Universität zu Köln

Wallbach, Manuel, Halbach, Marcel, Reuter, Hannes, Passauer, Jens, Lueders, Stephan, Boehning, Enrico, Zenker, Dieter, Mueller, Gerhard A., Wachter, Rolf ORCID: 0000-0003-2231-2200 and Koziolek, Michael J. (2016). Baroreflex activation therapy in patients with prior renal denervation. J. Hypertens., 34 (8). S. 1630 - 1639. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1473-5598

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Abstract

Background: Both baroreflex activation therapy (BAT) and renal denervation modulate sympathetic activity. The aim of this study was to systematically investigate whether additive modulation of autonomic nervous system by BAT lowers blood pressure (BP) in patients who still suffer from uncontrolled resistant hypertension despite prior renal denervation. Methods: From 2012 to January 2015, patients treated with BAT for uncontrolled resistant hypertension, who prior received renal denervation were consecutively analyzed in four German centers for hypertension. Analyses of office BP, 24-h ambulatory BP, central hemodynamics, parameters of renal function were performed. Results: A total of 28 patients, who underwent renal denervation at least 5 months before and still suffer from uncontrolled BP, were subsequently treated with BAT. The office SBP decreased from 182 +/- 28 to 163 +/- 27 mmHg (P<0.01) with a responder rate of 68% (office SBP reduction >= 10 mmHg) at month 6, whereas the number of prescribed antihypertensive drug classes remained unchanged (6.2 +/- 1.5 vs. 6.0 +/- 1.7, P = 0.30). Serum creatinine, estimated glomerular filtration rate and cystatin C remained stable (P = 1.00, P = 0.41 and P = 0.22, respectively), whereas albuminuria was significantly reduced by a median of -29% (P = 0.02). Central SBP (-15 +/- 24 mmHg, P = 0.047) and end systolic pressure (-14 +/- 20 mmHg, P = 0.03) were significantly reduced. Conclusion: The present data demonstrate that BAT may exert BP-lowering as well as antiproteinuric effects in patients with prior renal denervation. However, precise evaluation of BAT effects in patients with prior renal denervation will need randomized controlled trials using sham procedures.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wallbach, Manuel UNSPECIFIED UNSPECIFIED UNSPECIFIED Halbach, Marcel UNSPECIFIED UNSPECIFIED UNSPECIFIED Reuter, Hannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Passauer, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Lueders, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Boehning, Enrico UNSPECIFIED UNSPECIFIED UNSPECIFIED Zenker, Dieter UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Gerhard A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wachter, Rolf UNSPECIFIED orcid.org/0000-0003-2231-2200 UNSPECIFIED Koziolek, Michael J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-268932
DOI:	10.1097/HJH.0000000000000949
Journal or Publication Title:	J. Hypertens.
Volume:	34
Number:	8
Page Range:	S. 1630 - 1639
Date:	2016
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1473-5598
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TREATMENT-RESISTANT HYPERTENSION; LOWERS BLOOD-PRESSURE; SYMPATHETIC DENERVATION; CENTRAL HEMODYNAMICS; ARTERIAL STIFFNESS; BARORECEPTOR STIMULATION; CATHETER; TRIAL; REINNERVATION; ALBUMINURIA Multiple languages Peripheral Vascular Disease Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26893