Abstract
The objective of this work was to investigate the long-term safety and efficacy of renal denervation in Korean patients from the Global SYMPLICITY Registry (GSR). GSR Korea is a substudy of GSR with additional inclusion and exclusion criteria compared to GSR, including inclusion criteria of office systolic blood pressure ≥160 mmHg, or ≥150 mmHg for type 2 diabetes patients, while receiving 3 or more antihypertensive medications without changes for 2 weeks prior to enrollment. Renal denervation was performed using a Symplicity Flex catheter for ablation in the main renal arteries. Changes in office systolic blood pressure and adverse events were collected for up to 36 months of follow-up for 102 patients in GSR Korea. In addition, adverse events and reductions in office systolic blood pressure were analyzed for patients with and without type II diabetes mellitus. Renal denervation led to mean (± standard deviation) reductions in office systolic blood pressure at 12, 24, and 36 months in GSR Korea (−26.7 ± 18.5, −30.1 ± 21.6 mmHg, and −32.5 ± 18.8, respectively). The proportion of patients with a ≥10 mmHg office systolic blood pressure reduction from baseline was 86.3% at 12 months, 86.5% at 24 months, and 89.7% at 36 months. Adverse events at 3 years were rare. In addition, reductions in office systolic blood pressure were similar for patients with vs. without diabetes mellitus (p > 0.05 at all timepoints). Office systolic blood pressure was safely reduced at up to 36 months post-renal denervation in GSR Korea, and adverse events were rare. In addition, patients with and without diabetes had similar office systolic blood pressure reductions.
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References
Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. J Am Coll Cardiol. 2018;71:2199–269.
Grossman A, Grossman E. Blood pressure control in type 2 diabetic patients. Cardiovasc Diabetol. 2017;16:3.
de Boer IH, Bangalore S, Benetos A, Davis AM, Michos ED, Muntner P, et al. Diabetes and hypertension: a position statement by the American Diabetes Association. Diabetes Care. 2017;40:1273–84.
Azizi M, Schmieder RE, Mahfoud F, Weber MA, Daemen J, Davies J, et al. Endovascular ultrasound renal denervation to treat hypertension (RADIANCE-HTN SOLO): a multicentre, international, single-blind, randomised, sham-controlled trial. Lancet. 2018;391:2335–45.
Kandzari DE, Bohm M, Mahfoud F, Townsend RR, Weber MA, Pocock S, et al. Effect of renal denervation on blood pressure in the presence of antihypertensive drugs: 6-month efficacy and safety results from the SPYRAL HTN-ON MED proof-of-concept randomised trial. Lancet. 2018;391:2346–55.
Townsend RR, Mahfoud F, Kandzari DE, Kario K, Pocock S, Weber MA, et al. Catheter-based renal denervation in patients with uncontrolled hypertension in the absence of antihypertensive medications (SPYRAL HTN-OFF MED): a randomised, sham-controlled, proof-of-concept trial. Lancet. 2017;390:2160–70.
Kario K, Yamamoto E, Tomita H, Okura T, Saito S, Ueno T, et al. Sufficient and persistent blood pressure reduction in the final long-term results from SYMPLICITY HTN-Japan—safety and efficacy of renal denervation at 3 years. Circ J. 2019;83:622–9.
Lee CK, Wang TD, Lee YH, Fahy M, Lee CH, Sung SH, et al. Efficacy and safety of renal denervation for patients with uncontrolled hypertension in Taiwan: 3-year results from the Global SYMPLICITY Registry-Taiwan (GSR-Taiwan). Acta Cardiol Sin. 2019;35:618–26.
Bohm M, Mahfoud F, Ukena C, Hoppe UC, Narkiewicz K, Negoita M, et al. First report of the Global SYMPLICITY Registry on the effect of renal artery denervation in patients with uncontrolled hypertension. Hypertension. 2015;65:766–74.
Kim BK, Bohm M, Mahfoud F, Mancia G, Park S, Hong MK, et al. Renal denervation for treatment of uncontrolled hypertension in an Asian population: results from the Global SYMPLICITY Registry in South Korea (GSR Korea). J Hum Hypertens. 2016;30:315–21.
Mahfoud F, Bohm M, Schmieder R, Narkiewicz K, Ewen S, Ruilope L, et al. Effects of renal denervation on kidney function and long-term outcomes: 3-year follow-up from the Global SYMPLICITY Registry. Eur Heart J. 2019;40:3474–82.
Krum H, Schlaich MP, Sobotka PA, Bohm M, Mahfoud F, Rocha-Singh K, et al. Percutaneous renal denervation in patients with treatment-resistant hypertension: final 3-year report of the Symplicity HTN-1 study. Lancet. 2014;383:622–9.
Esler MD, Bohm M, Sievert H, Rump CL, Schmieder RE, Krum H, et al. Catheter-based renal denervation for treatment of patients with treatment-resistant hypertension: 36 month results from the SYMPLICITY HTN-2 randomized clinical trial. Eur Heart J. 2014;35:1752–9.
Mahfoud F, Mancia G, Schmieder R, Narkiewicz K, Ruilope L, Schlaich M, et al. Renal denervation in high-risk patients with hypertension. J Am Coll Cardiol. 2020;75:2879–88.
Pocock SJ, Bakris G, Bhatt DL, Brar S, Fahy M, Gersh BJ. Regression to the mean in SYMPLICITY HTN-3: implications for design and reporting of future trials. J Am Coll Cardiol. 2016;68:2016–25.
Kario K. PREFACE: is renal denervation effective option for management of hypertension in Asia?. Curr Hypertens Rev. 2017;13:2–5.
Osborn JW, Banek CT. Catheter-based renal nerve ablation as a novel hypertension therapy: lost, and then found, in translation. Hypertension. 2018;71:383–8.
Osborn JW, Foss JD. Renal nerves and long-term control of arterial pressure. Compr Physiol. 2017;7:263–320.
Witkowski A, Prejbisz A, Florczak E, Kadziela J, Sliwinski P, Bielen P, et al. Effects of renal sympathetic denervation on blood pressure, sleep apnea course, and glycemic control in patients with resistant hypertension and sleep apnea. Hypertension. 2011;58:559–65.
Kario K, Kim BK, Akoi J, Wong AY, Lee YH, Wongprparut N, et al. Renal denervation in Asia: consensus statement of the Asia Renal Denervation Consortium (ARDeC). Hypertension. 2020;75:590–602.
Wang TD, Lee YH, Chang SS, Tung YC, Yeh CF, Lin YH, et al. 2019 Consensus statement of the Taiwan Hypertension Society and the Taiwan Society of Cardiology on Renal Denervation for the Management of Arterial Hypertension. Acta Cardiol Sin. 2019;35:199–230.
Mahfoud F, Schlaich M, Kindermann I, Ukena C, Cremers B, Brandt MC, et al. Effect of renal sympathetic denervation on glucose metabolism in patients with resistant hypertension: a pilot study. Circulation. 2011;123:1940–6.
Pan T, Guo JH, Teng GJ. Renal denervation: a potential novel treatment for type 2 diabetes mellitus? Medicine. 2015;94:e1932.
Schlaich MP, Straznicky N, Grima M, Ika-Sari C, Dawood T, Mahfoud F, et al. Renal denervation: a potential new treatment modality for polycystic ovary syndrome? J Hypertens. 2011;29:991–6.
Verloop WL, Spiering W, Vink EE, Beeftink MM, Blankestijn PJ, Doevendans PA, et al. Denervation of the renal arteries in metabolic syndrome: the DREAMS-study. Hypertension. 2015;65:751–7.
Buse JB, Ginsberg HN, Bakris GL, Clark NG, Costa F, Eckel R, et al. Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation. 2007;115:114–26.
Roper NA, Bilous RW, Kelly WF, Unwin NC, Connolly VM. Excess mortality in a population with diabetes and the impact of material deprivation: longitudinal, population based study. BMJ. 2001;322:1389–93.
Acknowledgements
Marianne Wanten and So-Jeong You provided expert study management and Beth Ferri, PhD, CMPP, provided medical writing support and generation of figures and tables (all employees of Medtronic).
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The Global SYMPLICITY Registry was funded by Medtronic.
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Cheryl Shen is an employee of Medtronic. The other authors have no competing interests to declare.
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Kim, BK., Kim, HS., Park, SJ. et al. Long-term outcomes after renal denervation in an Asian population: results from the Global SYMPLICITY Registry in South Korea (GSR Korea). Hypertens Res 44, 1099–1104 (2021). https://doi.org/10.1038/s41440-021-00683-5
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DOI: https://doi.org/10.1038/s41440-021-00683-5
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