Hyperresponders vs. nonresponder patients after renal denervation: do they differ?

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Hypertension Management

Background:

• Blood pressure (BP) response to renal denervation (RDN) is highly variable.
• Predictors of BP response to RDN remain inconsistently identified.
• Differences between major BP decrease responders and nonresponders after RDN require investigation.

Purpose of the Study:

• To identify extreme BP responders and nonresponders to RDN.
• To compare baseline characteristics and 6-month BP changes in these subsets.
• To evaluate the impact of measurement method (office vs. ambulatory BP) on response definition.

Main Methods:

• Utilized the European Network COordinating research on Renal Denervation database (n=109).
• Defined extreme responders (first quintile) and nonresponders (fifth quintile) based on office or 24-h ambulatory BP.
• Compared baseline characteristics and BP changes at 6 months post-RDN.

Main Results:

• Ambulatory BP-defined responders showed similar office and out-of-office BP changes.
• Office BP-defined responders exhibited a significant white-coat effect reduction.
• Office BP-defined responders had higher baseline office BP, were more often women, and had higher eGFR compared to nonresponders.

Conclusions:

• Office BP measurements may overestimate RDN response compared to ambulatory BP.
• Lower estimated glomerular filtration rate (eGFR) is associated with poorer RDN response.
• Higher proportion of women among extreme responders might indicate sex differences in adherence.