Sustained Sympathetic and Blood Pressure Reduction 1 Year After Renal Denervation in Patients With Resistant Hypertension
Abstract
Renal denervation (RDN) reduces muscle sympathetic nerve activity (MSNA) and blood pressure (BP) in resistant hypertension. Although a persistent BP-lowering effect has been demonstrated, the long-term effect on MSNA remains elusive. We investigated whether RDN influences MSNA over time. Office BP and MSNA were obtained at baseline, 3, 6, and 12 months after RDN in 35 patients with resistant hypertension. Office BP averaged 166±22/88±19 mm Hg, despite the use of an average of 4.8±2.1 antihypertensive drugs. Baseline MSNA was 51±11 bursts/min ≈2- to 3-fold higher than the level observed in healthy controls. Mean office systolic and diastolic BP significantly decreased by –12.6±18.3/–6.5±9.2, –16.1±25.6/–8.6±12.9, and –21.2±29.1/–11.1±12.9 mm Hg ( P <0.001 for both systolic BP and diastolic BP) with RDN at 3-, 6-, and 12-month follow-up, respectively. MSNA was reduced by –8±12, –6±12, and –6±11 bursts/min ( P <0.01) at 3-, 6-, and 12-month follow-up. The reduction in MSNA was maintained, despite a progressive fall in BP over time. No such changes were observed in 7 control subjects at 6-month follow-up. These findings confirm previous reports on the favorable effects of RDN on elevated BP and demonstrate sustained reduction of central sympathetic outflow ≤1-year follow-up in patients with resistant hypertension and high baseline MSNA. These observations are compatible with the hypothesis of a substantial contribution of afferent renal nerve signaling to increased BP in resistant hypertension and argue against a relevant reinnervation at 1 year after procedure.
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In the SYMPLICITY HTN clinical trials, renal denervation decreased 24-hour ambulatory systolic/diastolic blood pressure by −11/−7 mmHg.
“In the SYMPLICITY HTN clinical trials, RDN also decreased 24-hour ambulatory systolic/diastolic BP by −11/−7mmHg 164.”
From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [164]
In overweight or obese patients with resistant hypertension, catheter-based radiofrequency renal denervation lowered office systolic/diastolic blood pressure by −25 to −30/−10 to −12 mmHg for up to 24 months.
“In overweight or obese patients with resistant hypertension, catheter-based radiofrequency RDN lowered office systolic/diastolic BP by −25 to −30/−10 to −12 mmHg for up to 24 months164.”
From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [164]
Similar results have been found in obese humans with resistant hypertension in which catheter-based radiofrequency RDN consistently lowered office BP by 25-30 mmHg systolic BP and 10-12 mmHg diastolic BP for up to 24 months.
“Similar results have been found in obese humans with resistant hypertension in which catheter-based radiofrequency RDN consistently lowered office BP by 25–30 mmHg systolic BP and 10–12 mmHg diastolic BP for up to 24 months70,71.”
From Obesity-Induced Hypertension: Interaction of Neurohumoral and Renal Mechanisms (2015) · cites this paper as [71]
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- Authors
- Hering, D., Marusic, P., Walton, A. S., Lambert, E. A., Krum, H., Narkiewicz, K., Lambert, G. W., Esler, M. D., & Schlaich, M. P.
- Affiliations
- Baker Heart and Diabetes Institute (AU)
- From the Neurovascular Hypertension and Kidney Disease Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia (D.H., P.M., E.A.L., G.W.L., M.D.E., M.P.S.); Department of Hypertension and Diabetology, Medical University of Gdansk, Gdańsk, Poland (D.H., K.N.); Heart Centre Alfred Hospital, Melbourne, Australia (A.S.W., H.K., M.D.E., M.P.S.); and Department of Physiology, Faculty of Medicine, Nursing and Health Sciences (E.A.L., G.W.L., M.P.S.) and Department of Epidemiology and...
- ORCID
- Venue
- Hypertension
- Published
- 2014-07
- Volume
- 64
- Issue
- 1
- Pages
- 118-124
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2100734162
- Cited by
- 142
- References
- 36
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 2 · 2023: 9 · 2022: 1 · 2021: 10 · 2020: 4 · 2019: 10 · 2018: 13 · 2017: 15 · 2016: 26 · 2015: 29 · 2014: 13
- FWCI
- 18.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Keywords
- renal denervation, resistant hypertension, muscle sympathetic nerve activity, blood pressure reduction, central sympathetic outflow, long-term follow-up, reinnervation
- MeSH terms
- Adult, Aged, Blood Pressure, Denervation, Female, Humans, Hypertension, Kidney, Male, Middle Aged, Sympathectomy, Sympathetic Nervous System, Treatment Outcome, Cross-Over Studies
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