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Canadian Journal of Cardiology

It Is Urgent to Investigate Predictors of the Response of Blood Pressure to Renal Denervation

Published:January 06, 2014DOI:https://doi.org/10.1016/j.cjca.2013.12.028
      I read with great interest the article by Khan et al., published online in advance of print in the Canadian Journal of Cardiology.
      • Khan N.A.
      • Herman R.J.
      • Quinn R.R.
      • et al.
      Renal denervation therapy for the treatment of resistant hypertension: a position statement by the Canadian Hypertension Education Program.
      This article presents a position statement on renal denervation by the Canadian Hypertension Education Program, and stated that “the limited trial data published to date have shown clinically significant reduction in BP (blood pressure).” However, the authors did not cite references with different results. For example, in 2012, Brinkmann and colleagues showed that renal denervation (n = 12) did not decrease office systolic blood pressure (157 mm Hg vs 157 mm Hg, for baseline and 3-6 months after the procedure).
      • Brinkmann J.
      • Heusser K.
      • Schmidt B.M.
      • et al.
      Catheter-based renal nerve ablation and centrally generated sympathetic activity in difficult-to-control hypertensive patients: prospective case series.
      Shortly after the acceptance of this position paper, Drs Fadl Elmula and Hart separately reported that renal denervation non-significantly decreased office systolic blood pressure by 7-8 mm Hg six months after the procedure (P > 0.05 for both studies).
      • Fadl Elmula F.E.
      • Hoffmann P.
      • Fossum E.
      • et al.
      Renal sympathetic denervation in patients with treatment-resistant hypertension after witnessed intake of medication before qualifying ambulatory blood pressure.
      • Hart E.C.
      • McBryde F.D.
      • Burchell A.E.
      • et al.
      Translational examination of changes in baroreflex function after renal denervation in hypertensive rats and humans.
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      References

        • Khan N.A.
        • Herman R.J.
        • Quinn R.R.
        • et al.
        Renal denervation therapy for the treatment of resistant hypertension: a position statement by the Canadian Hypertension Education Program.
        Can J Cardiol. 2014; 30: 16-21
        • Brinkmann J.
        • Heusser K.
        • Schmidt B.M.
        • et al.
        Catheter-based renal nerve ablation and centrally generated sympathetic activity in difficult-to-control hypertensive patients: prospective case series.
        Hypertension. 2012; 60: 1485-1490
        • Fadl Elmula F.E.
        • Hoffmann P.
        • Fossum E.
        • et al.
        Renal sympathetic denervation in patients with treatment-resistant hypertension after witnessed intake of medication before qualifying ambulatory blood pressure.
        Hypertension. 2013; 62: 526-532
        • Hart E.C.
        • McBryde F.D.
        • Burchell A.E.
        • et al.
        Translational examination of changes in baroreflex function after renal denervation in hypertensive rats and humans.
        Hypertension. 2013; 62: 533-541

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