Michael Böhm1, Christian Ukena, Sebastian Ewen, Dominik Linz, Ina Zivanovic, Uta Hoppe, Krzysztof Narkiewicz, Luis Ruilope, Markus Schlaich, Manuela Negoita, Roland Schmieder, Bryan Williams, Uwe Zeymer, Andreas Zirlik, Giuseppe Mancia, Felix Mahfoud. 1. aUniversitätskliniken des Saarlandes und Universität des Saarlandes, Klinik für Innere Medizin III, Homburg/Saar, Germany bUniversitätsklinik für Innere Medizin II, Kardiologie, Internistische Intensivmedizin und Notaufnahme, SALK - Paracelsus Universität Salzburg, Salzburg, Austria cDepartment of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland dHypertension Unit, Department of Nephrology, Hospital 12 de Octubre, Madrid, Spain eDobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, The University of Western Australia, Perth, Australia fMedtronic, Santa Rosa, California, USA gUniversität Erlangen-Nürnberg, Medizinische Klinik 4, Nürnberg, Germany hInstitute of Cardiovascular Science and NHR Biomedical Research Centre, University College London, London, UK iKlinikum der Stadt Ludwigshafen am Rhein, Ludwigshafen am Rhein, Germany jDepartment of Cardiology and Angiology, Universitäts-Herzzentrum Freiburg, Bad Krozingen, Freiburg, Germany kCentro di Fisiologia Clinica e Ipertensione, University of Milano-Bicocca, Milan, Italy.
Abstract
OBJECTIVES: Renal denervation (RDN) can reduce sympathetic activity and blood pressure (BP) in patients with hypertension. The effects on resting and ambulatory heart rate (HR), also regulated by the sympathetic nervous system, are not established. METHODS: Herein, we report 12-month outcomes from the Global SYMPLICITY Registry on office and ambulatory HR and BP in patients with uncontrolled hypertension (n = 846). RESULTS: HR declined in correlation with the HR at baseline and at 12 months, in particular, in patients in the upper tertile of HR (>74 bpm). BP reduction was similar in the tertiles of HR at baseline. Similar effects were observed when 24-h ambulatory HR and SBP were determined. Office HR was similarly decreased when patients were on a β-blocker or not. Antihypertensive treatment remained unchanged during the 12-month period of the Global SYMPLICITY Registry. CONCLUSION: RDN reduces BP independent from HR. A HR reduction is dependent on baseline HR and unchanged by β-blocker treatment. The effects of RDN on SBP and HR are durable up to 1 year. HR reduction might be a target for RDN in patients with high HR at baseline, which needs to be scrutinized in prospective trials.
OBJECTIVES: Renal denervation (RDN) can reduce sympathetic activity and blood pressure (BP) in patients with hypertension. The effects on resting and ambulatory heart rate (HR), also regulated by the sympathetic nervous system, are not established. METHODS: Herein, we report 12-month outcomes from the Global SYMPLICITY Registry on office and ambulatory HR and BP in patients with uncontrolled hypertension (n = 846). RESULTS: HR declined in correlation with the HR at baseline and at 12 months, in particular, in patients in the upper tertile of HR (>74 bpm). BP reduction was similar in the tertiles of HR at baseline. Similar effects were observed when 24-h ambulatory HR and SBP were determined. Office HR was similarly decreased when patients were on a β-blocker or not. Antihypertensive treatment remained unchanged during the 12-month period of the Global SYMPLICITY Registry. CONCLUSION: RDN reduces BP independent from HR. A HR reduction is dependent on baseline HR and unchanged by β-blocker treatment. The effects of RDN on SBP and HR are durable up to 1 year. HR reduction might be a target for RDN in patients with high HR at baseline, which needs to be scrutinized in prospective trials.
Authors: Dominik Linz; Mathias Hohl; Adrian D Elliott; Dennis H Lau; Felix Mahfoud; Murray D Esler; Prashanthan Sanders; Michael Böhm Journal: Clin Auton Res Date: 2018-02-10 Impact factor: 4.435
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Authors: Maria Peleli; Peter Flacker; Zhengbing Zhuge; Cristina Gomez; Craig E Wheelock; A Erik G Persson; Mattias Carlstrom Journal: Redox Biol Date: 2017-07-05 Impact factor: 11.799
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