Renal denervation seems safe and provides sustained reduction of blood pressure up to one year post-procedure, according to a study published in Circulation (2012;126:2976-2982).
Noting that the Symplicity HTN-2 trial had demonstrated that catheter-based renal denervation resulted in significant reduction in blood pressure at six-months post-procedure, Murray D. Esler, PhD, MBBS, of the Baker IDI Heart and Diabetes Institute in Melbourne, Australia, and colleagues analyzed one-year follow-up data for 47 patients from the trial who were randomized to immediate renal denervation and six-month post-procedure results for patients who crossed over. Patients taking three or more antihypertensive drugs with a baseline systolic blood pressure (SBP) of 160 mm Hg or higher (150 mm Hg or higher for those with type 2 diabetes) were eligible for inclusion.
At 12 months post-procedure, the mean reduction in office SBP in the initial renal denervation group was similar to the reduction at six months (−28.1 mm Hg at 12 months; −31.7 mm Hg at six months). For the crossover group, the mean SBP was significantly lower at six months post-procedure (change, −23.7 mm Hg). Within the crossover group, one renal artery dissection occurred during guided catheter insertion, prior to denervation, which was corrected by renal artery stenting, and one hypotensive episode occurred which was resolved with adjustment of medication.
“The Symplicity HTN-2 trial demonstrates that radio frequency ablation of renal nerves can significantly lower blood pressure in patients with systolic blood pressures greater than 160 mm Hg with no loss of treatment effect through one year and thus may provide a safe and effective adjunctive therapy for treatment-resistant hypertensive patients,” the authors wrote.