The effect of renal sympathetic denervation on nocturnal dipping in patients with resistant hypertension; observational data from a tertiary referral centre in the Republic of Ireland

Tuohy, Stephen; Kyvelou, Stella-Maria; Gleeson, Patrick; Daniels, Florrie; Ryan, Louise; Lappin, David; O’Donnell, Martin J.; Sharif, Faisal

doi:10.1007/s11845-015-1324-3

Cited by 5 publications

(8 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, nighttime intensification of BAT parameters resulted in a class change from non‐dippers to dippers in six patients (26%). The present results are in accordance with reports investigating the effect of renal denervation on dipping status, which showed an improved dipping pattern as well 21,37 . However the largest study of renal denervation which investigated 346 patients did not show any improvement of dipping status 38 .…”

Section: Discussionsupporting

confidence: 92%

“…The present results are in accordance with reports investigating the effect of renal denervation on dipping status, which showed an improved dipping pattern as well. 21 , 37 However the largest study of renal denervation which investigated 346 patients did not show any improvement of dipping status. 38 In the present cohort four patients (17 %) had prior RDN.…”

Section: Discussionmentioning

confidence: 98%

“…For renal denervation, there are both experimental and clinical references, indicating an effect to improve dipping patterns. 20 , 21 BAT with its possibility to program a separate night interval might be effective in improving nighttime dipping. However, data on the effects of BAT on dipping pattern are lacking so far.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of baroreflex activation therapy on dipping pattern in patients with resistant hypertension

Wallbach

Born

Schäfer

et al. 2022

J of Clinical Hypertension

View full text Add to dashboard Cite

A relevant number of patients with resistant hypertension do not achieve blood pressure (BP) dipping during nighttime. This inadequate nocturnal BP reduction is associated with elevated cardiovascular risks. The aim of this study was to evaluate whether a nighttime intensification of BAT might improve nocturnal BP dipping. In this prospective observational study, non-dippers treated with BAT for at least 6 months were included. BAT programming was modified in a two-step intensification of nighttime stimulation at baseline and week 6. Twenty-four hours ambulatory BP (ABP) was measured at inclusion and after 3 months. A number of 24 patients with non-or inverted dipping pattern, treated with BAT for a median of 44 months (IQR 25-52) were included. At baseline of the study, patients were 66 ± 9 years old, had a BMI of 33 ± 6 kg/m 2 , showed an office BP of 135 ± 22/72 ± 10 mmHg, and took a median number of antihypertensives of 6 (IQR 4-9). Nighttime stimulation of BAT was adapted by an intensification of pulse width from 237 ± 161 to 267 ± 170 µs (p = .003) while frequency (p = .10) and amplitude (p = .95) remained unchanged. Uptitration of BAT programming resulted in an increase of systolic dipping from 2 ± 6 to 6 ± 8% (p = .03) accompanied with a significant improvement of dipping pattern (p = .02). Twenty four hours ABP, day-and nighttime ABP remained unchanged. Programming of an intensified nighttime BAT interval improved dipping profile in patients treated with BAT, while the overall 24 h ABP did not change. Whether the improved dipping response contributes to a reduction of cardiovascular risk beyond the BP-lowering effects of BAT, however, remains to be shown.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Effect of baroreflex activation therapy on dipping pattern in patients with resistant hypertension

Wallbach

Born

Schäfer

et al. 2022

J of Clinical Hypertension

View full text Add to dashboard Cite

show abstract

“…In a small cohort of renal denervated patients, half of which presented with a nondipping blood pressure phenotype before denervation, there was a significant improvement in dipping pattern following denervation (Krum et al, 2009). Another small Irish cohort subjected to bilateral renal denervation via Symplicity catheters also had a significant improvement in dipping status post denervation relative to baseline (Tuohy et al, 2016). These smaller cohort studies lacked a sham control and the dipping status of ambulatory blood pressure data following renal denervation needs to be further characterized in larger clinical cohorts.…”

Section: Renal Nerves and Circadian Controlmentioning

confidence: 99%

Autonomic nerves and circadian control of renal function

Becker¹,

Zhang²,

Soliman³

et al. 2019

Autonomic Neuroscience

View full text Add to dashboard Cite

Cardiovascular and renal physiology follow strong circadian rhythms. For instance, renal excretion of solutes and water is higher during the active period compared to the inactive period, and blood pressure peaks early in the beginning of the active period of both diurnal and nocturnal animals. The control of these rhythms is largely dependent on the expression of clock genes both in the central nervous system and within peripheral organs themselves. Although it is understood that the central and peripheral clocks interact and communicate, few studies have explored the specific mechanism by which various organ systems within the body are coordinated to control physiological processes. The renal sympathetic nervous innervation has long been known to have profound effects on renal function, and because the sympathetic nervous system follows strong circadian rhythms, it is likely that autonomic control of the kidney plays an integral role in modulating renal circadian function. This review highlights studies that provide insight into this interaction, discusses areas lacking clarity, and suggests the potential for future work to explore the role of renal autonomics in areas such as blood pressure control and chronic kidney disease.

show abstract

“…Reports of the impact of renal denervation on nocturnal blood pressure dipping patterns are mixed. Although some trials have reported improvements in nocturnal dipping status after renal denervation, 26,27 several nonrandomized 28–32 as well as randomized controlled studies 33–35 failed to show an impact of renal denervation on nocturnal dipping patterns. However, these results may be due in part to nonspecific definitions and modest reproducibility of baseline dipping status.…”

Section: Effects Of Percutaneous Renal Denervation Therapy On 24-hourmentioning

confidence: 99%

Changes in 24-Hour Patterns of Blood Pressure in Hypertension Following Renal Denervation Therapy

et al. 2019

View full text Add to dashboard Cite

The effect of renal sympathetic denervation on nocturnal dipping in patients with resistant hypertension; observational data from a tertiary referral centre in the Republic of Ireland

Abstract: These data suggest that RSD may lead to an improvement in nocturnal dipping in selected patients with resistant hypertension. This may have cardiovascular benefits even if reduction in BP is not achieved with RSD.

Cited by 5 publications

References 23 publications

Effect of baroreflex activation therapy on dipping pattern in patients with resistant hypertension

Effect of baroreflex activation therapy on dipping pattern in patients with resistant hypertension

Autonomic nerves and circadian control of renal function

Changes in 24-Hour Patterns of Blood Pressure in Hypertension Following Renal Denervation Therapy

Contact Info

Product

Resources

About