hg ( P =0.059/ P =0.01) after 6 and 12 months, respectively. Heart rate was reduced after renal denervation from 71±3 bpm at rest, 128±5 bpm at maximum workload, and 96±5 bpm at recovery after 1 minute to 66±2 ( P <0.001), 115±5 ( P =0.107), and 89±3 bpm ( P =0.008) after 6 months and to 69±3 ( P =0.092), 122±7 ( P =0.01), and 93±4 bpm ( P =0.032) after 12 months. Mean exercise time increased from 6.59±0.33 to 8.4±0.32 ( P <0.001) and 9.0±0.41 minutes ( P =0.008), and mean workload increased from 93±2 to 100±2 ( P <0.001) and 101±3 W ( P =0.007) at 6- and 12-month follow-up, respectively. No changes were observed in the control group. In conclusion, renal denervation reduced blood pressure and heart rate during exercise, improved mean workload, and increased exercise time without impairing chronotropic competence.
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Several open-label trials have documented the efficacy of renal denervation in subjects with resistant hypertension many of whom are obese.
“Several open-label trials have documented the efficacy of renal denervation in subjects with resistant hypertension many of whom are obese (24–28).”
From Obesity-Associated Hypertension: Recent Progress in Deciphering the Pathogenesis (2014) · cites this paper as [28]
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2013 ESH/ESC Guidelines for the management of arterial hypertension
Authors Task Force Members, Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhm, M., Christiaens, T., Cífková, R., Backer, G. D., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht151 · Cited by 13,638 · see citing works
Self-citationLim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., AlMazroa, M. A., Amann, M., Anderson, H. R., Andrews, K. G., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61766-8 · Cited by 11,805 · see citing works
Mancia, G., Fagard, R., Narkiewicz, K., Redón, J., Zanchetti, A., Böhm, M., Christiaens, T., Cifkova, R., De Backer, G., Dominiczak, A., et al. (2013) · Journal of Hypertension · doi:10.1097/01.hjh.0000431740.32696.cc · Cited by 5,655 · see citing works
Self-citationACC/AHA 2002 Guideline Update for Exercise Testing: Summary Article
Gibbons, R. J., Balady, G. J., Bricker, J. T., CHAITMAN, B. R., Fletcher, G. F., Froelicher, V. F., Mark, D. B., McCallister, B. D., Mooss, A. N., O’Reilly, M. G., et al. (2002) · Circulation · doi:10.1161/01.cir.0000034670.06526.15 · Cited by 2,606 · see citing works
Heart-rate Recovery Immediately After Exercise as a Predictor of Mortality
Cole, C. R., Blackstone, E. H., Pashkow, F. J., Snader, C. E., & Lauer, M. S. (1999) · New England Journal of Medicine · doi:10.1056/nejm199910283411804 · Cited by 1,935 · see citing works
ACC/AHA 2002 guideline update for exercise testing: summary article
Gibbons, R. J., Balady, G. J., Bricker, J. T., CHAITMAN, B. R., Fletcher, G. F., Froelicher, V. F., Mark, D. B., McCallister, B. D., Mooss, A. N., O’Reilly, M. G., et al. (2002) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(02)02164-2 · Cited by 1,231 · see citing works
Catheter-Based Renal Sympathetic Denervation for Resistant Hypertension
Symplicity HTN-1 Investigators (2011) · Hypertension · doi:10.1161/hypertensionaha.110.163014 · Cited by 743 · see citing works
Krum, H., Schlaich, M. P., Sobotka, P. A., Böhm, M., Mahfoud, F., Rocha‐Singh, K. J., Katholi, R. E., & Esler, M. (2013) · The Lancet · doi:10.1016/s0140-6736(13)62192-3 · Cited by 622 · see citing works
Self-citationSchultz, M. G., Otahal, P., Cleland, V. J., Blizzard, L., Marwick, T. H., & Sharman, J. E. (2013) · American Journal of Hypertension · doi:10.1093/ajh/hps053 · Cited by 306 · see citing works
Systolic Blood Pressure Response to Exercise Stress Test and Risk of Stroke
Kurl, S., Laukkanen, J. A., Rauramaa, R., Lakka, T. A., Sivenius, J., & Salonen, J. T. (2001) · Stroke · doi:10.1161/hs0901.095395 · Cited by 302 · see citing works
Blood Pressure Response to Heart Rate During Exercise Test and Risk of Future Hypertension
Miyai, N., Arita, M., Miyashita, K., Morioka, I., Shiraishi, T., & Nishio, I. (2002) · Hypertension · doi:10.1161/hy0302.105777 · Cited by 283 · see citing works
Mahfoud, F., Lüscher, T. F., Andersson, B., Baumgärtner, I., Cífková, R., Mario, C. D., Doevendans, P. A., Fagard, R. H., Fajadet, J. C., Michel Komajda, N., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht154 · Cited by 234 · see citing works
Self-citationGottdiener, J. S., Brown, J., Zoltick, J., & Fletcher, R. D. (1990) · Annals of Internal Medicine · doi:10.7326/0003-4819-112-3-161 · Cited by 224 · see citing works
Thanassoulis, G., Lyass, A., Benjamin, E. J., Larson, M. G., Vita, J. A., Levy, D. A., Hamburg, N. M., Widlansky, M. E., O’Donnell, C. J., Mitchell, G. F., et al. (2012) · Circulation · doi:10.1161/circulationaha.111.063933 · Cited by 192 · see citing works
Exercise Blood Pressure Predicts Mortality From Myocardial Infarction
Mundal, R., Kjeldsen, S. E., Sandvik, L., Erikssen, G., Thaulow, E., & Erikssen, J. (1996) · Hypertension · doi:10.1161/01.hyp.27.3.324 · Cited by 185 · see citing works
Sympatho-renal axis in chronic disease
Sobotka, P. A., Mahfoud, F., Schlaich, M. P., Hoppe, U. C., Böhm, M., & Krum, H. (2011) · Clinical Research in Cardiology · doi:10.1007/s00392-011-0335-y · Cited by 178 · see citing works
Self-citationExercise Blood Pressure and Future Cardiovascular Death in Asymptomatic Individuals
Weiss, S. A., Blumenthal, R. S., Sharrett, A. R., Redberg, R. F., & Mora, S. (2010) · Circulation · doi:10.1161/circulationaha.109.895292 · Cited by 166 · see citing works
Ukena, C., Mahfoud, F., Kindermann, I., Barth, C., Lenski, M., Kindermann, M., Brandt, M. C., Hoppe, U. C., Krum, H., Esler, M., et al. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2011.05.036 · Cited by 147 · see citing works
Self-citationLewis, G. D., Gona, P., Larson, M. G., Plehn, J. F., Benjamin, E. J., O'Donnell, C. J., Levy, D., Vasan, R. S., & Wang, T. J. (2008) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2008.01.046 · Cited by 133 · see citing works
Laukkanen, J. A., Kurl, S., Salonen, R. M., Lakka, T. A., Rauramaa, R., & Salonen, J. T. (2004) · Hypertension · doi:10.1161/01.hyp.0000148460.95060.f2 · Cited by 129 · see citing works
Laukkanen, J. A., Kurl, S., Rauramaa, R., Lakka, T. A., Venäläinen, J. M., & Salonen, J. T. (2006) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/01.hjr.0000198915.83234.59 · Cited by 117 · see citing works
Circulatory response to exercise in health.
Shepherd, J. T. (1987) · PubMed · Cited by 86 · see citing works
Dobre, D., Zannad, F. M., Keteyian, S. J., Stevens, S. R., Rossignol, P., Kitzman, D. W., Landzberg, J. S., Howlett, J. G., Kraus, W. E., & Ellis, S. J. (2013) · European Heart Journal · doi:10.1093/eurheartj/ehs433 · Cited by 79 · see citing works
Exaggerated blood pressure response to exercise: pathophysiologic mechanisms and clinical relevance.
Palatini, P. (1998) · PubMed · Cited by 70 · see citing works
Predicting Maximal HR in Heart Failure Patients on β-Blockade Therapy
Keteyian, S. J., Kitzman, D. W., Zannad, F. M., Landzberg, J. S., Arnold, J. M. O., Brubaker, P. H., Brawner, C. A., Bensimhon, D., Hellkamp, A. S., & Ewald, G. A. (2011) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e318234316f · Cited by 46 · see citing works
Renal sympathetic denervation: the jury is still out
Doumas, M. N., & Δούμα, Σ. (2010) · The Lancet · doi:10.1016/s0140-6736(10)62111-3 · Cited by 45 · see citing works
Response and non-response to renal denervation: who is the ideal candidate?
Ukena, C., Cremers, B., Ewen, S., Böhm, M., & Mahfoud, F. (2013) · EuroIntervention · doi:10.4244/eijv9sra10 · Cited by 42 · see citing works
Self-citationBlood pressure responses during exercise testing—is up best for prognosis?
Laukkanen, J. A., & Kurl, S. (2011) · Annals of Medicine · doi:10.3109/07853890.2011.560180 · Cited by 39 · see citing works
Exercise hypertension: its measurement and evaluation.
Iw, F. (1987) · PubMed · Cited by 23 · see citing works
Skretteberg, P. T., Grundvold, I., Kjeldsen, S. E., Engeseth, K., Liestøl, K., Erikssen, G., Erikssen, J. E., Gjesdal, K., & Bodegård, J. (2013) · Hypertension · doi:10.1161/hypertensionaha.111.00793 · Cited by 18 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Esler MD, Krum H, Sobotka PA, Schlaich MP, Schmieder RE, Böhm M. Renal sympathetic denervation in patients with treatment-resistant hyper- tension (the Symplicity HTN-2 trial). Lancet. 2010;376:1903-1909.
Cited by
Sorted by citations
Obesity-Associated Hypertension: Recent Progress in Deciphering the Pathogenesis
Rahmouni, K. (2014) · Hypertension · doi:10.1161/hypertensionaha.114.00920 · Cited by 150 · see citing works
Renal Denervation for the Treatment of Cardiovascular High Risk-Hypertension or Beyond?
Böhm, M., Linz, D., Ukena, C., Esler, M., & Mahfoud, F. (2014) · Circulation Research · doi:10.1161/circresaha.115.302522 · Cited by 77 · see citing works
Self-citationGrassi, G. M., Seravalle, G., Brambilla, G., Trabattoni, D., Cuspidi, C., Corso, R., Pieruzzi, F., Genovesi, S., Stella, A., Facchetti, R., et al. (2015) · Hypertension · doi:10.1161/hypertensionaha.114.04823 · Cited by 75 · see citing works
Renal denervation for resistant hypertension
Coppolino, G., Pisano, A., Rivoli, L., & Bolignano, D. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011499.pub2 · Cited by 55 · see citing works
Cai, A., & Calhoun, D. A. (2017) · Hypertension · doi:10.1161/hypertensionaha.117.08929 · Cited by 54 · see citing works
Huang, B. S., Yu, L., He, B., Lu, Z., Wang, S., He, W., Yang, K., Liao, K., Zhang, L., & Jiang, H. (2014) · Experimental Physiology · doi:10.1113/expphysiol.2014.082057 · Cited by 51 · see citing works
Catheter-Based Renal Denervation Exacerbates Blood Pressure Fall During Hemorrhage
Singh, R. R., Sajeesh, V., Booth, L. C., McArdle, Z., May, C. N., Head, G. A., Moritz, K. M., Schlaich, M. P., & Denton, K. M. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2016.12.014 · Cited by 46 · see citing works
Renal denervation for resistant hypertension
Pisano, A., Iannone, L. F., Leo, A., Russo, E., Coppolino, G., & Bolignano, D. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011499.pub3 · Cited by 30 · see citing works
Singh, R. R., & Denton, K. M. (2018) · Hypertension · doi:10.1161/hypertensionaha.118.10265 · Cited by 30 · see citing works
Shi, Z., Jiang, S., Wang, G., Xu, A.-L., & Guo, L. (2014) · Autonomic Neuroscience · doi:10.1016/j.autneu.2014.10.001 · Cited by 26 · see citing works
Pancholy, S. B., Shantha, G. P. S., Patel, T. M., Sobotka, P. A., & Kandzari, D. E. (2014) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2014.06.018 · Cited by 23 · see citing works
Renal denervation for the management of resistant hypertension
Patel, H. C., Hayward, C., Vassiliou, V. S., Patel, K., Howard, J. P., & Mario, C. D. (2015) · Integrated Blood Pressure Control · doi:10.2147/ibpc.s65632 · Cited by 18 · see citing works
Renal Sympathetic Denervation: A Comprehensive Review
Akinseye, O. A., Ralston, W. F., Johnson, K., Ketron, L., Womack, C. R., & Ibebuogu, U. N. (2020) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2020.100598 · Cited by 19 · see citing works
Fengler, K., Heinemann, D., Okon, T., Röhnert, K., Stiermaier, T., von Roeder, M., Besler, C., Müller, U., Höllriegel, R., Schuler, G. C., et al. (2016) · Clinical Research in Cardiology · doi:10.1007/s00392-015-0955-8 · Cited by 16 · see citing works
Selejan, S., Linz, D., Tatu, A.-M., Hohl, M., Speer, T., Ewen, S., Mahfoud, F., Kindermann, I., Zamyatkin, O., Kazakov, A., et al. (2018) · Journal of Molecular and Cellular Cardiology · doi:10.1016/j.yjmcc.2018.08.003 · Cited by 14 · see citing works
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Fengler, K., Rommel, K., Okon, T., Schuler, G. C., & Lurz, P. C. (2016) · World Journal of Cardiology · doi:10.4330/wjc.v8.i8.436 · Cited by 9 · see citing works
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Qi, X.-Y., Cheng, B., Li, Y., & Wang, Y. (2016) · Medicine · doi:10.1097/md.0000000000003939 · Cited by 3 · see citing works
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Self-citationEwen, S., Ukena, C., Pöss, J., Linz, D., Böhm, M., & Mahfoud, F. (2014) · Herz
Self-citationShahverdi, E., Shahi, S., Schneider, C., & Lange, M. (2026) · Clinical Hypertension · doi:10.5646/ch.2026.32.e39
- Authors
- Ewen, S., Mahfoud, F., Linz, D., Pöss, J., Cremers, B., Kindermann, I., Laufs, U., Ukena, C., & Böhm, M.
- Affiliations
- Universitätsklinikum des Saarlandes (DE)
- ORCID
- Venue
- Hypertension
- Published
- 2014-04
- Volume
- 63
- Issue
- 4
- Pages
- 839-845
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2047838684
- Cited by
- 26
- References
- 31
- Citations by year
- 2026: 1 · 2021: 2 · 2020: 1 · 2018: 3 · 2017: 3 · 2016: 4 · 2015: 3 · 2014: 9
- FWCI
- 4.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- renal denervation, resistant hypertension, blood pressure response to exercise, heart rate, chronotropic index, exercise capacity, post-exercise recovery, blood pressure reduction, autonomic nervous system, renal sympathetic nerves
- MeSH terms
- Aged, Antihypertensive Agents, Blood Pressure, Exercise Test, Female, Follow-Up Studies, Heart Rate, Humans, Hypertension, Kidney, Male, Middle Aged, Sympathectomy, Sympathetic Nervous System, Time Factors, Exercise, Exercise Tolerance, Catheter Ablation
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