Renal denervation for the treatment of resistant hypertension in Spain. The Flex-Spyral Registry

Abstract

Introduction and objectives: Renal denervation is a percutaneous intervention for the treatment of resistant hypertension. Randomized studies have shown contradictory results on its efficacy. We present the results of a renal denervation registry for the treatment of resistant hypertension in real-life patients in Spain.

Methods: Multicenter registry of consecutive patients with resistant hypertension treated with renal denervation in Spain between 2009 and 2018.

Results: We included 125 patients (mean age, 56 years; 41% female; mean onset of hypertension 14±9 years previously). Office systolic and diastolic blood pressure and ambulatory blood pressure monitoring decreased 6 months after the intervention (166±20/95±16 to 149±22/87±16 mmHg and 151±14/89±12 to 143±15/84±11, both P <.0001). At 12 months, the blood pressure reduction was maintained and the number of antihypertensive drugs decreased from 4.9±1.2 to 4.4±1.5 (P=.0001). There were no significant procedure-related complications. The response rate to denervation at 1 year was 80%, but there were wide differences between centers.

Conclusions: In patients with resistant hypertension, treatment with renal denervation was related to a decrease in office blood pressure and, more importantly, in ambulatory blood pressure monitoring, with a significant reduction in pharmacological treatment.

Keywords: Blood pressure; Denervación renal percutánea; Hipertensión arterial; Hypertension; Percutaneous renal denervation; Presión arterial; Sistema nervioso simpático; Sympathetic nervous system.