Durable 13-year outcomes after renal denervation in patients with resistant arterial hypertension in Ukraine
O Rekovets, Yu Sirenko, O Torbas, G Primak, S Progonov, G RadchenkoAbstract
Background
Renal denervation (RDN) has demonstrated short-term blood pressure (BP) reduction in randomized trials; however, very long-term durability data beyond 10 years are scarce.
Purpose
To assess 13-year efficacy and safety of RDN in patients with resistant arterial hypertension (RAH).
Methods
Among 1,146 patients with RAH treated with ≥3 antihypertensive drugs, 16 met eligibility criteria; 8 underwent RDN. Mean age was 52.1 ± 3.9 years; hypertension duration 16.8 ± 2.2 years; baseline medication burden 5.5 ± 0.2 drugs. After therapy optimization, office BP was 156.9/95.0 ± 3.0 mmHg and 24-hour BP 149.2 ± 5.4/87.0 ± 5.1 mmHg. Follow-up included office and ambulatory BP monitoring (ABPM), heart rate (HR), Computer Tomography (CT), renal function (GFR), medication burden, and cardiovascular outcomes over 13 years.
Results
RDN resulted in early BP reduction that was sustained throughout follow-up. Maximal office BP reduction reached −30/−17 mmHg at long-term assessment. Twenty-four-hour BP decreased significantly at all time points (p < 0.05), confirming persistent ambulatory BP control. All treated patients (100%) achieved target BP by year 2 and maintained control through year 13 (office and ABPM). Medication burden decreased by 36% (from 5.5 to 3.5 drugs at 5 years and 3.7 at 10 years) and remained reduced at 13 years. Renal function remained stable over time (p > 0.05). During 13 years, no cardiovascular events or cardiovascular deaths occurred; one non-cardiovascular death (thyroid cancer) was recorded.
Conclusion
In this long-term observational cohort, RDN demonstrated sustained BP reduction, significant medication burden reduction, preserved renal function, and absence of cardiovascular events over 13 years, supporting durable efficacy and safety in carefully selected RAH patients.