Disappointing real-world results with renal denervation: BP reductions small with ABPM

Disappointing real-world results with renal denervation: BP reductions small with ABPM

from http://www.theheart.org:

Milan, Italy – A study of the benefits of renal denervation for the treatment of resistant hypertension suggests that the reduction in blood pressure is smaller than observed in clinical trials and is considerably smaller when systolic blood pressure is assessed using ambulatory blood-pressure monitoring (ABPM).

 

In fact, when ABPM was used to measure blood pressure, the reduction was just one-third of that observed when assessed in the office. On average, the reduction in blood pressure when using traditional office-cuff measurements was 17.6 mm Hg six months after renal denervation, but the reduction was just 5.9 mm Hg when assessed using 24-hour ABPM.

The results on ABPM are not impressive.

Speaking with heartwire, lead investigator Prof Alexandre Persu (Cliniques Universitaires Saint-Luc, Brussels, Belgium) said that in drug studies, 60% to 70% of the office reduction is retained on ABPM, so the smaller decrease observed with renal denervation is highly unusual.

“Our results on the office measurement are less than what was observed in the SYMPLICITY HTN-2 trial but still in the same range,” said Persu. “But in SYMPLICITY, there are only few ABPM results, and even in those that were done, the reduction was also just one-third [of the office measurements]. Our study is the largest collection of ambulatory blood-pressure measurements, and the results on ABPM are not impressive. That’s why we are skeptical. We are not sure if this modest reduction would translate into a reduction into hard clinical events. It’s possible, but it still remains to be proven.”

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