Hyperresponders vs. nonresponder patients after renal denervation: do they differ?

Détails

ID Serval
serval:BIB_1DDE970B2389
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Hyperresponders vs. nonresponder patients after renal denervation: do they differ?
Périodique
Journal of Hypertension
Auteur(s)
Persu A., Azizi M., Jin Y., Volz S., Rosa J., Fadl Elmula F.E., Pechere-Bertschi A., Burnier M., Mark P.B., Elvan A., Renkin J., Sapoval M., Kahan T., Kjeldsen S., Staessen J.A.
Collaborateur(s)
European Network COordinating research on Renal Denervation (ENCOReD) consortium
ISSN
1473-5598 (Electronic)
ISSN-L
0263-6352
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
32
Numéro
12
Pages
2422-7; discussion 2427
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
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.
Mots-clé
Blood Pressure, Blood Pressure Monitoring, Ambulatory, Catheter Ablation, Cohort Studies, Denervation, Europe, Female, Humans, Hypertension/physiopathology, Kidney/innervation, Male, Middle Aged, Sex Characteristics, Treatment Outcome
Pubmed
Web of science
Création de la notice
18/12/2014 18:30
Dernière modification de la notice
20/08/2019 12:54
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