Higher baseline BP and heart rate and the presence of orthostatic hypertension predict larger response
By Lori Solomon HealthDay Reporter
THURSDAY, March 16, 2023 (HealthDay News) — Blood pressure (BP) reductions with ultrasound renal denervation (uRDN) are greater versus sham procedure and consistent across hypertension severity, according to a study published online Feb. 28 in JAMA Cardiology.
Ajay J. Kirtane, M.D., from the Columbia University Medical Center in New York City, and colleagues assessed whether the magnitude of two-month daytime ambulatory systolic BP (dASBP) reduction observed with uRDN was consistent across varying hypertension severity. The analysis included pooled data from three randomized clinical trials of uRDN versus sham (506 patients). Patients had either mild-to-moderate hypertension and no history of medications or hypertension resistant to standardized triple-combination therapy.
The researchers found that at two months, dASBP decreased by 8.5 mm Hg to a mean of 141.8 mm Hg among patients treated with uRDN versus 2.9 mm Hg to a mean of 147.9 mm Hg among patients treated with a sham procedure (mean difference, −5.9). Across trials and across BP parameters, BP decreases from baseline with uRDN versus sham were consistent (office systolic BP: mean difference, −6.4 mm Hg; home systolic BP: mean difference, −6.8 mm Hg). A larger BP response to uRDN was independently predicted by higher baseline BP and heart rate and the presence of orthostatic hypertension. Early safety end points were similar between the groups.
“Once the device is available, we envision recommending it to patients who have tried other therapies first,” Kirtane said in a statement. “The hope is that by controlling blood pressure, we might be able to prevent kidney damage and other effects of uncontrolled blood pressure.”
Several authors disclosed financial ties to medical device companies, including ReCor Medical, which funded the study.
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