Rate dynamics of daily monitoring of blood pressure in patients with resistant hypertension.Design and method:
The study included 53 patients (mean age 54,6 ± 19,6 years) with drug-resistant essential hypertension. All patients underwent ambulatory monitoring of blood pressure (BP) at baseline, after 12 months after renal denervation (RD).Results:
The original figures average BP amounted to 155,6/93,5 mmHg. After renal denervation according to the daily monitoring showed marked antihypertensive effect with BP reduction on a 13.0/−7,9 mmHg. Revealed a similar decline in the average daily (−15,8/−9,0 mmHg.) and average night (−12,0/−8,7) mmHg. The level of pulse pressure decreased in comparison with baseline after 1 year after the intervention from 64,5 to 56,5 mmHg. Under the influence of the RD also notes the decrease average variability of the systolic BP from 16,5 to 15,0 mmHg, average variability diastolic BP in the daytime from 16,4 to 14,5 mmHg. Under the influence of RD, showed a reduction of the provisional index of systolic BP and diastolic BP by the end of the study, 17% and 19.2% respectively. In all cases, p < 0.05. The indicators of the daily index, on the average, after the sympathetic denervation of the kidneys did not change significantly. However, the positive effect of an intervention on the dynamics of the circadian profiles of BP 48 % of patients, in the form of higher of the daily index SBP by the end of the study. The daily index DBP increased to 51%. None of the patients included in this study, there have been no unwanted side effects related to the denervation. Dynamics of the level of blood creatinine or signs of renal artery stenosis after ablation was not detected.Conclusions:
In patients with hypertension resistant to drug therapy, conducting renal denervation contributes to a significant reduction average BP, average daily and average night BP. The decrease in pulse BP, BP variability and temporal load index pressure observed after ablation indicate a decrease in risk of cardiovascular complications.