Magod Benjamin L, Glynn Peter A, Manz Wesley J, Shah Pal V, Vidovich Mladen I
Department of Medicine Northwestern University Chicago Illinois USA.
Division of Cardiology University of Illinois Chicago Chicago Illinois USA.
Health Sci Rep. 2025 Mar 10;8(3):e70549. doi: 10.1002/hsr2.70549. eCollection 2025 Mar.
Catheter-based renal denervation (RDN) is a safe and effective alternative treatment for hypertension. However, data on patient preferences are limited. This study sought to delineate preferences for RDN among Veterans with difficult-to-control hypertension at an urban VA Medical Center with the goal of optimizing management and referral practices in hypertensive Veterans.
Patients on 3+ antihypertensive medications and a measured creatinine < 2.5 mg/dL were identified from the pharmacy database. A total of 100 randomly selected patients were telephoned for the administration of a survey assessing patient preferences for RDN, expectations for RDN, as well as medication adherence using the Medication Adherence Report Scale (MARS-5). Additional chart review was performed to gather demographic and clinical data of survey respondents.
A total of 51 Veterans completed the survey. While 29 (56.9%) Veterans indicated a preference against RDN, 22 (43.1%) indicated a preference for this procedure, and 33 (64.7%) expressed that if their blood pressure were uncontrolled, they would prefer RDN over additional medication. A history of congestive heart failure ( = 0.017) and lower MARS-5 score ( = 0.007) were associated with a preference for RDN. Age, reported medication side effects, and hypertension treatment satisfaction ratings were not associated with preference for or against RDN.
A considerable portion of Veterans with difficult-to-control hypertension at an urban VA Medical Center expressed a preference for RDN if their blood pressure were to be uncontrolled or if recommended by their doctor. These survey results should be considered in shared decision-making discussions for hypertension management in this population.
基于导管的肾去神经支配术（RDN）是一种安全有效的高血压替代治疗方法。然而，关于患者偏好的数据有限。本研究旨在明确城市退伍军人事务部（VA）医疗中心难以控制高血压的退伍军人对RDN的偏好，以优化高血压退伍军人的管理和转诊实践。
从药房数据库中识别出服用3种及以上抗高血压药物且测量的肌酐<2.5mg/dL的患者。总共随机选择100名患者进行电话调查，评估患者对RDN的偏好、对RDN的期望以及使用药物依从性报告量表（MARS-5）的药物依从性。进行额外的病历审查以收集调查受访者的人口统计学和临床数据。
共有51名退伍军人完成了调查。虽然29名（56.9%）退伍军人表示不倾向于RDN，但22名（43.1%）表示倾向于该手术，33名（64.7%）表示如果他们的血压未得到控制，他们更倾向于RDN而非额外用药。充血性心力衰竭病史（P = 0.017）和较低的MARS-5评分（P = 0.007）与倾向于RDN相关。年龄、报告的药物副作用和高血压治疗满意度评分与倾向于或不倾向于RDN无关。
城市VA医疗中心相当一部分难以控制高血压的退伍军人表示，如果他们的血压未得到控制或医生推荐，他们倾向于RDN。在该人群高血压管理的共同决策讨论中应考虑这些调查结果。
