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The effect of renal sympathetic denervation on nocturnal dipping in patients with resistant hypertension; observational data from a tertiary referral centre in the Republic of Ireland

Irish Journal of Medical Science (1971 -) volume 185, pages 635–641 (2016)Cite this article

Abstract

Objective

Renal sympathetic denervation (RSD) is an emerging device based treatment for patients with resistant hypertension. Nocturnal dipping (ND) is defined as a decrease in BP of 10–20 % during sleep, and has been shown to be protective against cardiovascular disease. This study examined the effect of RSD on the 24 h BP profile of patients with resistant hypertension.

Methods and results

The first 23 consecutive patients with resistant hypertension scheduled for renal denervation in a single centre were included. 24 h ambulatory blood pressure monitors (ABPM) were given to patients pre-procedure and 9 months post-procedure. RSD led to a statistically non-significant reduction in overall 24 h ABPM BP (150/85 ± 12/9 vs. 143/84 ± 15/11 mmHg; P > 0.05) despite a reduction in the number of antihypertensive medications (4.9 ± 1.2 vs. 4.3 ± 1.2; P = 0.001). There were improvements in systolic ND 1.7 ± 8 vs. 5.2 ± 8 %; P < 0.05), diastolic ND (5.2 ± 8 vs. 10.2 ± 9 %; P < 0.05) and mean arterial pressure (MAP) ND (4.2 ± 8 vs. 8.0 ± 8 %; P < 0.05). Non-significant changes in ND status were observed in systolic (17 vs. 43 % of participants; P > 0.05), diastolic (30 vs. 43 % of participants; P > 0.05) and MAP (22 vs. 39 % of participants; P > 0.05) measurements.

Conclusions

These data suggest that RSD may lead to an improvement in nocturnal dipping in selected patients with resistant hypertension. This may have cardiovascular benefits even if reduction in BP is not achieved with RSD.

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Fig. 1

Abbreviations

BP:

Blood pressure

RSD:

Renal sympathetic denervation

ND:

Nocturnal dipping

ABPM:

Ambulatory blood pressure monitoring

HR:

Heart rate

BPM:

Beats per minute

mmHg:

Millimetres of mercury

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

MAP:

Mean arterial pressure

SD:

Standard deviation

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Authors and Affiliations

  1. Department of Cardiology, Galway University Hospital, Galway, Republic of Ireland

    S. T. Tuohy, S.-M. G. Kyvelou, P. J. Gleeson, F. B. Daniels, L. A. Ryan, M. J. O’Donnell & F. Sharif

  2. Department of Nephrology, Galway University Hospital, Galway, Republic of Ireland

    D. W. Lappin

  3. Clinical Research Facility, National University of Ireland, Galway, Republic of Ireland

    M. J. O’Donnell & F. Sharif

Authors
  1. S. T. Tuohy
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  2. S.-M. G. Kyvelou
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  3. P. J. Gleeson
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  4. F. B. Daniels
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  5. L. A. Ryan
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  6. D. W. Lappin
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  7. M. J. O’Donnell
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  8. F. Sharif
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Correspondence to S. T. Tuohy.

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Tuohy, S.T., Kyvelou, SM.G., Gleeson, P.J. et al. The effect of renal sympathetic denervation on nocturnal dipping in patients with resistant hypertension; observational data from a tertiary referral centre in the Republic of Ireland. Ir J Med Sci 185, 635–641 (2016). https://doi.org/10.1007/s11845-015-1324-3

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  • DOI: https://doi.org/10.1007/s11845-015-1324-3

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