Central pulse pressure predicts BP reduction after renal denervation in patients with treatment-resistant...

Area of Science:

• Cardiology
• Vascular Medicine
• Hypertension Research

Background:

• Enhanced vascular ageing is linked to increased central pulse pressure (cPP), a key predictor of cardiovascular events.
• Despite antihypertensive treatments, significant residual cardiovascular risk persists, often due to irreversible vascular damage.
• Renal denervation (RDN) offers a potential treatment for resistant hypertension (TRH), but its effectiveness varies.

Purpose of the Study:

• To investigate whether central pulse pressure (cPP) can predict blood pressure (BP) reduction following renal denervation (RDN).
• To determine if baseline cPP levels influence the efficacy of RDN in patients with treatment-resistant hypertension (TRH).

Main Methods:

• Sixty-three patients with true TRH underwent catheter-based RDN.
• Central pulse pressure (cPP) was measured at baseline using pulse wave analysis.
• Patients were stratified into 'low cPP' and 'high cPP' groups based on the median value (55 mmHg).

Main Results:

• Patients with low cPP showed significantly greater reductions in office BP (-22±19/-13±11 mmHg) compared to those with high cPP (-12±20/-5±13 mmHg) six months post-RDN.
• A trend towards greater 24-hour ambulatory BP reduction was observed in the low cPP group.
• Baseline cPP and systolic BP were independent predictors of office systolic BP reduction after RDN.

Conclusions:

• Central pulse pressure (cPP) serves as an indicator of large arterial stiffening.
• cPP may be a valuable tool for identifying patients who are likely to respond favorably to renal denervation (RDN).