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Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
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Patient-Specific Factors Predicting Renal Denervation Response in Patients With Hypertension: A Systematic Review and
Xin-Ru Hu1, Guang-Zhi Liao1, Jun-Wen Wang1
1Department of Cardiology West China Hospital, Sichuan University Chengdu Sichuan People's Republic of China.
Journal of the American Heart Association
|July 9, 2024
Summary
Identifying patients who will benefit from renal denervation (RDN) is key for hypertension treatment. Higher heart rate and lower pulse wave velocity predict significant blood pressure reduction after RDN.
Area of Science:
- Cardiology
- Nephrology
- Hypertension Management
Background:
- Accurate patient selection is crucial for optimizing outcomes in renal denervation (RDN) for hypertension.
- This systematic review evaluates patient-specific factors that predict response to RDN.
Purpose of the Study:
- To identify patient characteristics associated with blood pressure reduction following renal denervation.
- To synthesize evidence from existing studies on predictors of RDN efficacy.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials and nonrandomized studies.
- Included 50 studies, with 17 used for meta-analysis.
- Assessed risk of bias and quality of evidence using established methodologies.
Main Results:
- Higher baseline heart rate was associated with significant 24-hour systolic blood pressure reduction (WMD: -4.05 mmHg).
- Lower pulse wave velocity predicted significant 24-hour systolic blood pressure reduction (WMD: -7.20 mmHg).
- Qualitative analysis suggested higher baseline BP, orthostatic hypertension, impaired baroreflex sensitivity, and certain biomarkers are also associated with better RDN response.
Conclusions:
- Higher heart rate and lower pulse wave velocity are key predictors of blood pressure reduction after RDN in hypertensive patients.
- Other factors like baseline BP, orthostatic hypertension, BP variability, baroreflex sensitivity, and biomarkers may also indicate a better response to RDN.
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