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Impact of renal denervation in daytime and nighttime distribution of ambulatory blood pressure at 1 year follow-up
Session:
Posters 1 - Écran 7 - Hipertensão Arterial
Speaker:
Catarina Brízido
Congress:
CPC 2019
Topic:
I. Hypertension
Theme:
27. Hypertension
Subtheme:
27.4 Hypertension – Treatment
Session Type:
Posters
FP Number:
---
Authors:
Catarina Brízido; Manuel Almeida; Pedro de Araújo Gonçalves; Patrícia Branco; Augusta Gaspar; Rita Veríssimo; Gonçalo Lopes Da Cunha; Mariana Gonçalves; Miguel Mendes
Abstract
<p><u>Introduction</u>:</p> <p>Renal denervation (RDN) exerts its effects through sympathetic drive reduction and 24-hour ambulatory blood pressure measurement (ABPM) is currently considered the most accurate measurement of its effect. However, little is known about the impact of RDN on 24-hour distribution of blood pressure. Our aim was to evaluate the effect of RDN on daytime/nighttime blood pressure at 1 year follow up.</p> <p><u>Methods</u>:</p> <p>From a single center prospective registry including 65 consecutive patients with resistant hypertension undergoing RDN between July/2011 and April/2015, 31 patients with baseline and 1- year follow-up 24-hour ABPM were included in this analysis. Mean hourly systolic and diastolic blood pressure (SBP and DPB) were compared before and after RDN. Nighttime was defined as the previous 8 hours before awakening.</p> <p><u>Results</u>:</p> <p>Mean age was 65±7 years, 48% were males, 71% had type 2 diabetes. Most had hypertension lasting for more than 10 years (90%) and were being treated with a median number of 6 anti-hypertensive drugs, including 74% on spironolactone.</p> <p>At 1 year, there was a significant reduction in mean 24-hour ABPM systolic and diastolic blood pressure (146 ± 17mmHg vs 131 ± 16mmHg, p=0.001 and 82 ± 8mmHg vs 73 ± 9mmHg, p=0.001). This difference was more pronounced during daytime (151 ± 16mmHg vs 133 ± 15mmHg for SBP, p=0.001), while blood pressure differences were attenuated but still significant during nighttime (138 ± 20mmHg vs 127 ± 21mmHg for SBP, p=0.069) – figure.</p> <p><u>Conclusion</u>:</p> <p>The evaluation of RDN impact on 24-hour ABPM demonstrated a significant drop in both SBP and DBP at 1-year follow-up. In addition, the reduction was present both for daytime and nighttime (more pronounced in the former), suggesting an “always-on” effect over the 24-hour period.</p>
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