BACKGROUND: Studies of endovascular renal denervation (RDN) have demonstrated significant blood pressure reduction in eligible patients with resistant hypertension. These trials have used stringent inclusion and exclusion criteria in patient enrollment, potentially selecting for a small subset of patients with resistant hypertension. In this study, we examined the changes in estimated prevalence of resistant hypertension when using increasingly stringent definitions of resistant hypertension in a fixed population and assessed the generalizability of RDN when applying study criteria to a community-based hypertensive population. METHODS: A retrospective chart review was done of hypertensive outpatients. Four increasingly stringent interpretations of the American Heart Association definition of resistant hypertension were used to calculate prevalence estimates. Patients eligible for RDN were identified using criteria from SYMPLICITY HTN-3. Demographic and clinical characteristics were compared. RESULTS: We identified 1,756 hypertensive outpatients; 55.0% were male, 53.9% were white, and subjects had a mean age of 66.6 ± 12.5 years and a body mass index (BMI) of 30.1 ± 10.7 kg/m(2). Only 14 (0.8%) were eligible for RDN. Among these patients, 10 (71.4%) were female and all were black, with a mean age of 69.9 ± 8.8 and BMI of 35.7 ± 6.6. Congestive heart failure was more common in patients eligible for RDN. CONCLUSIONS: Patients eligible for RDN based on published studies represent an exceedingly small proportion of the total hypertensive population. Further studies are necessary to determine if the benefits of RDN can be generalized to a broader range of hypertensive patients than those included in previous trials.
BACKGROUND: Studies of endovascular renal denervation (RDN) have demonstrated significant blood pressure reduction in eligible patients with resistant hypertension. These trials have used stringent inclusion and exclusion criteria in patient enrollment, potentially selecting for a small subset of patients with resistant hypertension. In this study, we examined the changes in estimated prevalence of resistant hypertension when using increasingly stringent definitions of resistant hypertension in a fixed population and assessed the generalizability of RDN when applying study criteria to a community-based hypertensive population. METHODS: A retrospective chart review was done of hypertensive outpatients. Four increasingly stringent interpretations of the American Heart Association definition of resistant hypertension were used to calculate prevalence estimates. Patients eligible for RDN were identified using criteria from SYMPLICITY HTN-3. Demographic and clinical characteristics were compared. RESULTS: We identified 1,756 hypertensive outpatients; 55.0% were male, 53.9% were white, and subjects had a mean age of 66.6 ± 12.5 years and a body mass index (BMI) of 30.1 ± 10.7 kg/m(2). Only 14 (0.8%) were eligible for RDN. Among these patients, 10 (71.4%) were female and all were black, with a mean age of 69.9 ± 8.8 and BMI of 35.7 ± 6.6. Congestive heart failure was more common in patients eligible for RDN. CONCLUSIONS:Patients eligible for RDN based on published studies represent an exceedingly small proportion of the total hypertensive population. Further studies are necessary to determine if the benefits of RDN can be generalized to a broader range of hypertensivepatients than those included in previous trials.
Authors: Simone Romano; Chiara Idolazzi; Cristiano Fava; Luigi Fondrieschi; Mario Celebrano; Pietro Delva; Lorella Branz; Angela Donato; Andrea Dalbeni; Pietro Minuz Journal: High Blood Press Cardiovasc Prev Date: 2018-06-29
Authors: Nuno Miguel Pires; Bruno Igreja; Eduardo Moura; Lyndon Christopher Wright; Maria Paula Serrão; Patrício Soares-da-Silva Journal: Hypertens Res Date: 2015-04-09 Impact factor: 3.872
Authors: Bruno Igreja; Nuno Miguel Pires; Maria João Bonifácio; Ana Isabel Loureiro; Carlos Fernandes-Lopes; Lyndon Christopher Wright; Patrício Soares-da-Silva Journal: Hypertens Res Date: 2014-10-09 Impact factor: 3.872
Authors: T Denolle; B Chamontin; G Doll; J-P Fauvel; X Girerd; D Herpin; B Vaïsse; F Villeneuve; J M Halimi Journal: J Hum Hypertens Date: 2016-01-28 Impact factor: 3.012
Authors: Melvin D Lobo; Mark A de Belder; Trevor Cleveland; David Collier; Indranil Dasgupta; John Deanfield; Vikas Kapil; Charles Knight; Matthew Matson; Jonathan Moss; Julian F R Paton; Neil Poulter; Iain Simpson; Bryan Williams; Mark J Caulfield Journal: Heart Date: 2014-11-27 Impact factor: 5.994