IMR Press / RCM / Volume 23 / Issue 2 / DOI: 10.31083/j.rcm2302065
Open Access Original Research
Preprocedural features of patients under antihypertensive drugs may help identify responders to renal denervation: a hypothesis-generating study
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1 Cardiovascular Center, MacKay Memorial Hospital, 104217 Taipei, Taiwan
2 Department of Medicine, Mackay Medical College, 252 New Taipei, Taiwan
3 Department of Healthcare Administration, College of Medicine, I-Shou University, 84001 Kaohsiung, Taiwan
4 Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, 112 Taipei, Taiwan
5 Department of Cardiology, Hsinchu MacKay Memorial Hospital, 300 Hsinchu, Taiwan
6 Department of Cardiology, Taitung MacKay Memorial Hospital, 950 Taitung, Taiwan
7 Department of Artificial intelligence and Medical Application, MacKay Junior College of Medicine, Nursing, and Management, 11260 Taipei, Taiwan
8 Department of Internal Medicine, National Taiwan University Hospital, 100 Taipei, Taiwan
*Correspondence: (Ying-Hsiang Lee)
Academic Editors: Stefano Omboni, Brian Tomlinson and Takatoshi Kasai
Rev. Cardiovasc. Med. 2022, 23(2), 65;
Submitted: 1 December 2021 | Revised: 12 January 2022 | Accepted: 19 January 2022 | Published: 16 February 2022
(This article belongs to the Special Issue State-of-the-Art Cardiovascular Medicine in Asia 2021)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Renal denervation (RDN) is effective to lower systolic blood pressure (SBP) in essential hypertension. However, patient selection under medications remains an important unmet clinical need. Methods: This multicenter study aimed at observing whether preprocedural features associated with increased renin-angiotensin-aldosterone activity influence RDN response. This study enrolled the patients who underwent RDN for uncontrolled hypertension. Medical records were reviewd and patients were divided into 2 groups depending by meeting any of the following conditions prior to RDN: (1) >10 mmHg of office SBP reduction after aldosterone inhibition, (2) aldosterone-renin ratio >30 or (3) slow flow on the renal angiogram. RDN responders were defined by a reduction in 24-hour mean 6 mmHg or by 1 class of antihypertensive drug withdraw. Results: A total of 46 patients were enrolled, of which 27 (59%) were in control group A and 19 (41%) in group B. The baseline age, gender, office and 24-hour SBP (mean 140.0 ± 12.8 mmHg vs. 144.0 ± 16.5 mmHg, p = 0.577) were comparable, while the number of prescribed drug classes was fewer in group A (4.0 ± 1.3 vs. 4.9 ± 0.9, p = 0.014). The proportion patients with prescribed aldosterone antagonist or high aldosterone-renin ratios were higher in group B. At 12 months post RDN, the results were significantly better in group B in terms of mean change in office SBP (12.4 ± 23.5 mmHg vs. 29.9 ± 25.5 mmHg, p = 0.046) and the proportion of RDN responders (51.9% vs. 89.5%, p < 0.001). Conclusion: RDN was more effective in patients with any of 3 clinical indices.

patient selection
renal denervation
Fig. 1.
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