Effects of Renal Sympathetic Denervation on Blood Pressure, Sleep Apnea Course, and Glycemic Control in Patients With Resistant Hypertension and Sleep Apnea
Adam Witkowski,Aleksander Prejbisz,Elżbieta Florczak,Jacek Kądziela,Paweł Śliwiński,Przemyslaw Bielen,Ilona Michałowska,Marek Kabat,E. Warchol,Magdalena Januszewicz,Krzysztof Narkiewicz,Virend K. Somers,Paul A. Sobotka,Andrzej Januszewicz +13 more
Reads0
Chats0
TLDR
Catheter-based renal sympathetic denervation lowered BP in patients with refractory hypertension and obstructiveSleep apnea, which was accompanied by improvement of sleep apnea severity, and Interestingly, there are also accompanying improvements in glucose tolerance.Abstract:
Percutaneous renal sympathetic denervation by radiofrequency energy has been reported to reduce blood pressure (BP) by the reduction of renal sympathetic efferent and afferent signaling. We evaluated the effects of this procedure on BP and sleep apnea severity in patients with resistant hypertension and sleep apnea. We studied 10 patients with refractory hypertension and sleep apnea (7 men and 3 women; median age: 49.5 years) who underwent renal denervation and completed 3-month and 6-month follow-up evaluations, including polysomnography and selected blood chemistries, and BP measurements. Antihypertensive regimens were not changed during the 6 months of follow-up. Three and 6 months after the denervation, decreases in office systolic and diastolic BPs were observed (median: -34/-13 mm Hg for systolic and diastolic BPs at 6 months; both P<0.01). Significant decreases were also observed in plasma glucose concentration 2 hours after glucose administration (median: 7.0 versus 6.4 mmol/L; P=0.05) and in hemoglobin A1C level (median: 6.1% versus 5.6%; P<0.05) at 6 months, as well as a decrease in apnea-hypopnea index at 6 months after renal denervation (median: 16.3 versus 4.5 events per hour; P=0.059). In conclusion, catheter-based renal sympathetic denervation lowered BP in patients with refractory hypertension and obstructive sleep apnea, which was accompanied by improvement of sleep apnea severity. Interestingly, there are also accompanying improvements in glucose tolerance. Renal sympathetic denervation may conceivably be a potentially useful option for patients with comorbid refractory hypertension, glucose intolerance, and obstructive sleep apnea, although further studies are needed to confirm these proof-of-concept data.read more
Citations
More filters
Journal ArticleDOI
Renal sympathetic denervation: A potential therapeutic approach for long QT syndrome.
Journal ArticleDOI
Chronic intermittent hypoxia impairs diuretic and natriuretic responses to volume expansion in rats with preserved low-pressure baroreflex control of the kidney.
Sara AlMarabeh,Julie O'Neill,Jeremy Cavers,Eric F. Lucking,Ken D. O'Halloran,Mohammed H. Abdulla +5 more
TL;DR: It is suggested that exposure to CIH causes renal dysfunction, which may be relevant to obstructive sleep apnea, and impairs diuretic and natriuretic responses to fluid overload.
Journal ArticleDOI
Renal sympathetic denervation for treatment of resistant hypertension
P Araujo Goncalves,M Sousa Almeida,Patrícia Branco,Augusto Gaspar,Hélder Dores,Maria Salomé Carvalho,Maria João Andrade,André Weigert,J. Diogo Barata,A. Canha Gomes,Luís Raposo,H Mesquita Gabriel,R Campante Teles,M Mendes +13 more
TL;DR: The authors describe two cases of radiofrequency renal sym- pathetic denervation that illustrate the feasibility of this new technique for the treatment of resistant hypertension.
References
More filters
Journal ArticleDOI
2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).
Giuseppe Mancia,Robert Fagard,Krzysztof Narkiewicz,Josep Redon,Alberto Zanchetti,Michael Böhm,Thierry Christiaens,Renata Cifkova,Guy De Backer,Anna F. Dominiczak,Maurizio Galderisi,Diederick E. Grobbee,Tiny Jaarsma,Paulus Kirchhof,Sverre E. Kjeldsen,Stéphane Laurent,Athanasios J. Manolis,Peter M. Nilsson,Luis M. Ruilope,Roland E. Schmieder,Per Anton Sirnes,Peter Sleight,Margus Viigimaa,Bernard Waeber,Faiez Zannad,Michel Burnier,Ettore Ambrosioni,Mark Caufield,Antonio Coca,Michael H. Olsen,Costas Tsioufis,Philippe van de Borne,José Luis Zamorano,Stephan Achenbach,Helmut Baumgartner,Jeroen J. Bax,Héctor Bueno,Veronica Dean,Christi Deaton,Çetin Erol,Roberto Ferrari,David Hasdai,Arno W. Hoes,Juhani Knuuti,Philippe Kolh,Patrizio Lancellotti,Aleš Linhart,Petros Nihoyannopoulos,Massimo F Piepoli,Piotr Ponikowski,Juan Tamargo,Michal Tendera,Adam Torbicki,William Wijns,Stephan Windecker,Denis Clement,Thierry C. Gillebert,Enrico Agabiti Rosei,Stefan D. Anker,Johann Bauersachs,Jana Brguljan Hitij,Mark J. Caulfield,Marc De Buyzere,Sabina De Geest,Geneviève Derumeaux,Serap Erdine,Csaba Farsang,Christian Funck-Brentano,Vjekoslav Gerc,Giuseppe Germanò,Stephan Gielen,Herman Haller,Jens Jordan,Thomas Kahan,Michel Komajda,Dragan Lovic,Heiko Mahrholdt,Jan Östergren,Gianfranco Parati,Joep Perk,Jorge Polónia,Bogdan A. Popescu,Zeljko Reiner,Lars Rydén,Yuriy Sirenko,Alice Stanton,Harry A.J. Struijker-Boudier,Charalambos Vlachopoulos,Massimo Volpe,David A. Wood +89 more
TL;DR: In this article, a randomized controlled trial of Aliskiren in the Prevention of Major Cardiovascular Events in Elderly people was presented. But the authors did not discuss the effect of the combination therapy in patients living with systolic hypertension.
Journal ArticleDOI
A new method for measuring daytime sleepiness: the Epworth sleepiness scale.
TL;DR: The development and use of a new scale, the Epworth sleepiness scale (ESS), is described, which is a simple, self-administered questionnaire which is shown to provide a measurement of the subject's general level of daytime sleepiness.
Journal ArticleDOI
2007 Guidelines for the Management of Arterial Hypertension : The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).
Giuseppe Mancia,Guy De Backer,Anna F. Dominiczak,Renata Cifkova,Robert Fagard,Giuseppe Germanò,Guido Grassi,Anthony M. Heagerty,Sverre E. Kjeldsen,Stéphane Laurent,Krzysztof Narkiewicz,Luis M. Ruilope,Andrzej Rynkiewicz,Roland E. Schmieder,Harry A.J. Struijker Boudier,Alberto Zanchetti +15 more
TL;DR: 2007 Guidelines for the Management of Arterial Hypertension : The Task Force for the management of Arterspertension of the European Society ofhypertension (ESH) and of theEuropean Society of Cardiology (ESC).
Journal ArticleDOI
A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects.
TL;DR: Techniques of recording, scoring, and doubtful records are carefully considered, and Recommendations for abbreviations, types of pictorial representation, order of polygraphic tracings are suggested.
Related Papers (5)
Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): A randomised controlled trial
Murray D. Esler,Henry Krum,Paul A. Sobotka,Markus P. Schlaich,Roland E. Schmieder,Michael Böhm,Felix Mahfoud,Horst Sievert,Nina Wunderlich,Lars Christian Rump,Oliver Vonend,Michael Uder,Mel Lobo,Mark J. Caulfield,Andrejs Erglis,Michel Azizi,Marc Sapoval,S. Thambar,Alexandre Persu,Jean Renkin,Heribert Schunkert,Joachim Weil,Uta C. Hoppe,Tony Walton,Dierk Scheinert,Thomas Binder,Andrzej Januszewicz,Adam Witkowski,Luis M. Ruilope,Robert Whitbourn,Heike Bruck,Mark Downes,Thomas F. Lüscher,Alan G. Jardine,Mark Webster,Thomas Zeller,Jerzy Sadowski,Krzysztof Bartus,Craig A. Straley,Neil C. Barman,David P. Lee,Ronald M. Witteles,Vivek Bhalla,Joseph M. Massaro +43 more