{"id":"f26b8d650c72","type":"article","url":"https://hartvaat.nl/2016/09/20/medicatietrouw-en-bloeddrukeffecten-van-renale-denervatie-rsd-pathway-2-analyse/","title":"Medicatietrouw en bloeddrukeffecten van renale denervatie: RSD PATHWAY-2-analyse","title_en":"Adherence to Antihypertensive Treatment and the Blood Pressure-Lowering Effects of Renal Denervation in the Renal Denervation for Hypertension (DENERHTN) Trial.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","internist"],"tags":["bloeddrukbehandeling","cardiorenal-behandelstrategie","figaro-dkd","flow-trial","renale-denervatie"],"journal":"Circulation","doi":"10.1161/CIRCULATIONAHA.116.022922","source_url":"https://doi.org/10.1161/CIRCULATIONAHA.116.022922","authors":["Michel Azizi","Helena Pereira","Idir Hamdidouche","Philippe Gosse","Matthieu Monge","Guillaume Bobrie","Pascal Delsart","Claire Mounier-Véhier","Pierre-Yves Courand","Pierre Lantelme","Thierry Denolle","Caroline Dourmap-Collas","Xavier Girerd","Jean Michel Halimi","Faiez Zannad","Olivier Ormezzano","Bernard Vaïsse","Daniel Herpin","Jean Ribstein","Bernard Chamontin","Jean-Jacques Mourad","Emile Ferrari","Pierre-François Plouin","Vincent Jullien","Marc Sapoval","Gilles Chatellier"],"significance":7,"published":"2016-09-20","source_date":"2016-09-20","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/resistente-hypertensie/","https://hartvaat.nl/kennis/hypertensie/esc-richtlijn-hypertensie-2024/"],"congress":"","summary_en":"This DENERHTN analysis examined the relationship between antihypertensive medication adherence and the blood pressure-lowering effects of renal denervation, highlighting that non-adherence is a major confounder in renal denervation trials.","created":"2026-07-03T10:26:18Z","updated":"2026-07-03T18:38:27Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Analyse naar de relatie tussen antihypertensieve medicatietrouw en de bloeddrukverlagende effecten van renale denervatie. Benadrukt dat non-adherentie het effect van devicetherapie kan verklaren.","abstract_original":"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. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01570777."}