Abstract:
INTRODUCTION:Recent randomized controlled trials have confirmed the ability of renal denervation to lower blood pressure (BP) in patients, resistant to the BP-lowering effect of multiple antihypertensive drug administration. Evidence is limited, however, in patients with end-stage renal disease (ESRD) and haemodialysis, a condition in which a persistent BP elevation, despite administration of many antihypertensive drugs, is common. Aim of the present study was to test the BP-lowering efficacy of renal denervation in patients with resistant hypertension and ESRD on haemodialysis. BP was measured repeatedly in the office and over the 24 h during 1-year follow-up. METHODS AND RESULTS:The study was conducted from February 2017 to January 2018 at the Policlinico of Monza, Monza, Italy. We included 24 men and women aged at least 20 years (mean 55 ± 16) who had ESRD, were on long-term haemodialysis and exhibited resistant hypertension, that is, elevated office and ambulatory BP values, despite multidrug antihypertensive treatment (n = 5.4 ± 1). We excluded patients with renal artery stenosis, malignancy, and a probable life expectancy less than 1 year. Twelve patients were included in the renal denervation and 12 in the medical treatment (control) group. All patients underwent office and 24 h ambulatory BP measurements at baseline and at 1, 6 and 12 months during the follow-up. In the renal denervation group, baseline office and 24 h mean SBP were 180 ± 112 and 175 ± 11 mmHg, respectively, the corresponding values in the control group being 181 ± 19 and 181 ± 20 mmHg. Most of the other baseline characteristics were also similar or only slightly different between groups, including the mean number of administered antihypertensive drugs at baseline. SBP showed an early and persistent reduction after renal denervation (office SBP: 165 ± 13; 150 ± 7 and 149 ± 11mmHg; 24 h SBP 163 ± 20, 148 ± 10 and 149 ± 17 mmHg after 1, 6 and 12 months, respectively). The BP-lowering effect was almost always present and statistically significant during both the day and night. DBP changes followed a similar pattern whereas heart rate never showed any significant change. No significant periprocedural complication of renal denervation was seen. The mean number of administered drugs did not show any significant BP change during the study. CONCLUSION:In ESRD patients under long-term haemodialysis in whom BP was markedly elevated despite administration of many antihypertensive drugs, renal denervation lowered both ambulatory and office BP. The reduction persisted over a 1-year follow-up.
journal_name
J Hypertensjournal_title
Journal of hypertensionauthors
Scalise F,Sole A,Singh G,Sorropago A,Sorropago G,Ballabeni C,Maccario M,Vettoretti S,Grassi G,Mancia Gdoi
10.1097/HJH.0000000000002358subject
Has Abstractpub_date
2020-05-01 00:00:00pages
936-942issue
5eissn
0263-6352issn
1473-5598journal_volume
38pub_type
杂志文章abstract::Microvascular alterations associated with reversal of hypertension by exposure to simulated high altitude were investigated in the gracilis muscle of the spontaneously hypertensive rat (SHR). Male, 4-week-old SHR were either placed in a hypobaric chamber (SHR-HA) at 430 mmHg or maintained at ambient barometric pressur...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198612000-00008
更新日期:1986-12-01 00:00:00
abstract:OBJECTIVE:The optimal time to initiate antihypertensive therapy among patients with acute ischemic stroke remains uncertain. We tested the effects of blood pressure reduction among patients with acute ischemic stroke according to time from onset to initiation of antihypertensive treatment. METHODS:We randomly assigned...
journal_title:Journal of hypertension
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/HJH.0000000000001288
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Recent cross-sectional studies have suggested that higher serum sodium levels may be a marker of elevated blood pressure. It is unclear whether serum sodium levels are related to the risk of developing hypertension in the community. METHODS:We investigated the association of serum sodium with longitudinal b...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32830fe4a5
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Sleep-disordered breathing, predominantly obstructive sleep apnea (OSA), is highly prevalent in patients with hypertension. OSA may underlie the progression to resistant hypertension, partly due to increased activation of the sympathetic nervous system. This analysis of patients with and without OSA evaluate...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001142
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Across ethnicities, offspring of hypertensive parents (OH) have higher risk of hypertension than offspring of normotensive parents (ON). Sympathetic hyperactivity and reduced nitric oxide availability have been reported in normotensive OH; but the role of vasodilator cyclooxygenase (COX) products is unclear....
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001794
更新日期:2018-11-01 00:00:00
abstract:PURPOSE:Cardiovascular reactivity to mental stress has been used as a tool to predict short-term hypertension risk in adults but the impact of cardiovascular reactivity in childhood on hypertension in adulthood is unknown. Using the 1970 British Cohort study, we examined the association between pulse rate reactivity in...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001023
更新日期:2016-09-01 00:00:00
abstract::The effects on serum ionized calcium (ICa) and pH of different storage conditions of blood or serum, and of physiological influences such as over-ventilation, food intake and dietary sodium intake have been investigated. Temperature and time-related changes in ICa occurred with storage and were minimized by immediate ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1987-08-01 00:00:00
abstract:BACKGROUND AND AIM:The prevalence and associated risks of white-coat hypertension (WCH) are still a matter of debate. We aimed to assess differences in prevalence and associated conditions of WCH defined on the basis of the normality of all daytime, night-time, and 24-h blood pressure (BP), only daytime, or only 24-h B...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001493
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The sleep apnea syndrome (SAS) is a common health problem with a 30% prevalence among patients with so-called essential hypertension. OBJECTIVE:Prompted by this epidemiologic link we tried to find out whether there is a cause-effect relationship between SAS and systemic hypertension. DESIGN:We developed an...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199715120-00060
更新日期:1997-12-01 00:00:00
abstract:OBJECTIVES:To compare the reproducibility of clinic and ambulatory blood pressure measurements in elderly hypertensive subjects. SUBJECTS:Twenty-two untreated elderly hypertensives, with a clinic systolic blood pressure (SBP) > 160 mmHg and/or diastolic blood pressure (DBP) > 95 mmHg, and a mean age of 76 years (range...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199305000-00014
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:To determine adrenocorticotrophin dose-response relationships for increase of blood pressure and metabolic parameters of the Sprague-Dawley rat. METHODS:We injected 120 male Sprague-Dawley rats twice daily subcutaneously for 10 days with 0.5, 1, 5, 50, 100, 200 or 500 microg/kg synthetic adrenocorticotrophin...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199816050-00006
更新日期:1998-05-01 00:00:00
abstract:OBJECTIVES:Current evidence demonstrates that both genetic and environmental factors influence blood pressure. The sympathetic nervous system is a key player in blood pressure control and functional genetic variants of the beta-2 adrenergic receptor (B2AR) have been identified and implicated in the pathogenesis of hype...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000209983.28735.33
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Obstructive sleep apnea (OSA) may lead to the development of hypertension and therapy with continuous positive airway pressure (CPAP) can promote reduction in blood pressure. OBJECTIVE:The objective of this study is to review systematically the effects of CPAP on blood pressure in patients with OSA. METHOD...
journal_title:Journal of hypertension
pub_type: 杂志文章,meta分析,评审
doi:10.1097/HJH.0000000000000250
更新日期:2014-09-01 00:00:00
abstract::The effects of age on the circadian blood pressure rhythm of patients with untreated essential hypertension (n = 133, World Health Organization stage I or II) were compared with those of normotensive subjects (n = 91). Subjects were classified into three groups by age: young (less than 40 years old), adult (40-59 year...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199105000-00004
更新日期:1991-05-01 00:00:00
abstract:OBJECTIVES:To assess the predictive role of changes in albuminuria on the loss of renal function under antihypertensive treatment in patients with type 2 diabetes (T2D). METHODS:Clinical records from a total of 12 611 patients with hypertension and T2D, attending 100 antidiabetic centers in Italy, with normal estimate...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001749
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:When assessing arterial stiffness, heart rate (HR) and blood pressure (BP) are potential confounders. It appears that the HR/BP dependences of pulse wave velocity (PWV) and distensibility are different, even though both assess arterial stiffness. This study aims to compare aortic PWV as measured using pulse ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002608
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:The objective of the present studies is to investigate if the enhanced expression of Gs alpha protein and their mRNA observed in various models of hypertensive rats is due to the expressed hypertrophy or hypertension. METHODS:Hypertension, in Sprague-Dawley rats was induced by the oral administration of the ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200018080-00013
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:The inverse association between socioeconomic status (SES) and cardiovascular disease (CVD) risk is well documented. Aortic stiffness assessed by aortic pulse wave velocity (PWV) is a strong predictor of CVD events. However, no previous study has examined the effect of SES on arterial stiffening over time. Th...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001057
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:There is ongoing discussion on how best to screen for diabetes mellitus. Previous studies suggest that an abnormal oral glucose tolerance test (OGTT) is better than fasting glucose levels in predicting cardiovascular mortality, which is largely determined by macrovascular complications in type 2 diabetes. We ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32834e38b6
更新日期:2012-01-01 00:00:00
abstract:AIMS:Selenium is an antioxidant micronutrient with potential associations with hypertension. Few studies have investigated the association of serum selenium concentrations with blood pressure and hypertension in countries with low dietary selenium intake such as Germany, with inconsistent findings. METHODS:We undertoo...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32835414df
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:To investigate whether glucose or insulin is the cause of increases in oxidative stress and blood pressure in insulin-resistant animals, and to evaluate the effects of alpha-lipoic acid (LA) on the production of the superoxide anion (O2-) in the aorta and blood pressure elevations in various models of diabet...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000160215.78973.ba
更新日期:2005-03-01 00:00:00
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journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1097/00004872-199917090-00012
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVES:Urocortin 1 (Ucn1) and the sympathetic nervous system both participate in cardiac and circulatory regulation, but little is known about their possible interactions. METHODS:We report the effects of Ucn1 on the cardiac sympathetic nerve activity (CSNA), haemodynamics and plasma catecholamines in normal sheep...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3282f01428
更新日期:2008-01-01 00:00:00
abstract::Seventeen essential hypertensive patients with normal renal function were treated with a new non-sulphydryl orally active angiotensin converting enzyme (ACE) inhibitor, benazepril, 10 mg given once or twice daily, according to diastolic blood pressure levels, for 6 weeks. In all patients, changes in blood pressure, sy...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199011000-00003
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:Inflammatory processes may play a pivotal role in the pathogenesis of cerebrovascular injury in salt-loaded, stroke-prone, spontaneously hypertensive rats (SHRSP). Thromboxane A2 (TP) receptor stimulation by 8-iso-prostaglandin F2alpha (8-iso-PGF2alpha) is involved in the process of vascular inflammation. O...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3280464dc8
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:To evaluate whether efficacious counseling methods on sodium restriction can be successfully incorporated into primary care models for the management of hypertension. METHODS:We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects and Health Te...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/HJH.0000000000000182
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:Blood pressure normally declines during the night ('dipping'); a blunted nocturnal decline is an important cardiovascular risk factor. Marriage may be associated with lower ambulatory blood pressure, although this may be confounded by socio-economic and dietary factors. We examined the association of marital ...
journal_title:Journal of hypertension
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/HJH.0000000000000107
更新日期:2014-04-01 00:00:00
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journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199715110-00005
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVES AND DESIGN:Angiotensinogen (AGT) gene variants influence angiotensinogen plasma levels in children and young adults. The angiotensinogen promoter (-6)A variant facilitates gene transcription in human tissues and it has been associated with high blood pressure in older adults. A young adult population can be ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200112000-00009
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:Hypertension and fractures related to osteoporosis are major public health problems that often coexist. This study examined the associations between exposure to different antihypertensive drug classes and the risk of hip fracture in hypertensive patients. METHOD:We included 59 246 individuals, 50 years and o...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002245
更新日期:2020-01-01 00:00:00