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BP lowering effects of renal denervation maintained upto 1 year with fewer medicines: JACC
![BP lowering effects of renal denervation maintained upto 1 year with fewer medicines: JACC BP lowering effects of renal denervation maintained upto 1 year with fewer medicines: JACC](https://medicaldialogues.in/h-upload/2020/10/14/750x450_135819-renal-denervation.webp)
Delhi: With fewer prescribed antihypertensive medications, the BP lowering effect of endovascular ultrasound renal denervation (RDN) was maintained at 12 months compared to sham, according to a recent study in the journal JACC: Cardiovascular Interventions.
Previous RCTs have shown the blood pressure (BP)–lowering efficacy and safety of endovascular ultrasound renal denervation in the absence and presence of antihypertensive medications. This study by Michel Azizi , Hypertension Department and DMU Carte, Paris, France, and colleagues reports the 12-month results of the RADIANCE-HTN (A Study of the ReCor Medical Paradise System in Clinical Hypertension) SOLO trial following unblinding of patients at 6 months.
It included patients with daytime ambulatory BP ≥135/85 mm Hg after 4 weeks off medication. They were randomized to receive RDN (n = 74) or sham (n = 72) and maintained off medication for 2 months. A standardized medication escalation protocol was instituted between 2 and 5 months (blinded phase). Between 6 and 12 months (unblinded phase), patients received antihypertensive medications at physicians' discretion.
Outcomes at 12 months included medication burden, change in daytime ambulatory systolic BP (dASBP) and office or home systolic BP (SBP), visit-to-visit variability in SBP, and safety.
Key findings of the study include:
- Sixty-five of 74 RDN patients and 67 of 72 sham patients had 12-month dASBP measurements.
- The proportion of patients on ≥2 medications (27.7% vs. 44.8%), the number of medications (0 vs. 1.4), and defined daily dose (1.4 vs. 2.2) were less with RDN versus sham.
- The decrease in dASBP from baseline in the RDN group (−16.5 ± 12.9 mm Hg) remained stable at 12 months.
- The RDN versus sham adjusted difference at 12 months was −2.3 mm Hg for dASBP, −6.3 mm Hg for office SBP, and −3.4 mm Hg for home SBP.
- Visit-to-visit variability in SBP was smaller in the RDN group.
- No renal artery injury was detected on computed tomographic or magnetic resonance angiography.
"The decrease in BP with a treatment strategy including RDN followed by subsequent addition of antihypertensive medications was associated with a lower VVV of BP than a treatment strategy including stepped-care intensified antihypertensive treatment only," wrote the authors.
"Despite unblinding, the BP-lowering effect of RDN was maintained at 12 months with fewer prescribed medications compared with sham." they concluded.
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: editorial@medicaldialogues.in. Contact no. 011-43720751