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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Eligibility for renal denervation: Experience at 11 European expert centers
Hypertension, Volume 63, No. 6, Year 2014
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Description
Based on the SYMPLICITY studies and CE (Conformité Européenne) certification, renal denervation is currently applied as a novel treatment of resistant hypertension in Europe. However, information on the proportion of patients with resistant hypertension qualifying for renal denervation after a thorough work-up and treatment adjustment remains scarce. The aim of this study was to investigate the proportion of patients eligible for renal denervation and the reasons for noneligibility at 11 expert centers participating in the European Network COordinating Research on renal Denervation in treatment-resistant hypertension (ENCOReD). The analysis included 731 patients. Age averaged 61.6 years, office blood pressure at screening was 177/96 mm Hg, and the number of blood pressure-lowering drugs taken was 4.1. Specialists referred 75.6% of patients. The proportion of patients eligible for renal denervation according to the SYMPLICITY HTN- 2 criteria and each center's criteria was 42.5% (95% confidence interval, 38.0%-47.0%) and 39.7% (36.2%-43.2%), respectively. The main reasons of noneligibility were normalization of blood pressure after treatment adjustment (46.9%), unsuitable renal arterial anatomy (17.0%), and previously undetected secondary causes of hypertension (11.1%). In conclusion, after careful screening and treatment adjustment at hypertension expert centers, only ≈40% of patients referred for renal denervation, mostly by specialists, were eligible for the procedure. The most frequent cause of ineligibility (approximately half of cases) was blood pressure normalization after treatment adjustment by a hypertension specialist. Our findings highlight that hypertension centers with a record in clinical experience and research should remain the gatekeepers before renal denervation is considered. © 2014 American Heart Association, Inc.
Authors & Co-Authors
Persu, Alexandre
Belgium, Louvain-la-neuve
Université Catholique de Louvain
Jin, Yu
Belgium, Leuven
Ku Leuven
Schmidt, Bernhard Magnus Wilhelm
Germany, Hannover
Hannover Medical School
Blicher, Marie Kofoed
Denmark, Odense
Odense Universitetshospital
Wuerzner, Grégoire Crossed D.Sign©goire
Switzerland, Lausanne
Centre Hospitalier Universitaire Vaudois
Ehret, Georg B.
Switzerland, Geneva
Hôpitaux Universitaires de Genève
Kahan, Thomas
Sweden, Danderyd
Danderyds Sjukhus
Jacobs, Lotte
Belgium, Leuven
Ku Leuven
Spiering, Wilko
Netherlands, Utrecht
University Medical Center Utrecht
Burnier, Michel
Switzerland, Lausanne
Centre Hospitalier Universitaire Vaudois
Olsen, Michael Hecht
Denmark, Odense
Odense Universitetshospital
Blankestijn, Peter J.
Netherlands, Utrecht
University Medical Center Utrecht
Kjeldsen, Sverre Erik
Norway, Oslo
Universitetet I Oslo
Bots, Michiel L.
Netherlands, Utrecht
University Medical Center Utrecht
Staessen, Jan A.
Belgium, Leuven
Ku Leuven
Statistics
Citations: 64
Authors: 15
Affiliations: 12
Identifiers
Doi:
10.1161/HYPERTENSIONAHA.114.03194
ISSN:
0194911X
Research Areas
Noncommunicable Diseases