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Renal sympathetic denervation in Sweden: a report from the Swedish registry for renal denervation

Völz, Sebastiana; Spaak, Jonasb; Elf, Johanc; Jägrén, Christinad; Lundin, Christere; Stenborg, Annag; Andersson, Jonasf; Rundqvist, Bengta; Kahan, Thomasb; Andersson, Berta

doi: 10.1097/HJH.0000000000001517
ORIGINAL PAPERS: Resistant hypertension
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Background: Renal denervation (RDN) is a catheter-based intervention to treat patients with resistant hypertension. The biological effects of RDN are not fully understood, and randomized controlled trials have generated conflicting evidence. This report presents data from the Swedish Registry for Renal Denervation, an investigator-driven nationwide registry.

Purpose: To assess the safety and efficacy of RDN on patients with resistant hypertension in a real-world clinical setting.

Methods: This nationwide database contains patient characteristics, procedural details, and follow-up data on all RDN procedures performed in Sweden. Consecutive procedures between 2011 and 2015 were included.

Results: The data analysis consists of 252 patients (mean age 61 ± 10 years, 38% women; mean 4.5 ± 1.5 antihypertensive drugs). Office SBP and DBP and 24-h ambulatory blood pressure (BP) decreased 6 months after RDN (176 ± 23/97 ± 17 to 161 ± 26/91 ± 16 mmHg, both P < 0.001; and 155 ± 17/89 ± 14 to 147 ± 18/82 ± 12 mmHg, both P < 0.001). Significant office and ambulatory BP reductions persisted throughout the observation period of 36 months. Major procedure-related vascular complications occurred in four patients. Renal function and number of antihypertensive drugs were unchanged during follow-up.

Conclusion: In this complete national cohort, RDN was associated with a sustained reduction in office and ambulatory BP in patients with resistant hypertension. The procedure proved to be feasible and associated with a low-complication rate, including long-term adverse events.

aDepartment of Cardiology, Sahlgrenska Academy at Gothenburg University, Gothenburg

bDivision of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm

cDepartment of Vascular Diseases, Skåne University Hospital, Malmö

dDepartment of Cardiology, South General Hospital, Stockholm

eDepartment of Cardiology, Örebro University Hospital, Örebro

fDepartment of Cardiology, Umeå University Hospital, Umeå

gDepartment of Internal Medicine, Uppsala University Hospital, Uppsala, Sweden

Correspondence to Sebastian Völz, MD, Department of Cardiology, Sahlgrenska University Hospital, Blå stråket 4, 413 45 Gothenburg, Sweden. Tel: +46 31 3427588; e-mail: sebastian.volz@vgregion.se

Abbreviations: ABPM, ambulatory blood pressure measurement; ACE, angiotensin-converting enzyme; ARB, angiotension receptor blocker; BP, blood pressure; CAD, coronary artery disease; eGFR, estimated glomerular filtration rate; ISH, isolated systolic hypertension; MDRD, modification of diet in renal disease; RDN, renal denervation; RH, resistant hypertension

Received 10 April, 2017

Revised 1 June, 2017

Accepted 17 July, 2017

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