Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Clinical Development Department, Terumo Corporation, Tokyo, Japan.
Hypertens Res. 2022 Feb;45(2):232-240. doi: 10.1038/s41440-021-00760-9. Epub 2021 Oct 17.
Renal denervation is a potential alternative to antihypertensive drug therapy. However, data on patient preference for this treatment option are limited and there are no data specifically from Asian patients. This study evaluated patient preference for renal denervation in patients with hypertension from Japan. Patients were a subset of those who participated in a March 2020 online electronic survey of patients with hypertension who had regularly visited medical institutions for treatment, were receiving antihypertensive drug therapy and had home blood pressure recordings available. The survey included a question about patient preference for treatment with renal denervation. A total of 2,392 patients were included (66% male, mean age 59.8 ± 11.6 years, mean duration of hypertension 11.4 ± 9.5 years). Preference for renal denervation was expressed by 755 patients (31.6%), and was higher in males than in females, in younger compared with older patients, in those with higher versus lower blood pressure, in patients who were less adherent versus more adherent to antihypertensive drug therapy, and in those who did rather than did not have antihypertensive drug-related side effects. Significant predictors of preference for renal denervation on logistic regression analysis were younger patient age, male sex, higher home or office systolic blood pressure, poor antihypertensive drug adherence, the presence of heart failure, and the presence of side effects during treatment with antihypertensive drugs. Overall, a relevant proportion of Japanese patients with hypertension expressed a preference for renal denervation. This should be taken into account when making shared decisions about antihypertensive drug therapy.
肾动脉去神经术是一种潜在的抗高血压药物治疗替代方法。然而,关于患者对这种治疗选择的偏好的数据有限,而且没有专门来自亚洲患者的数据。本研究评估了日本高血压患者对肾动脉去神经术的治疗偏好。患者是参加 2020 年 3 月针对定期到医疗机构就诊、接受抗高血压药物治疗且有家庭血压记录的高血压患者的在线电子调查的一部分。该调查包括一个关于患者对肾动脉去神经术治疗偏好的问题。共纳入 2392 名患者(66%为男性,平均年龄 59.8±11.6 岁,高血压平均病程 11.4±9.5 年)。755 名患者(31.6%)表达了对肾动脉去神经术的偏好,男性比女性更偏好,年轻患者比老年患者更偏好,血压较高的患者比血压较低的患者更偏好,药物治疗依从性较差的患者比药物治疗依从性较好的患者更偏好,且有抗高血压药物相关副作用的患者比没有副作用的患者更偏好。Logistic 回归分析显示,对肾动脉去神经术偏好的显著预测因素为年龄较小、男性、家庭或诊所收缩压较高、抗高血压药物治疗依从性差、心力衰竭以及在抗高血压药物治疗期间存在副作用。总体而言,相当一部分日本高血压患者表达了对肾动脉去神经术的偏好。在做出抗高血压药物治疗的共同决策时,应考虑这一点。