Title: Eligibility for renal denervation: experience at 11 European expert centers
Authors: Persu, Alexandre ×
Jin, Yu
Baelen, Marie
Vink, Eva
Verloop, Willemien L
Schmidt, Bernhard
Blicher, Marie K
Severino, Francesca
Wuerzner, Grégoire
Taylor, Alison
Pechère-Bertschi, Antoinette
Jokhaji, Fadi
Fadl Elmula, Fadl Elmula M
Rosa, Jan
Czarnecka, Danuta
Ehret, Georg
Kahan, Thomas
Renkin, Jean
Widimsky, Jiři
Jacobs, Lotte
Spiering, Wilko
Burnier, Michel
Mark, Patrick B
Menne, Jan
Olsen, Michael H
Blankestijn, Peter J
Kjeldsen, Sverre
Bots, Michiel L
Staessen, Jan A
European Network Coordinating research on REnal Denervation Consortium #
Issue Date: Jun-2014
Publisher: Lippincott Williams & Wilkins
Series Title: Hypertension vol:63 issue:6 pages:1319-25
Article number: 10.1161/HYPERTENSIONAHA.114.03194
Abstract: Based on the SYMPLICITY studies and CE (Conformité Européenne) certification, renal denervation is currently applied as a novel treatment of resistant hypertension in Europe. However, information on the proportion of patients with resistant hypertension qualifying for renal denervation after a thorough work-up and treatment adjustment remains scarce. The aim of this study was to investigate the proportion of patients eligible for renal denervation and the reasons for noneligibility at 11 expert centers participating in the European Network COordinating Research on renal Denervation in treatment-resistant hypertension (ENCOReD). The analysis included 731 patients. Age averaged 61.6 years, office blood pressure at screening was 177/96 mm Hg, and the number of blood pressure-lowering drugs taken was 4.1. Specialists referred 75.6% of patients. The proportion of patients eligible for renal denervation according to the SYMPLICITY HTN-2 criteria and each center's criteria was 42.5% (95% confidence interval, 38.0%-47.0%) and 39.7% (36.2%-43.2%), respectively. The main reasons of noneligibility were normalization of blood pressure after treatment adjustment (46.9%), unsuitable renal arterial anatomy (17.0%), and previously undetected secondary causes of hypertension (11.1%). In conclusion, after careful screening and treatment adjustment at hypertension expert centers, only ≈40% of patients referred for renal denervation, mostly by specialists, were eligible for the procedure. The most frequent cause of ineligibility (approximately half of cases) was blood pressure normalization after treatment adjustment by a hypertension specialist. Our findings highlight that hypertension centers with a record in clinical experience and research should remain the gatekeepers before renal denervation is considered.
ISSN: 0194-911X
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Hypertension and Cardiovascular Epidemiology
Department of Cardiovascular Sciences - miscellaneous
× corresponding author
# (joint) last author

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