Renal artery sympathetic denervation: observations from the UK experience.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sharp Andrew S P, Davies Justin E, Lobo Melvin D, Bent Clare L, Mark Patrick B, Burchell Amy E, Thackray Simon D, Martin Una, McKane William S, Gerber Robert T, Wilkinson James R, Antonios Tarek F, Doulton Timothy W, Patterson Tiffany, Clifford Piers C, Lindsay Alistair, Houston Graeme J, Freedman Jonathan, Das Neelan, Belli Anna M, Faris Mohamad, Cleveland Trevor J, Nightingale Angus K, Hameed Awais, Mahadevan Kalaivani, Finegold Judith A, Mather Adam N, Levy Terry, D'Souza Richard, Riley Peter, Moss Jonathan G, Di Mario Carlo, Redwood Simon R, Baumbach Andreas, Caulfield Mark J, Dasgupta Indranil
Аннотация
METHODS: We examined all patients treated with RDN for treatment-resistant hypertension in 18 UK centres.
RESULTS: Results from 253 patients treated with five technologies are shown. Pre-procedural mean office BP (OBP) was 185/102 mmHg (SD 26/19; n = 253) and mean daytime ABP was 170/98 mmHg (SD 22/16; n = 186). Median number of antihypertensive drugs was 5.0: 96 % ACEi/ARB; 86 % thiazide/loop diuretic and 55 % aldosterone antagonist. OBP, available in 90 % at 11 months follow-up, was 163/93 mmHg (reduction of 22/9 mmHg). ABP, available in 70 % at 8.5 months follow-up, was 158/91 mmHg (fall of 12/7 mmHg). Mean drug changes post RDN were: 0.36 drugs added, 0.91 withdrawn. Dose changes appeared neutral. Quartile analysis by starting ABP showed mean reductions in systolic ABP after RDN of: 0.4; 6.5; 14.5 and 22.1 mmHg, respectively (p < 0.001 for trend). Use of aldosterone antagonist did not predict response (p > 0.2).
CONCLUSION: In 253 patients treated with RDN, office BP fell by 22/9 mmHg. Ambulatory BP fell by 12/7 mmHg, though little response was seen in the lowermost quartile of starting blood pressure. Fall in BP was not explained by medication changes and aldosterone antagonist use did not affect response.