TY - JOUR
T1 - Hyperresponders vs. nonresponder patients after renal denervation: do they differ?
AU - Persu, Alexandre
AU - Azizi, Michel
AU - Jin, Yu
AU - Volz, Sebastian
AU - Rosa, Jan
AU - Elmula, Fadl Elmula M. Fadl
AU - Pechere-Bertschi, Antoinette
AU - Burnier, Michel
AU - Mark, Patrick B.
AU - Elvan, Arif
AU - Renkin, Jean
AU - Sapoval, Marc
AU - Kahan, Thomas
AU - Kjeldsen, Sverre
AU - Staessen, Jan A.
PY - 2014/12
Y1 - 2014/12
N2 - Background: Blood pressure (BP) response after renal denervation (RDN) is highly variable. Besides baseline BP, no reliable predictors of response have been consistently identified. The differences between patients showing a major BP decrease after RDN vs. nonresponders have not been studied so far. Aim and methods: We identified extreme BP responders (first quintile) and nonresponders (fifth quintile) to RDN defined according to office or 24-h ambulatory BP in the European Network COordinating research on Renal Denervation database (n = 109) and compared the baseline characteristics and BP changes 6 months after RDN in both subsets. Results: In extreme responders defined according to ambulatory BP, baseline BP and BP changes 6 months after RDN were similar for office and out-of-the office BP. In contrast, extreme responders defined according to office BP were characterized by a huge white-coat effect at baseline, with dramatic shrinkage at 6 months. Compared with nonresponders, extreme responders defined according to office BP were more frequently women, had higher baseline office - but not ambulatory - BP, and higher estimated glomerular filtration rate (eGFR). In contrast, when considering ambulatory BP decrease to define extreme responders and nonresponders, the single relevant difference between both subsets was baseline ambulatory BP. Conclusion: This study suggests a major overestimation of BP response after RDN in extreme responders defined according to office, but not ambulatory BP. The association of lower eGFR with poor response to RDN is consistent with our previous analysis. The increased proportion of women in extreme responders may reflect sex differences in drug adherence.
AB - Background: Blood pressure (BP) response after renal denervation (RDN) is highly variable. Besides baseline BP, no reliable predictors of response have been consistently identified. The differences between patients showing a major BP decrease after RDN vs. nonresponders have not been studied so far. Aim and methods: We identified extreme BP responders (first quintile) and nonresponders (fifth quintile) to RDN defined according to office or 24-h ambulatory BP in the European Network COordinating research on Renal Denervation database (n = 109) and compared the baseline characteristics and BP changes 6 months after RDN in both subsets. Results: In extreme responders defined according to ambulatory BP, baseline BP and BP changes 6 months after RDN were similar for office and out-of-the office BP. In contrast, extreme responders defined according to office BP were characterized by a huge white-coat effect at baseline, with dramatic shrinkage at 6 months. Compared with nonresponders, extreme responders defined according to office BP were more frequently women, had higher baseline office - but not ambulatory - BP, and higher estimated glomerular filtration rate (eGFR). In contrast, when considering ambulatory BP decrease to define extreme responders and nonresponders, the single relevant difference between both subsets was baseline ambulatory BP. Conclusion: This study suggests a major overestimation of BP response after RDN in extreme responders defined according to office, but not ambulatory BP. The association of lower eGFR with poor response to RDN is consistent with our previous analysis. The increased proportion of women in extreme responders may reflect sex differences in drug adherence.
KW - ambulatory blood pressure
KW - renal denervation
KW - resistant hypertension
KW - responders
U2 - 10.1097/HJH.0000000000000347
DO - 10.1097/HJH.0000000000000347
M3 - Article
C2 - 25375391
VL - 32
SP - 2422
EP - 2427
JO - Journal of Hypertension
JF - Journal of Hypertension
SN - 0263-6352
IS - 12
ER -