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Hypertension

How should data from SYMPLICITY HTN-3 be interpreted?

The SYMPLICITY HTN-3 trial demonstrated unexpectedly large and small blood pressure reductions in the control and renal denervation groups, respectively. Although this study was well designed, it had several weaknesses and the results are inconclusive, with the exception of the positive signal for renal denervation in non-African-American individuals.

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Figure 1: Between-group differences (RDN vs control) in the change in office SBP from baseline to 6 months in African American and non-African-American patients in the SYMPLICITY HTN-3 trial.3

References

  1. Bangalore, S. et al. Prevalence, predictors, and outcomes in treatment-resistant hypertension in patients with coronary disease. Am. J. Med. 127, 71–81.e1 (2014).

    Article  Google Scholar 

  2. Mancia, G. et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J. Hypertens. 31, 1281–1357 (2013).

    Article  CAS  Google Scholar 

  3. Bhatt, D. L. et al. A controlled trial of renal denervation for resistant hypertension. N. Engl. J. Med. 370, 1393–1401 (2014).

    Article  CAS  Google Scholar 

  4. Krum, H. for the Symplicity HTN-1 Investigators. Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months. Hypertension 57, 911–917 (2011).

    Article  CAS  Google Scholar 

  5. Esler, M. D. et al. Renal sympathetic denervation in patients with treatment-resistant hypertension (the Symplicity HTN-2 trial): a randomised controlled trial. Lancet 376, 1903–1909 (2010).

    Article  Google Scholar 

  6. Mahfoud, F. et al. Reduction in office blood pressure after renal denervation in a large real world patient population with uncontrolled hypertension: interim results from the global SYMPLICITY registry. Presented at the 2014 ACC Scientific Sessions.

  7. O'Brien, E. et al. European society of hypertension position paper on ambulatory blood pressure monitoring. J. Hypertens. 31, 1731–1768 (2013).

    Article  CAS  Google Scholar 

  8. Weber, M. A. et al. A selective endothelin-receptor antagonist to reduce blood pressure in patients with treatment-resistant hypertension: a randomised, double-blind, placebo-controlled trial. Lancet 374, 1423–1431 (2009).

    Article  CAS  Google Scholar 

  9. Oxlund, C. S. et al. Low dose spironolactone reduces blood pressure in patients with resistant hypertension and type 2 diabetes mellitus: a double blind randomized clinical trial. J. Hypertens. 31, 2094–2102 (2013).

    Article  CAS  Google Scholar 

  10. Mahfoud, F. et al. Ambulatory blood pressure changes after renal sympathetic denervation in patients with resistant hypertension. Circulation 128, 132–140 (2013).

    Article  CAS  Google Scholar 

Download references

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Correspondence to Roland E. Schmieder.

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The author has received speaker's honoraria from Kona Medical, Medtronic, ReCor Medical, and Rox Medical; grants or research support from Medtronic and Rox Medical; and has acted as an advisory board member for Kona Medical, Medtronic, ReCor Medical, and Rox Medical.

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Schmieder, R. How should data from SYMPLICITY HTN-3 be interpreted?. Nat Rev Cardiol 11, 375–376 (2014). https://doi.org/10.1038/nrcardio.2014.70

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