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Predictors of blood pressure response to ultrasound renal denervation in the RADIANCE-HTN SOLO study
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-h...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9287166/ https://www.ncbi.nlm.nih.gov/pubmed/34031548 http://dx.doi.org/10.1038/s41371-021-00547-y |
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author | Saxena, Manish Schmieder, Roland E. Kirtane, Ajay J. Mahfoud, Felix Daemen, Joost Basile, Jan Lurz, Philipp Gosse, Philippe Sanghvi, Kintur Fisher, Naomi D. L. Rump, Lars C. Pathak, Atul Blankestijn, Peter J. Mathur, Anthony Wang, Yale Weber, Michael A. Sharp, Andrew S. P. Bloch, Michael J. Barman, Neil C. Claude, Lisa Song, Yang Azizi, Michel Lobo, Melvin D. |
author_facet | Saxena, Manish Schmieder, Roland E. Kirtane, Ajay J. Mahfoud, Felix Daemen, Joost Basile, Jan Lurz, Philipp Gosse, Philippe Sanghvi, Kintur Fisher, Naomi D. L. Rump, Lars C. Pathak, Atul Blankestijn, Peter J. Mathur, Anthony Wang, Yale Weber, Michael A. Sharp, Andrew S. P. Bloch, Michael J. Barman, Neil C. Claude, Lisa Song, Yang Azizi, Michel Lobo, Melvin D. |
author_sort | Saxena, Manish |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9287166 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-92871662022-07-17 Predictors of blood pressure response to ultrasound renal denervation in the RADIANCE-HTN SOLO study Saxena, Manish Schmieder, Roland E. Kirtane, Ajay J. Mahfoud, Felix Daemen, Joost Basile, Jan Lurz, Philipp Gosse, Philippe Sanghvi, Kintur Fisher, Naomi D. L. Rump, Lars C. Pathak, Atul Blankestijn, Peter J. Mathur, Anthony Wang, Yale Weber, Michael A. Sharp, Andrew S. P. Bloch, Michael J. Barman, Neil C. Claude, Lisa Song, Yang Azizi, Michel Lobo, Melvin D. J Hum Hypertens Article 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. Nature Publishing Group UK 2021-05-24 2022 /pmc/articles/PMC9287166/ /pubmed/34031548 http://dx.doi.org/10.1038/s41371-021-00547-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Saxena, Manish Schmieder, Roland E. Kirtane, Ajay J. Mahfoud, Felix Daemen, Joost Basile, Jan Lurz, Philipp Gosse, Philippe Sanghvi, Kintur Fisher, Naomi D. L. Rump, Lars C. Pathak, Atul Blankestijn, Peter J. Mathur, Anthony Wang, Yale Weber, Michael A. Sharp, Andrew S. P. Bloch, Michael J. Barman, Neil C. Claude, Lisa Song, Yang Azizi, Michel Lobo, Melvin D. Predictors of blood pressure response to ultrasound renal denervation in the RADIANCE-HTN SOLO study |
title | Predictors of blood pressure response to ultrasound renal denervation in the RADIANCE-HTN SOLO study |
title_full | Predictors of blood pressure response to ultrasound renal denervation in the RADIANCE-HTN SOLO study |
title_fullStr | Predictors of blood pressure response to ultrasound renal denervation in the RADIANCE-HTN SOLO study |
title_full_unstemmed | Predictors of blood pressure response to ultrasound renal denervation in the RADIANCE-HTN SOLO study |
title_short | Predictors of blood pressure response to ultrasound renal denervation in the RADIANCE-HTN SOLO study |
title_sort | predictors of blood pressure response to ultrasound renal denervation in the radiance-htn solo study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9287166/ https://www.ncbi.nlm.nih.gov/pubmed/34031548 http://dx.doi.org/10.1038/s41371-021-00547-y |
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