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Potential Game Changer In Hypertension: Renal Denervation

Substantial Reduction in Single Sympathetic Nerve Firing After Renal Denervation in Patients With Resistant Hypertension
Hering D, Lambert EA, Marusic P, Walton AS, Krum H, Lambert GW, Esler MD, Schlaich MP. Substantial Reduction in Single Sympathetic Nerve Firing After Renal Denervation in Patients with Resistant Hypertension. Hypertension. 2013;61:457-464, doi:10.1161/HYPERTENSIONAHA.111.00194
Abstract

   

In patients with resistant hypertension, renal denervation has been shown to reduce blood pressure and muscle sympathetic nerve activity. Renal denervation was shown to influence the rapid reduction in firing properties of single sympathetic vasoconstrictor fibers.

Renal Sympathetic Denervation Provides Ventricular Rate Control But Does Not Prevent Atrial Electrical Remodeling During Atrial Fibrillation
Linz D, Mahfoud F, Schotten U, Ukena C, Hohl M, Neuberger H-R, Wirth K, Böhm M. Renal Sympathetic Denervation Provides Ventricular Rate Control But Does Not Prevent Atrial Electrical Remodeling During Atrial Fibrillation. Hypertension. 2013;61:225-231, doi:10.1161/HYPERTENSIONAHA.111.00182
Abstract

 

In patients with resistant hypertension, renal denervation has been shown to reduce blood pressure by reducing renal efferent and afferent sympathetic activity. The effect of modulation of the autonomic nervous system by renal denervation on atrial electrophysiology and ventricular rate control during atrial fibrillation is unknown. In patients with permanent atrial fibrillation undergoing renal denervation, there is a reduction of ventricular heart rate.

 

 

Renal Sympathetic Denervation Suppresses Postapneic Blood Pressure Rises and Atrial Fibrillation in a Model for Sleep Apnea
Linz D, Mahfoud F, Schotten U, Ukena, C, Neuberger HR, Wirth K, Bohm M. Renal Sympathetic Denervation Suppresses Postapneic Blood Pressure Rises and Atrial Fibrillation in a Model for Sleep Apnea. Hypertension. 2012;58:172-178, 10.1161/HYPERTENSIONAHA.112.191965
Abstract

 

Increases in sympathovagal disbalance, atrial fibrillation, and postapneic blood pressure have been linked to obstructive sleep apnea. In resistant hypertensive patients, renal denervation has been shown to reduce renal efferent as well as afferent sympathetic activity and blood pressure. Renal deprivation and atenolol were shown to modulate vagally-mediated negative tracheal pressure–induced atrial effective refractory period shortening, highlighting the importance of autonomic disbalance in obstructive sleep apnea–associated atrial fibrillation.

 

 

Effects of Renal Sympathetic Denervation on Blood Pressure, Sleep Apnea Course, and Glycemic Control in Patients With Resistant Hypertension and Sleep Apnea
Witkowski A, Prejbisz A, Florczak E, Kadziela J, Sliwinski P, Bielen P, Michalowska I, Kabat M, Warchol E, Januszewicz, M, Narkiewicz K, Somers VK, Sobotka PA, Januszewicz A. Effects of Renal Sympathetic Denervation on Blood Pressure, Sleep Apnea Course, and Glycemic Control in Patients With Resistant Hypertension and Sleep Apnea. Hypertension. 2011;58:559-565, doi:10.1161/HYPERTENSIONAHA.111.173799.
Abstract

 

In patients with refractory hypertension and obstructive sleep apnea, catheter-based renal denervation lowered blood pressure. In addition, improvements were also seen in the severity of sleep apnea and glucose tolerance.

 

 

Catheter-Based Renal Sympathetic Denervation for Resistant Hypertension: Durability of Blood Pressure Reduction Out to 24 Months
Symplicity HTN Investigators. Hypertension. 2011; 57:911-917, doi:10.1161/HYPERTENSIONAHA.110.163014.
Abstract

 

Renal sympathetic denervation has been shown to play a vital role in the reduction of blood pressure and even more of a seminal role in the maintenance and progression of hypertension. In patients with resistant hypertension, catheter based renal sympathetic denervation resulted in a significant reduction in blood pressure sustained out to ≥2 years of follow-up, without significant adverse events.

Posted by Stacy AHA Science on Apr 4, 2013 12:11 PM US/Central

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