Objectives To explore the best indicator of catheter based renal sympathetic denervation (RSD) treatment of resistant hypertension, to choose the appropriate hypertensive patients undergo RSD, providing a theoretical basis.
Methods Thirty patients with resistant hypertension underwent the experiment from June 2011 to July 2012 and were retrospectively reviewed. The 30 patients were screened for eligibility and were allocated to renal denervation. Primary endpoints were changes of mean blood pressure 6 month and 1 year after procedure. By linear regression analysis, We assessed the correlation between the baseline level of NE, renin, Ang-II, ET-1, ALD and the BP reduction.
Results Systolic blood pressure after catheter-based renal denervation decreased by 35.52 ± 17.65, 36.63 ± 18.54 mmHgat 6 months and 1 year, respectively (P < 0.001). Diastolic blood pressure decreased by 15.19 ± 15.44, 16.13 ± 15.51 mmHg, at 6 months, and 1 year, respectively (P < 0.001). Meanwhile, there is a clear positive correlation between NE and the BP reduction (r2 = 0.82, P < 0.001), and a similar correlation between rennin (r2 = 0.72, P < 0.001), AngII (r2 = 0.75, P < 0.001), ALD (r2 = 0.71, P < 0.001), ET-1 (r2 = 0.72, P < 0.001) and the BP reduction was observed in our study. In addition, there is a significantly decline in NE, renin, AngII, ALD and ET-1 (all P < 0.01).
Conclusions Catheter-based renal sympathetic denervation reduces the level of renin acivity, angiotensin II, aldosterone, ET-1 and NE, causes substantial and sustained blood-pressure reduction, and more importantly, The NE and AngII are suitable indicators in selecting appropriate hypertensive patients undergo RSD.