Beeftink Martine M A, Spiering Wilko, Bots Michiel L, Verloop Willemien L, De Jager Rosa L, Sanders Margreet F, Vonken Evert-Jan, Blankestijn Peter J, Voskuil Michiel
Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands.
Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.
PLoS One. 2016 Sep 15;11(9):e0162251. doi: 10.1371/journal.pone.0162251. eCollection 2016.
To investigate the blood pressure dynamics after renal denervation through monthly home blood pressure measurements throughout the first 12 months.
A cohort of 70 patients performed highly standardized monthly home blood pressure monitoring during the first year after denervation according to the European Society of Hypertension guidelines. At baseline and 12 months follow-up, office and ambulatory blood pressure as well as routine physical and laboratory assessment was performed.
Home blood pressure decreased with a rate of 0.53 mmHg/month (95% CI 0.20 to 0.86) systolic and 0.26 mmHg/month (95% CI 0.08 to 0.44) diastolic throughout 12 months of follow-up, while the use of antihypertensive medication remained stable (+0.03 daily defined doses/month, 95% CI -0.01 to 0.08). On average, a 12 month reduction of 8.1 mmHg (95% CI 4.2 to 12.0) was achieved in home systolic blood pressure, 9.3 mmHg (95% CI -14.2 to -4.4) as measured by 24-hour ambulatory blood pressure monitoring and 15.9 mmHg (95% CI -23.8 to -7.9) on office measurements.
Blood pressure reduction after renal denervation occurs as a gradual decrease that extends to at least one-year follow-up. Home monitoring seems a suitable alternative for ambulatory blood pressure monitoring after renal denervation.
通过在最初12个月内每月进行家庭血压测量,研究肾去神经支配术后的血压动态变化。
70名患者组成的队列根据欧洲高血压学会指南,在去神经支配术后的第一年进行高度标准化的每月家庭血压监测。在基线和12个月随访时,进行诊室血压和动态血压测量以及常规体格检查和实验室评估。
在12个月的随访期间,家庭收缩压以每月0.53 mmHg(95%可信区间0.20至0.86)的速率下降,舒张压以每月0.26 mmHg(95%可信区间0.08至0.44)的速率下降,而降压药物的使用保持稳定(每月增加0.03个每日规定剂量,95%可信区间-0.01至0.08)。家庭收缩压平均在12个月内降低8.1 mmHg(95%可信区间4.2至12.0),24小时动态血压监测测得降低9.3 mmHg(95%可信区间-1�.2至-4.4),诊室测量降低15.9 mmHg(95%可信区间-23.8至-7.9)。
肾去神经支配术后血压降低是一个逐渐下降的过程,至少持续到一年的随访期。家庭监测似乎是肾去神经支配术后动态血压监测的合适替代方法。