# Hartfrequentie en uitkomsten van renale denervatie bij ongecontroleerde hypertensie

*geplaatst 2021-09-07 · Hartfalen · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2021.06.044 · https://hartvaat.nl/2021/09/07/hartfrequentie-en-uitkomsten-van-renale-denervatie-bij-ongecontroleerde-hyperten/*

Analyse van het effect van hartfrequentie op de uitkomsten van renale denervatie bij ongecontroleerde hypertensie.

## English: Effect of Heart Rate on the Outcome of Renal Denervation in Patients With Uncontrolled Hypertension.

This analysis showed that baseline heart rate influences the blood pressure-lowering response to renal denervation, identifying heart rate as a predictor of RDN efficacy in uncontrolled hypertension.

## Abstract (original, from the publication)

BACKGROUND: Sham-controlled trials demonstrated safety and efficacy of renal denervation (RDN) to lower blood pressure (BP). Association of baseline heart rate with BP reduction after RDN is incompletely understood. OBJECTIVES: The purpose of this analysis was to evaluate the impact of baseline heart rate on BP reduction without antihypertensive medications in the SPYRAL HTN-OFF MED (Global Clinical Study of Renal Denervation With the Symplicity Spyral Multi-electrode Renal Denervation System in Patients With Uncontrolled Hypertension in the Absence of Antihypertensive Medications) Pivotal trial. METHODS: Patients removed from any antihypertensive medications were enrolled with office systolic blood pressure (SBP) ≥150 and <180 mm Hg and randomized 1:1 to RDN or sham control. Patients were separated according to baseline office heart rate <70 or ≥70 beats/min. BP changes from baseline to 3 months between treatment arms were adjusted for baseline SBP using analysis of covariance. RESULTS: Scatter plots of 3-month changes in 24-hour and office SBP illustrate a wide range of changes in SBP for different baseline heart rates. Treatment difference at 3 months between RDN and sham control with baseline office heart rate ≥70 beats/min for 24-hour SBP was -6.2 mm Hg (95% CI: -9.0 to -3.5 mm Hg) (P < 0.001) and for baseline office heart rate <70 beats/min it was -0.1 mm Hg (-3.8 to 3.6 mm Hg) (P = 0.97) with an interaction P value of 0.008. Results were similar for changes in office, daytime, and nighttime SBP at 3 months, with a greater reduction in SBP with baseline office heart rate ≥70 beats/min. CONCLUSIONS: Reduction in mean office, 24-hour, daytime, and nighttime SBP for RDN at 3 months was greater with baseline office heart rate ≥70 than <70 beats/min, suggesting an association between baseline heart rate and BP reduction after RDN. (SPYRAL PIVOTAL-SPYRAL HTN-OFF MED Study; NCT02439749).

Auteurs: Michael Böhm, Konstantinos Tsioufis, David E Kandzari, Kazuomi Kario, Michael A Weber, Roland E Schmieder, Raymond R Townsend, Saarraaken Kulenthiran, Christian Ukena, Stuart Pocock, Sebastian Ewen, Joachim Weil, Martin Fahy, Felix Mahfoud

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2021.06.044. Bijgewerkt 2026-07-03T18:38:50Z. 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.