Department of Nephrology and Hypertension, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany.
Campus Lübeck Medizinische Klinik III, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany.
J Clin Hypertens (Greenwich). 2018 Feb;20(2):366-372. doi: 10.1111/jch.13193. Epub 2018 Jan 25.
Ambulatory blood pressure (BP) and central BP are better predictors for overall cardiovascular risk and mortality than brachial BP. Renal denervation (RDN) has been shown to reduce office brachial and central BP as well as brachial ambulatory BP, but data on central ambulatory BP are limited. Patients (N = 94) with treatment resistant hypertension (TRH) who underwent RDN were included. Ambulatory BP, including central pressures, hemodynamics, and arterial stiffness were measured at baseline and 3, 6, 12 months after RDN by an oscillometric device (MobiloGraph ). At 3, 6, and 12-month follow-ups, brachial ambulatory BP was reduced (P for all < .001). Consistently, central ambulatory BP was reduced (P for all < .001). Ambulatory assessed averaged daytime pulse wave velocity improved after RDN (P < .05). Total vascular resistance decreased (P for all < .01). In patients with TRH, RDN improves brachial and central ambulatory BP, arterial stiffness, and total vascular resistance, indicating an improvement of cardiovascular outcome.
动态血压(BP)和中心 BP 比臂部 BP 更能预测整体心血管风险和死亡率。肾去神经术(RDN)已被证明可降低诊室臂部和中心 BP 以及臂部动态 BP,但有关中心动态 BP 的数据有限。本研究纳入了 94 名患有难治性高血压(TRH)并接受 RDN 的患者。通过示波法设备(MobiloGraph)在基线和 RDN 后 3、6、12 个月测量动态血压,包括中心压、血液动力学和动脉僵硬。在 3、6 和 12 个月的随访中,臂部动态 BP 降低(所有 P 值均<.001)。一致地,中心动态 BP 也降低(所有 P 值均<.001)。RDN 后,动态评估的平均日间脉搏波速度改善(P<.05)。总血管阻力降低(所有 P 值均<.01)。在 TRH 患者中,RDN 可改善臂部和中心动态 BP、动脉僵硬和总血管阻力,表明心血管结局得到改善。