Title :

Adherence to antihypertensive treatment and the blood pressure-lowering effects of renal denervation in the renal denervation for hypertension (denerhtn) trial

Author(s) :

Azizi, Michel [Auteur]
Pereira, Helena [Auteur]
Hamdidouche, Idir [Auteur]
Gosse, Philippe [Auteur]
Monge, Matthieu [Auteur]
Bobrie, Guillaume [Auteur]
Delsart, Pascal [Auteur]
Mounier Vehier, Claire [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Courand, Pierre-Yves [Auteur]
Lantelme, Pierre [Auteur]
Denolle, Thierry [Auteur]
Dourmap-Collas, Caroline [Auteur]
Girerd, Xavier [Auteur]
Halimi, Jean-Michel [Auteur]
Zannad, Faiez [Auteur]
Ormezzano, Olivier [Auteur]
Vaisse, Bernard [Auteur]
Herpin, Daniel [Auteur]
Ribstein, Jean [Auteur]
Chamontin, Bernard [Auteur]
Mourad, Jean-Jacques [Auteur]
Ferrari, Emile [Auteur]
Plouin, Pierre-François [Auteur]
Jullien, Vincent [Auteur]
Sapoval, Marc [Auteur]
Chatellier, Gilles [Auteur]

Journal title :

Circulation

Abbreviated title :

Circulation

Volume number :

134

Pages :

847-857

Publication date :

2016-09-01

ISSN :

0009-7322

English keyword(s) :

medications
nervous system
sympathetic nervous system
kidney
hypertension
ablation techniques

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure-lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment for resistant hypertension ...
Show more >BACKGROUND: The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure-lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment for resistant hypertension at 6 months. We report the influence of adherence to antihypertensive treatment on blood pressure control. METHODS: One hundred six patients with hypertension resistant to 4 weeks of treatment with indapamide 1.5 mg/d, ramipril 10 mg/d (or irbesartan 300 mg/d), and amlodipine 10 mg/d were randomly assigned to renal denervation plus standardized stepped-care antihypertensive treatment, or the same antihypertensive treatment alone. For standardized stepped-care antihypertensive treatment, spironolactone 25 mg/d, bisoprolol 10 mg/d, prazosin 5 mg/d, and rilmenidine 1 mg/d were sequentially added at monthly visits if home blood pressure was ≥135/85 mm Hg after randomization. We assessed adherence to antihypertensive treatment at 6 months by drug screening in urine/plasma samples from 85 patients. RESULTS: The numbers of fully adherent (20/40 versus 21/45), partially nonadherent (13/40 versus 20/45), or completely nonadherent patients (7/40 versus 4/45) to antihypertensive treatment were not different in the renal denervation and the control groups, respectively (P=0.3605). The difference in the change in daytime ambulatory systolic blood pressure from baseline to 6 months between the 2 groups was -6.7 mm Hg (P=0.0461) in fully adherent and -7.8 mm Hg (P=0.0996) in nonadherent (partially nonadherent plus completely nonadherent) patients. The between-patient variability of daytime ambulatory systolic blood pressure was greater for nonadherent than for fully adherent patients. CONCLUSIONS: In the DENERHTN trial, the prevalence of nonadherence to antihypertensive drugs at 6 months was high (≈50%) but not different in the renal denervation and control groups. Regardless of adherence to treatment, renal denervation plus standardized stepped-care antihypertensive treatment resulted in a greater decrease in blood pressure than standardized stepped-care antihypertensive treatment alone. BACKGROUND: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01570777.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2019-12-09T18:15:22Z