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Article Dans Une Revue Journal of Human Hypertension Année : 2021

Predictors of blood pressure response to ultrasound renal denervation in the RADIANCE-HTN SOLO study

Manish Saxena
Ajay Kirtane
Philippe Gosse
Kintur Sanghvi
  • Fonction : Auteur
Atul Pathak
Yale Wang
Michael Weber
Neil Barman
Lisa Claude
Yang Song
Melvin Lobo

Résumé

Abstract The blood pressure (BP) lowering response to renal denervation (RDN) remains variable with about one-third of patients not responding to ultrasound or radiofrequency RDN. Identification of predictors of the BP response to RDN is needed to optimize patient selection for this therapy. This is a post-hoc analysis of the RADIANCE-HTN SOLO study. BP response to RDN was measured by the change in daytime ambulatory systolic blood pressure (dASBP) at 2 months post procedure. Univariate regression was used initially to assess potential predictors of outcome followed by multivariate regression analysis. In the univariate analysis, predictors of response to RDN were higher baseline daytime ambulatory diastolic blood pressure (dADBP), the use of antihypertensive medications at screening, and presence of orthostatic hypertension (OHTN) whilst the presence of untreated accessory arteries was a negative predictor of response. Multivariate analysis determined that dADBP and use of antihypertensive medications were predictors of response to RDN with a trend for OHTN to predict response. Obese females also appeared to be better responders to RDN in an interaction model. RDN is more effective in patients with elevated baseline dADBP and those with OHTN, suggesting increased peripheral vascular resistance secondary to heightened sympathetic tone. These assessments are easy to perform in clinical setting and may help in phenotyping patients who will respond better to RDN.

Dates et versions

hal-03677472 , version 1 (24-05-2022)

Identifiants

Citer

Manish Saxena, Roland Schmieder, Ajay Kirtane, Felix Mahfoud, Joost Daemen, et al.. Predictors of blood pressure response to ultrasound renal denervation in the RADIANCE-HTN SOLO study. Journal of Human Hypertension, 2021, ⟨10.1038/s41371-021-00547-y⟩. ⟨hal-03677472⟩
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