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Cardiovascular Risk Reduction After Renal Denervation According to Time in Therapeutic Systolic Blood Pressure Range
Felix Mahfoud
Giuseppe Mancia
Roland E. Schmieder
Luis Ruilope
Krzysztof Narkiewicz
Markus P. Schlaich
Bryan Williams
Flavio L. Ribichini
Joachim Weil
Hsien-Li Kao
Oriol Rodriguez-Leor
Elias Noory
Tiong Kiam Ong
Thierry Unterseeh
Pedro de Araújo Gonçalves
Andreas Zirlik
Khaled Almerri
Faisal Sharif
Lucas Lauder
Marianne Wanten
Martin Fahy
Michael Böhm
出版
Universität
, 2022
URL
http://books.google.com.hk/books?id=96iezwEACAAJ&hl=&source=gbs_api
註釋
Abstract: Background
Renal denervation (RDN) has been shown to lower blood pressure (BP), but its effects on cardiovascular events have only been preliminarily evaluated. Time in therapeutic range (TTR) of BP is associated with cardiovascular events.
Objectives
This study sought to assess the impact of catheter-based RDN on TTR and its association with cardiovascular outcomes in the GSR (Global SYMPLICITY Registry).
Methods
Patients with uncontrolled hypertension were enrolled and treated with radiofrequency RDN. Office and ambulatory systolic blood pressure (OSBP and ASBP) were measured at 3, 6, 12, 24, and 36 months postprocedure and used to derive TTR. TTR through 6 months was assessed as a predictor of cardiovascular events from 6 to 36 months using a Cox proportional hazard regression model.
Results
As of March 1, 2022, 3,077 patients were enrolled: 42.2% were female; mean age was 60.5 ± 12.2 years; baseline OSBP was 165.6 ± 24.8 mm Hg; and baseline ASBP was 154.3 ± 18.7 mm Hg. Patients were prescribed 4.9 ± 1.7 antihypertensive medications at baseline and 4.8 ± 1.9 at 36 months. At 36 months, mean changes were −16.7 ± 28.4 and −9.0 ± 20.2 mm Hg for OSBP and ASBP, respectively. TTR through 6 months was 30.6%. A 10% increase in TTR after RDN through 6 months was associated with significant risk reductions from 6 to 36 months of 15% for major adverse cardiovascular events (P 0.001), 11% cardiovascular death (P = 0.010), 15% myocardial infarction (P = 0.023), and 23% stroke (P 0.001).brbrConclusions