Abstract 513 Long-term clinical outcome after renal denervation in resistant hypertension

Clin Res Cardiol (2021) DOI DOI https://doi.org/10.1007/s00392-021-01843-w
Long-term clinical outcome after renal denervation in resistant hypertension
P. Reimann¹, K. Fengler¹, K.-P. Rommel¹, K.-P. Kresoja¹, S. Blazek¹, M. Unterhuber¹, M. von Roeder¹, S. Desch¹, H. Thiele¹, P. Lurz¹
¹Klinik für Innere Medizin/Kardiologie, Herzzentrum Leipzig - Universität Leipzig, Leipzig;
Background: Recent trial results support overall efficacy of renal sympathetic denervation (RDN) in lowering blood pressure (BP). While BP reduction in general is associated with a clinically meaningful reduction in cardiovascular events and mortality, such a relation has not been described for patients undergoing RDN. Objectives: We retrospectively assessed clinical events in a single-center cohort of patients undergoing RDN. Methods: Clinical events were assessed in patients who underwent RDN at our center using telephone- and clinical follow up, interviews with general practitioners as well as review of our hospital’s database. Event rates were compared between BP responders and non-responders. Results: Two-hundred-ninety-six patients were included. After 3 months, 180 of these were classified as responders and 116 as non-responders. 24h systolic ambulatory BP was reduced by 8.3±12.2 mmHg and diastolic BP by 4.8±7.0 mmHg (p < 0.001 for both) after 3 months, and similarly after 6 and 12 months (8.0/5.1±12.4/7.1 and 8.7/5.4±14.1/7.8 mmHg, p<0.001 for all). During a median follow up time of 48 months, significantly more major adverse cardiovascular events occurred in non-responders than in responders (22 vs. 14%, hazard ratio 0.55 [CI 0.31 to 0.99], p = 0.044). This was consistent after adjustment for age, gender and baseline BP as well as in a propensity score matched cohort. A linear relationship was found between BP reduction after 3 months and frequency of MACE (Odds ratio 0.75 per 10 mmHg 24h systolic ambulatory BP reduction). Conclusions: Blood pressure response to RDN is associated with improved long-term clinical outcome.
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