{"id":"5b12804e9537","type":"article","url":"https://hartvaat.nl/2024/06/11/target-bp-i-alcohol-gemedieerde-renale-denervatie-bij-hypertensie/","title":"TARGET BP I: alcohol-gemedieerde renale denervatie bij hypertensie","title_en":"Effect of Alcohol-Mediated Renal Denervation on Blood Pressure in the Presence of Antihypertensive Medications: Primary Results From the TARGET BP I Randomized Clinical Trial.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","internist"],"tags":["bloeddrukbehandeling","lipidenverlaging","renale-denervatie"],"journal":"Circulation","doi":"10.1161/CIRCULATIONAHA.124.069291","source_url":"https://doi.org/10.1161/CIRCULATIONAHA.124.069291","authors":["David E Kandzari","Michael A Weber","Atul Pathak","James P Zidar","Manish Saxena","Shukri W David","Roland E Schmieder","Adam J Janas","Christopher Langer","Alexandre Persu","Farrell O Mendelsohn","Koen Ameloot","Malcolm Foster","Tim A Fischell","Helen Parise","Felix Mahfoud"],"significance":7,"published":"2024-06-11","source_date":"2024-06-11","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/resistente-hypertensie/","https://hartvaat.nl/kennis/hypertensie/esc-richtlijn-hypertensie-2024/"],"congress":"","summary_en":"The TARGET BP I trial evaluated alcohol-mediated renal denervation, a novel technique, showing significant blood pressure reduction in patients on antihypertensive medications. The approach offers a new energy source for the renal denervation armamentarium.","created":"2026-07-03T10:30:59Z","updated":"2026-07-03T18:39:10Z","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":"De TARGET BP I-trial onderzocht een nieuwe methode van alcohol-gemedieerde renale denervatie. De techniek verlaagde de bloeddruk significant bovenop antihypertensiva, wat een kosteneffectiever alternatief voor bestaande RDN-technologieën kan bieden.","abstract_original":"BACKGROUND: Renal denervation (RDN) has demonstrated clinically relevant reductions in blood pressure (BP) among individuals with uncontrolled hypertension despite lifestyle intervention and medications. The safety and effectiveness of alcohol-mediated RDN have not been formally studied in this indication. METHODS: TARGET BP I is a prospective, international, sham-controlled, randomized, patient- and assessor-blinded trial investigating the safety and efficacy of alcohol-mediated RDN. Patients with office systolic BP (SBP) ≥150 and ≤180 mm Hg, office diastolic BP ≥90 mm Hg, and mean 24-hour ambulatory SBP ≥135 and ≤170 mm Hg despite prescription of 2 to 5 antihypertensive medications were enrolled. The primary end point was the baseline-adjusted change in mean 24-hour ambulatory SBP 3 months after the procedure. Secondary end points included mean between-group differences in office and ambulatory BP at additional time points. RESULTS: Among 301 patients randomized 1:1 to RDN or sham control, RDN was associated with a significant reduction in 24-hour ambulatory SBP at 3 months (mean±SD, -10.0±14.2 mm Hg versus -6.8±12.1 mm Hg; treatment difference, -3.2 mm Hg [95% CI, -6.3 to 0.0]; P=0.0487). Subgroup analysis of the primary end point revealed no significant interaction across predefined subgroups. At 3 months, the mean change in office SBP was -12.7±18.3 and -9.7±17.3 mm Hg (difference, -3.0 [95% CI, -7.0 to 1.0]; P=0.173) for RDN and sham, respectively. No significant differences in ambulatory or office diastolic BP were observed. Adverse safety events through 6 months were uncommon, with one instance of accessory renal artery dissection in the RDN group (0.7%). No significant between-group differences in medication changes or patient adherence were identified. CONCLUSIONS: Alcohol-mediated RDN was associated with a modest but statistically significant reduction in 24-hour ambulatory SBP compared with sham control. No significant differences between groups in office BP or 6-month major adverse events were observed. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02910414."}