Renal artery denervation in patients with resistant arterial hypertension: clinical and organ-protective effect

Abstract

Aim. To assess the clinical efficacy of renal artery denervation (RAD) in treatment of patients with resistant arterial hypertension (RAH) compared to patients taking drug therapy (DT) at long-term follow-up and the possibility of RAD impact on target organs (heart, kidneys). Materials and methods. 80 RAH patients were examined (mean age 54.3010.19 years). Patients were divided in two groups: the basic group was comprised of 40 RAH patients taking antihypertensive DT, who underwent RAD (gr. 1) and comparison group was composed of 40 RAH patients taking only antihypertensive DT (gr. 2). Gender and age differences between groups were statistically insignificant (p0.05). Mean duration of AH was 18.638.96 years. The follow-up was carried out during one year. Results. In RAD group there was confirmed decrease not only in the office, but also in the average day-time and night-time blood pressure (BP), changes were more significant in systolic BP (SBP) indicators: the overall daytime SBP was 17.369.31 mmHg (p0.001), the average day-time SBP was 17.1810.53 mmHg (p0.001), the average night-time SBP was 19.2210.76 mmHg (p0.001). At the same time, in DT group changes in values of overall, maximum, minimum, average day-time and average night-time SBP and diastolic BP were not statistically significant in 12 months. RAD in RAH was accompanied by decrease in left ventricular hypertrophy with initial hypertrophy (p0.05), decrease in microalbuminuria (p0.05), decrease in velocity in segmental (p0.05) and interlobar renal arteries (p0.01). Conclusion. RAD in patients with RAH had not only antihypertensive effect but also positive effect on target organs of AH (heart, kidneys).