Bloch Michael J, Kirtane Ajay J, Azizi Michel, Mahfoud Felix, Basile Jan, Daemen Joost, Saxena Manish, Thackeray Lisa, McGuire Maureen, Claude Lisa, Schmieder Roland E
Department of Medicine, University of Nevada School of Medicine, Vascular Care, Reno, NV, USA.
Renown Regional Medical Center, Reno, NV, USA.
Hypertens Res. 2024 Dec;47(12):3467-3472. doi: 10.1038/s41440-024-01854-w. Epub 2024 Sep 27.
Endovascular ultrasound renal denervation (uRDN) reduced blood pressure (BP) compared to sham at 2 months in patients with resistant hypertension in the multicenter, blinded, randomized, sham-controlled RADIANCE-HTN TRIO trial. This analysis evaluates longer-term outcomes of patients randomized to uRDN. Patients with resistant hypertension to a 3-drug combination pill were randomized to uRDN (n = 69) or sham (n = 67). From 2-5 months, patients followed a standardized anti-hypertensive medication (AHM) titration protocol. At 6 months, patients were unblinded and received AHM per standard of care. In the uRDN group, 71% (49/69) completed 36-month follow-up. Screening office BP was 159/103 on 3.9 AHM. Baseline office BP on the single-pill combination was 153/99 mmHg. At 36 months, office BP changed by -14.5 ± 26.1/-9.0 ± 14.8 mmHg from screening (p < 0.001 for both) and -8.0 ± 24.5/-5.0 ± 14.6 mmHg from baseline (p = 0.007; p = 0.022) on 3.7 AHM. The efficacy of uRDN was durable to 36 months in patients with resistant hypertension with no safety concerns.
在多中心、盲法、随机、假手术对照的RADIANCE-HTN TRIO试验中，与假手术组相比，血管内超声肾去神经支配术（uRDN）在2个月时降低了顽固性高血压患者的血压（BP）。本分析评估了随机接受uRDN治疗患者的长期预后。对三联复方抗高血压药耐药的高血压患者被随机分为uRDN组（n = 69）或假手术组（n = 67）。在2至5个月期间，患者遵循标准化的抗高血压药物（AHM）滴定方案。在6个月时，患者不再设盲，并按照标准治疗接受AHM治疗。在uRDN组中，71%（49/69）的患者完成了36个月的随访。筛查时诊室血压为159/103，服用3.9种AHM。单一片剂复方药物时的基线诊室血压为153/99 mmHg。在36个月时，服用3.7种AHM，诊室血压较筛查时变化了-14.5±26.1/-9.0±14.8 mmHg（两者p均<0.001），较基线变化了-8.0±24.5/-5.0±14.6 mmHg（p = 0.007；p = 0.022）。对于顽固性高血压患者，uRDN的疗效可持续至36个月，且无安全性问题。
