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Radiofrequency ablation of renal artery nerves has been shown to reduce blood pressure (BP) in patients with severe, treatment-resistant hypertension (rHTN, BP uncontrolled on at least 3 antihypertensive drugs). Longer follow-up of subjects undergoing renal denervation (RDN) is essential to establish the long-term safety and reliability of this novel treatment intervention.
The Symplicity™ HTN-2 trial randomized subjects with rHTN and systolic BP ≥160 mm Hg to treatment by RDN or to maintenance on prior therapy. Control subjects were eligible to crossover to RDN at 6 months. All subjects were followed for 2 years (18 months post-RDN for crossover patients) to assess long-term effectiveness and safety of RDN.
At baseline, more crossover than RDN subjects were female (60% vs 35%), and 40% of the RDN and 30 % of the crossover group subjects had type 2 diabetes. BP was significantly lower than baseline at each time point (table). Pulse pressure was reduced −18.5 in the RDN group at 24 months and −17.6 in the crossover group at 18 month (p<0.01 for both). Heart rate was reduced by renal denervation (table), presumably due to central sympathetic inhibition from afferent nerve ablation. No device-related serious adverse events occurred.
RDN with the Symplicity catheter consistently reduced systolic BP by 28-32 mm Hg over 2 years with no safety concerns.
North, Room 121
Sunday, March 10, 2013, 9:15 a.m.-9:30 a.m.
Session Title: Prevention: Blood Pressure – Hot Topics for 2013
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 918-8
- 2013 American College of Cardiology Foundation