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New data show promise for renal denervation in hypertension

12 Jun 2018

Renal denervation provides meaningful reductions in systolic blood pressure (BP) in hypertensive patients on or off BP-lowering medications, results of the SPYRAL HTN-ON MED and RADIANCE-HTN SOLO trials have shown.

In SPYRAL HTN-ON MED, 467 patients with uncontrolled hypertension despite the use of up to three antihypertensive medications were randomized to undergo renal denervation or a sham control procedure. Results from the first 80 patients showed significantly greater reductions in the renal denervation vs sham control group in office systolic BP (difference, -6.8 mm Hg; p=0.05), 24-hour systolic BP (difference, -7.4 mm Hg; p=0.0051), office diastolic BP (difference, -3.5 mm Hg; p=0.0478) and 24-hour diastolic BP (difference, -4.1 mm Hg, p=0.0292) at 6 months. [Lancet 2018, doi: https://doi.org/10.1016/S0140-6736(18)30951-6]

In RADIANCE-HTN SOLO, 146 patients with hypertension after discontinuation of up to two antihypertensive medications were randomized to undergo renal denervation or a sham procedure. At 2 months, patients in the renal denervation group had greater reductions in daytime ambulatory systolic BP than those in the sham control group (difference, -6.3 mm Hg; p=0.0001). [Lancet 2018, doi: https://doi.org/10.1016/S0140-6736(18)31082-1]

The two trials enrolled different patient populations. In SPYRAL HTN-ON MED, eligible patients had an office systolic BP of 150–180 mm Hg and a diastolic BP of 90 mm Hg, a 24-hour ambulatory systolic BP of 140–170 mm Hg at second screening, and were on 1–3 antihypertensive medications at stable doses for at least 6 weeks. In contrast, RADIANCE-HTN SOLO enrolled patients with ambulatory BP of 135/85 mm Hg and <170/105 mm Hg after a 4-week discontinuation of 2 antihypertensive medications.

No major adverse events were reported for either procedure in both trials. In SPYRAL HTN-ON MED, adherence to antihypertensive medications was incomplete, at about 60 percent, and varied for individual patients throughout the trial.

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Most Read Articles
Pearl Toh, 07 Aug 2018
A home-based, self-applied wearable electrocardiogram (ECG) patch facilitates diagnosis of atrial fibrillation (AF) among high-risk individuals, according to the mSToPS* trial.
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06 Aug 2018
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08 Aug 2018
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