AUTHOR=Vogt Alexander , Dutzmann Jochen , Nußbaum Michael , Hoyer Daniel , Tongers Jörn , Schlitt Axel , Sedding Daniel , Plehn Alexander 

TITLE=Safety and efficacy of renal sympathetic denervation: a 9-year long-term follow-up of 24-hour ambulatory blood pressure measurements

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1210801

DOI=10.3389/fcvm.2023.1210801

ISSN=2297-055X

ABSTRACT=Background: Renal sympathetic denervation (RDN) has been shown to lower arterial blood pressure in presence as well as in absence of antihypertensive medication in an observation period of up to 3 years. Long-term results beyond 3 years are scarce.
Methods: We performed long-term follow-up in patients who were previously enrolled in a local renal denervation registry and underwent radiofrequency RDN using the Symplicity Flex® renal denervation system between 2011 and 2014. Patients received assessment by 24-hour ambulatory blood pressure measurement (ABPM), medical history, and laboratory tests to evaluate renal function. 
Results: 24h ambulatory blood pressure readings were available for 72 patients at long-term follow-up (9.3 years [IQR 8.5-10.1]). We found a significant reduction of ABP from 150.1/86.1±16.9/12.0 mmHg at baseline to 138.3/77.1±16.5/11.1 mmHg at long-term follow-up (FU) (P<0.001 for both systolic and diastolic ABP). The number of antihypertensive medications used significantly decreased from 5.4±1.5 at baseline to 4.8±1.6 at long-term follow-up (P<0.01). Renal function showed a significant but expected age-associated decrease in eGFR from 87.8 (IQR 81.0-100.0) to 72.5 (IQR 55.8-86.8) ml/min/1.73m² (P<0.01) in patients with an initial eGFR > 60ml/min/1.73m², while a non-significant decrease was observed in patients with initial eGFR <60ml/min/1.73m² at long-term follow-up (56.0 [IQR 40.9-58.4] vs. 39.0 [IQR13.5-56.3] ml/min/1.73m²).
Conclusions: RDN was followed by a long-lasting reduction in blood pressure with a concomitant reduction in antihypertensive medication. No negative effects could be detected, especially with regard to renal function.