Ultra-long-term efficacy and safety of catheter-based renal denervation in resistant hypertension: 10-year follow-up outcomes

Abstract

Background Randomized sham-controlled trials have confrmed the efcacy and safety of catheter-based renal denervation in hypertension. Data on the very long-term efects of renal denervation are scarce. Aims This study evaluates the 10-year safety and efcacy of renal denervation in resistant hypertension. Methods This prospective single-center study included patients with resistant hypertension undergoing radio-frequency renal denervation between 2010 and 2012. Ofce blood pressure, 24-h ambulatory blood pressure, antihypertensive medication, color duplex sonography, and renal function were assessed after 1-, 2- and 10-years. Results Thirty-nine patients completed the 10-year follow-up (mean follow-up duration 9.4±0.7 years). Baseline ofce and 24-h ambulatory systolic blood pressure were 164±23 mmHg and 153±16 mmHg, respectively. After 10 years, 24-h ambulatory and ofce systolic blood pressure were reduced by 16±17 mmHg (P<0.001) and 14±23 mmHg (P=0.001), respectively. The number of antihypertensive drugs remained unchanged from 4.9±1.4 to 4.5±1.2 drugs (P=0.087). The estimated glomerular fltration rate declined within the expected range from 69 (95% CI 63 to 74) to 60 mL/min/1.73m2 (95% CI 53 to 68; P<0.001) through 10-year follow-up. Three renal artery interventions were documented for progression of pre-existing renal artery stenosis in two patients and one patient with new-onset renal artery stenosis. No other adverse events were observed during the follow-up. Conclusion Renal denervation was safe and sustainedly reduced ambulatory and ofce blood pressure out to 10 years in patients with resistant hypertension.