Related Experiment Video
Updated: Oct 2, 2025
Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
Published on: May 26, 2022
Preprocedural features of patients under antihypertensive drugs may help identify responders to renal denervation: a
Shu-I Lin1,2, Chun-Che Huang3, Shih-Hsien Sung4
1Cardiovascular Center, MacKay Memorial Hospital, 104217 Taipei, Taiwan.
Background:
Renal denervation (RDN) is effective to lower systolic blood pressure (SBP) in essential hypertension. However, patient selection under medications remains an important unmet clinical need.
Methods:
This multicenter study aimed at observing whether preprocedural features associated with increased renin-angiotensin-aldosterone activity influence RDN response. This study enrolled the patients who underwent RDN for uncontrolled hypertension. Medical records were reviewd and patients were divided into 2 groups depending by meeting any of the following conditions prior to RDN: (1) >10 mmHg of office SBP reduction after aldosterone inhibition, (2) aldosterone-renin ratio >30 or (3) slow flow on the renal angiogram. RDN responders were defined by a reduction in 24-hour mean ≥6 mmHg or by ≥1 class of antihypertensive drug withdraw.
Results:
A total of 46 patients were enrolled, of which 27 (59%) were in control group A and 19 (41%) in group B. The baseline age, gender, office and 24-hour SBP (mean 140.0 ± 12.8 mmHg vs. 144.0 ± 16.5 mmHg, p = 0.577) were comparable, while the number of prescribed drug classes was fewer in group A (4.0 ± 1.3 vs. 4.9 ± 0.9, p = 0.014). The proportion patients with prescribed aldosterone antagonist or high aldosterone-renin ratios were higher in group B. At 12 months post RDN, the results were significantly better in group B in terms of mean change in office SBP (12.4 ± 23.5 mmHg vs. 29.9 ± 25.5 mmHg, p = 0.046) and the proportion of RDN responders (51.9% vs. 89.5%, p < 0.001).
Conclusion:
RDN was more effective in patients with any of 3 clinical indices.
Insights
Renal denervation (RDN) is more effective for essential hypertension patients with specific preprocedural indicators. Identifying these patients improves RDN outcomes and blood pressure control.
Area of Science:
- Cardiology
- Nephrology
- Hypertension Management
Background:
- Renal denervation (RDN) effectively lowers systolic blood pressure (SBP) in essential hypertension.
- Patient selection for RDN, especially those on medication, remains a clinical challenge.
Purpose of the Study:
- To investigate if preprocedural indicators of increased renin-angiotensin-aldosterone activity influence RDN response.
- To identify patient subgroups that benefit most from RDN.
Main Methods:
- Multicenter study of uncontrolled hypertension patients undergoing RDN.
- Patients categorized based on aldosterone inhibition response, aldosterone-renin ratio, or renal angiogram findings.
- RDN response defined by SBP reduction or antihypertensive drug withdrawal.
Main Results:
- Group B (with specific indices) showed significantly greater office SBP reduction (29.9 vs. 12.4 mmHg) and higher RDN responder rates (89.5% vs. 51.9%) at 12 months.
- Baseline characteristics were comparable, but Group B had fewer prescribed drug classes initially.
- Higher proportions of aldosterone antagonist use or high aldosterone-renin ratios were noted in Group B.
Conclusions:
- RDN demonstrated superior efficacy in patients exhibiting at least one of the three preprocedural clinical indices.
- These findings support using specific biomarkers to select patients for RDN.
More Related Videos
04:37Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
Published on: June 6, 2025
06:30Quantifying Acute Changes in Renal Sympathetic Nerve Activity in Response to Central Nervous System Manipulations in Anesthetized Rats
Published on: September 11, 2018
Related Concept Videos
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:25Antihypertensive Drugs: Direct Renin Inhibitors
01:22Heart Failure Drugs: Diuretics
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:25Hemodialysis III: Nursing Management
01:30Heart Failure V: Medical Management