# Medicatietrouw en bloeddrukeffecten van renale denervatie: RSD PATHWAY-2-analyse

*geplaatst 2016-09-20 · Hypertensie · Circulation · doi 10.1161/CIRCULATIONAHA.116.022922 · https://hartvaat.nl/2016/09/20/medicatietrouw-en-bloeddrukeffecten-van-renale-denervatie-rsd-pathway-2-analyse/*

Analyse naar de relatie tussen antihypertensieve medicatietrouw en de bloeddrukverlagende effecten van renale denervatie. Benadrukt dat non-adherentie het effect van devicetherapie kan verklaren.

## English: Adherence to Antihypertensive Treatment and the Blood Pressure-Lowering Effects of Renal Denervation in the Renal Denervation for Hypertension (DENERHTN) Trial.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: Circulation, https://doi.org/10.1161/CIRCULATIONAHA.116.022922. Bijgewerkt 2026-07-03T18:38:27Z. 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.