Eligibility for renal denervation: experience at 11 European expert centers.

Details

Serval ID
serval:BIB_29FDFC4186D3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Eligibility for renal denervation: experience at 11 European expert centers.
Journal
Hypertension
Author(s)
Persu A., Jin Y., Baelen M., Vink E., Verloop W.L., Schmidt B., Blicher M.K., Severino F., Wuerzner G., Taylor A., Pechère-Bertschi A., Jokhaji F., Fadl Elmula F.E., Rosa J., Czarnecka D., Ehret G., Kahan T., Renkin J., Widimsky J., Jacobs L., Spiering W., Burnier M., Mark P.B., Menne J., Olsen M.H., Blankestijn P.J., Kjeldsen S., Bots M.L., Staessen J.A.
Working group(s)
European Network Coordinating research on REnal Denervation Consortium
Contributor(s)
Baelen M., Gerber B., Horman S., Kefer£££Joëlle£££ J. , Lengelé JP., de Waroux JB. , Renkin J., Scavée C., Severino F., Vanoverschelde JL., Ehret G., Péchère-Bertschi A., Berry C., Brady A., Delles C., Dominiczak A., Freel M., Jardine A., Moss J., Muir S., Mark P., Padmanabhan S., Roditi G., Bauersachs J., Brinkmann J., Haller H., Heusser K., Jordan J., Klein G., Menne J., Schmidt B., Tank J., Czarnecka D., Jastrzębski M., Styczkiewicz K., Burnier M., Wuerzner G., Asayama K., Gu Y., Hashimoto A., Jacobs L., Jin Y., Kuznetsova T., Liu Y., Thijs L., Staessen JA., Blicher M., Beck-Nielse H., Høilund-Carlsen PF., Olsen M., Brekke M., Engeseth K., Elmula FE., Fossum E., Gjønnæss E., Hjørnholm U., Hoffmann P., Høieggen A., Kjær V., Kjeldsen SE., Larstorp AC., Meyerdierks O., Os I., Rostrup M., Stenehjem A., Rosa J., Petrak O., Zelinka T., Strauch B., Curila K., Tousek P., Widimský£££Jiřί£££ J. , Widimský P., Jokhaji F., Lander R., Kahan T., Spaak J., Blankestijn PJ., Bots ML., Doevendans PA., Rookmaaker MB., Spiering W., Verloop WL., Vink EE., Voskuil M., Vonken EJ.
ISSN
1524-4563 (Electronic)
ISSN-L
0194-911X
Publication state
Published
Issued date
2014
Volume
63
Number
6
Pages
1319-1325
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Abstract
Based on the SYMPLICITY studies and CE (Conformité Européenne) certification, renal denervation is currently applied as a novel treatment of resistant hypertension in Europe. However, information on the proportion of patients with resistant hypertension qualifying for renal denervation after a thorough work-up and treatment adjustment remains scarce. The aim of this study was to investigate the proportion of patients eligible for renal denervation and the reasons for noneligibility at 11 expert centers participating in the European Network COordinating Research on renal Denervation in treatment-resistant hypertension (ENCOReD). The analysis included 731 patients. Age averaged 61.6 years, office blood pressure at screening was 177/96 mm Hg, and the number of blood pressure-lowering drugs taken was 4.1. Specialists referred 75.6% of patients. The proportion of patients eligible for renal denervation according to the SYMPLICITY HTN-2 criteria and each center's criteria was 42.5% (95% confidence interval, 38.0%-47.0%) and 39.7% (36.2%-43.2%), respectively. The main reasons of noneligibility were normalization of blood pressure after treatment adjustment (46.9%), unsuitable renal arterial anatomy (17.0%), and previously undetected secondary causes of hypertension (11.1%). In conclusion, after careful screening and treatment adjustment at hypertension expert centers, only ≈40% of patients referred for renal denervation, mostly by specialists, were eligible for the procedure. The most frequent cause of ineligibility (approximately half of cases) was blood pressure normalization after treatment adjustment by a hypertension specialist. Our findings highlight that hypertension centers with a record in clinical experience and research should remain the gatekeepers before renal denervation is considered.
Pubmed
Web of science
Open Access
Yes
Create date
20/06/2014 17:16
Last modification date
20/08/2019 13:09
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