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EFFICACY OF RENAL DENERVATION IN ELDERLY PATIENTS WITH RESISTANT HYPERTENSION
E1745 JACC March 12, 2013 Volume 61, Issue 10
TCT@ACC-i2: Invasive and Interventional Cardiology Efficacy of Renal Denervation in Elderly Patients with Resistant Hypertension Oral Contributions West, Room 2009 Sunday, March 10, 2013, 8:30 a.m.-8:40 a.m.
Session Title: Endovascular Intervention and Renal Denervation Abstract Category: 41. TCT@ACC-i2: Carotid, Neurovascular, and Endovascular Intervention Presentation Number: 2905-5 Authors: Ann-Kathrin Ziegler, Stefan Bertog, Dani Id, Benjamin Kaltenbach, Marius Hornung, Jennifer Franke, Laura Vaskelyte, Ilona Hofmann, Horst Sievert, CardioVascular Center, Frankfurt, Germany Background: Catheter-based renal sympathetic denervation (RD) causes significant blood pressure (BP) reductions in patients with resistant hypertension (rHTN). However, hypertensive elderly patients reportedly have a lower sympathetic tone than younger patients and a blood pressure lowering effect in this population has not yet been demonstrated. The purpose of this study was to assess the efficacy of RD in elderly patients. Methods: We reviewed all consecutive patients aged ≥ 75 years (rage: 75-89 years, mean: 78 years) with rHTN treated with RD. Twenty-four patients were included in this prospective study. Office and ambulatory BPs were assessed at baseline and 6 months follow-up. Primary endpoint was the change in office systolic BP at 6 months. Results: Baseline mean office BP was 172.6/85.6 +/- 21.2/12.6 mmHg. Baseline 24-hour mean ambulatory BP, available in 22 patients, was 158.4/80.0 mmHg +/- 19.6/13.0 mmHg. Baseline creatinine was 1.01 +/- 0.18 mg/dl and mean number of antihypertensive agents at baseline 4.3 +/- 1.4. A mean of 5.5 +/- 1.1 and 5.6 +/- 0.9 ablations were performed in the left and right renal artery, respectively. There were no device- or procedure-related adverse events. At 6 months follow-up the mean office BP decreased by 22.8/12.6 +- 24.6/13.9 mmHg (p< 0.01 compared to baseline). Mean systolic 24h ambulatory BP, available in 18 patients, decreased by 9.4 mmHg to an average of 150.6/75.3 +- 20.6/14.7 mmHg. The number of antihypertensive medications could be reduced in 9 and remained unchanged in the remainder of the patients. There was no significant change in renal function at 6 months follow-up. Conclusion: Our results demonstrate that a blood pressure reduction of similar magnitude as that reported in previous trials can be expected in elderly patients. Elderly patients with resistant hypertension should not be excluded from renal denervation.
TCT@ACC-i2: Invasive and Interventional Cardiology Efficacy of Renal Denervation in Elderly Patients with Resistant Hypertension Oral Contributions West, Room 2009 Sunday, March 10, 2013, 8:30 a.m.-8:40 a.m.
Session Title: Endovascular Intervention and Renal Denervation Abstract Category: 41. TCT@ACC-i2: Carotid, Neurovascular, and Endovascular Intervention Presentation Number: 2905-5 Authors: Ann-Kathrin Ziegler, Stefan Bertog, Dani Id, Benjamin Kaltenbach, Marius Hornung, Jennifer Franke, Laura Vaskelyte, Ilona Hofmann, Horst Sievert, CardioVascular Center, Frankfurt, Germany Background: Catheter-based renal sympathetic denervation (RD) causes significant blood pressure (BP) reductions in patients with resistant hypertension (rHTN). However, hypertensive elderly patients reportedly have a lower sympathetic tone than younger patients and a blood pressure lowering effect in this population has not yet been demonstrated. The purpose of this study was to assess the efficacy of RD in elderly patients. Methods: We reviewed all consecutive patients aged ≥ 75 years (rage: 75-89 years, mean: 78 years) with rHTN treated with RD. Twenty-four patients were included in this prospective study. Office and ambulatory BPs were assessed at baseline and 6 months follow-up. Primary endpoint was the change in office systolic BP at 6 months. Results: Baseline mean office BP was 172.6/85.6 +/- 21.2/12.6 mmHg. Baseline 24-hour mean ambulatory BP, available in 22 patients, was 158.4/80.0 mmHg +/- 19.6/13.0 mmHg. Baseline creatinine was 1.01 +/- 0.18 mg/dl and mean number of antihypertensive agents at baseline 4.3 +/- 1.4. A mean of 5.5 +/- 1.1 and 5.6 +/- 0.9 ablations were performed in the left and right renal artery, respectively. There were no device- or procedure-related adverse events. At 6 months follow-up the mean office BP decreased by 22.8/12.6 +- 24.6/13.9 mmHg (p< 0.01 compared to baseline). Mean systolic 24h ambulatory BP, available in 18 patients, decreased by 9.4 mmHg to an average of 150.6/75.3 +- 20.6/14.7 mmHg. The number of antihypertensive medications could be reduced in 9 and remained unchanged in the remainder of the patients. There was no significant change in renal function at 6 months follow-up. Conclusion: Our results demonstrate that a blood pressure reduction of similar magnitude as that reported in previous trials can be expected in elderly patients. Elderly patients with resistant hypertension should not be excluded from renal denervation.