PP.40.07

Abstract

Design and method: In the 3A registry, a non-randomized, non-interventional registry, 899 physicians included 14.988 patients whose blood pressure (BP) was not controlled (> = 140/90 mmHg) and in whom the physician decided to initiate or escalate antihypertensive medication. Office BP and 24-hour ambulatory BP (ABP) were measured at baseline and at 1 year follow-up (FU) with validated devices. TRH was defined as uncontrolled BP at baseline despite treatment with at least 3 antihypertensive drugs. For this analysis TRH patients were classified by office BP (> = or < 140/90 mmHg) and 24-hour ABP (> = or < 130/80 mmHg) at 1 year FU. Results:After 1 year FU, i.e. after intensification of antihypertensive therapy, office and ABP was available in 1628 subjects. The cross-sectional analysis showed that nearly half of patients had controlled hypertension according to office BP. Masked (office BP < 140/90 mmHg and ABP > = 130/80 mmHg) and white coat hypertension (office BP > = 140/90 mmHg and ABP < 130/80 mmHg) effects at 1 year FU were the following: Conclusions:After 1 year FU 2/3 of the apparently controlled hypertensives (office BP < 140 mmHg) had masked hypertension, and of the patients with apparent TRH (office BP >= 140/90 mmHg despite being on 3 drugs) 1/10 had white coat hypertension. Our data suggest the inclusion of 24-hour ABP for the treatment management.Objective: Takayasu's arteritis (TA) is a chronic, idiopathic, inflammatory disease affecting the aorta and its branches. Abdominal aortic thrombosis due to TA was rare. To date, only one case has been reported in English literatures. Design and method: Case report.Results: During the procedure, there was a severe pain (10 points on a numeric rating scale) and several episodes of vasovagal reactions -blood pressure decreased to 60/30 mm Hg, and heart rate decreased to 19, which required stopping RF exposures. In the first days after RDN a marked hypotensive effect with the development of orthostatic hypotension, office blood pressure decrease from 180/100 mmHg to 110/68 mmHg, and mean 24 h ambulatory blood pressure decrease from 158/96 mmHg to 109/64 mmHg, demand reduction of antihypertensive therapy to 2 drugs. The hypotensive effect persists up to the present time.Conclusions: In our experience, vasovagal reaction in response to severe pain during radiofrequency denervation of the renal arteries, proved a predictor of effectiveness of the procedure. This is probably due to the pronounced vagal innervation branches along the renal arteries.Objective: Nowadays there are more and more novel invasive methods in the therapy of high blood pressure. Here we present two cases with dual invasive sympatholytic therapeutic procedures of each one.Design and method: Patient 1 is a 60-year old man with obesity, impaired glucose tolerance, secondary hyperparathyeroidism, secondary hyperaldosteronism, severe obstructive sleep apnoe syndrome. Many of target organ damages are also known like left ventricular hypertrophy and hypertensive angiopathy. Patient 2 is a 37-year old...