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01.11.2012 | consensus report

Clinical application of interventional renal sympathetic denervation: recommendations of the Austrian Society of Hypertension 2012

verfasst von: Priv.-Doz. Dr. Thomas Weber, Univ.-Prof. Dr. Robert Zweiker, Univ.-Prof. Dr. Bruno Watschinger, Dr. Peter Grüner, Dr. Christian Koppelstätter, PhD, Dr. Mathias C. Brandt, Univ.-Prof. Dr. Jörg Horina, Asst. Prof. Dr. Helmut Brussee, Dr. Katharina Hohenstein, Dr. Thomas Lambert, Univ.-Doz. Dr. Johann Auer, Univ.-Prof. Dr. Uta C. Hoppe

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 21-22/2012

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Summary

Increased activity of the sympathetic nervous system plays a major role in the pathophysiology of primary arterial hypertension. Interventional renal sympathetic denervation (RSD) is a novel percutaneous treatment, decreasing sympathetic activity and consecutively blood pressure by ablating sympathetic nervous fibers located in the adventitia of the renal arteries. The procedure has been tested in several clinical trials in patients with resistant hypertension (defined as systolic office blood pressure > 160 mmHg—in diabetic patients > 150 mmHg—treated with ³ 3 antihypertensive drugs) and caused a meaningful blood pressure reduction, lasting for at least 3 years. So far, no major adverse events have been identified; however, data on the long-term consequences are lacking. The present position paper of the Austrian Society of Hypertension is aiming to assist in choosing possible indications for RSD in clinical routine, based on the available evidence in 2012.

Vorheriger Artikel Impact of mother tongue and gender on overweight, obesity and extreme obesity in 24,989 Viennese children/adolescents (2–16 years)

Nächster Artikel Mitteilungen November 2012

Esler M. The 2009 Carl Ludwig Lecture: pathophysiology of the human sympathetic nervous system in cardiovascular diseases: the transition from mechanisms to medical management. J Appl Physiol. 2010;108:227–37.PubMedCrossRef

Schlaich MP, Lambert E, Kaye DM, Krozowski Z, Campbell DJ, Lambert G, Hastings J, Aggarwal A, Esler M. Sympathetic augmentation in hypertension role of nerve firing, norepinephrine reuptake, and angiotensin neuromodulation. Hypertension. 2004;43:169–75.PubMedCrossRef

Esler M. Looking at the sympathetic nervous system as a primary source. In: Zanchetti A, Robertson JIS, Birkenhager WH, editors. Handbook of hypertension: hypertension research in the twentieth century. Amsterdam: Elsevier; 2004. pp. 81–103.

Grassi G, Seravalle G, Colombo M, Bolla G, Cattaneo BM, Cavagnini F, Mancia G. Body weight reduction, sympathetic nerve traffic, and arterial baroreflex in obese normotensive humans. Circulation. 1998;97:2037–42.PubMedCrossRef

Narkiewicz K, Pesek CA, Kato M, Phillips BG, Davison DE, Somers VK. Baroreflex control of sympathetic nerve activity and heart rate in obstructive sleep apnea. Hypertension. 1998;32:1039–43.PubMedCrossRef

Grassi G. Assessment of sympathetic cardiovascular drive in human hypertension achievements and perspectives. Hypertension. 2009;54:690–7.PubMedCrossRef

Tsioufis C, Kordalis A, Flessas D, Anastasopoulos I, Tsiachris D, Papademetriou V, Stefenadis C. Pathophysiology of resistant hypertension: the role of sympathetic nervous system. Int J Hypertens. 2011;2011:642416.PubMed

Atherton DS, Deep NL, Mendelsohn FO. Micro-anatomy of the renal sympathetic nervous system: a human postmortem histologic study. Clin Anat. 2012;25:628–33.PubMedCrossRef

Schmieder R, Redon J, Grassi G, Kjeldsen SE, Mancia G, Narkiewicz K, Parati G, Ruilope L, van de Borne P, Tsioufis C. ESH position paper: renal denervation: an interventional therapy of resistant hypertension. J Hypertens. 2012;30:837–41.PubMedCrossRef

10.

Schlaich MP, Socratous F, Hennebry S, Eikelis N, Lambert EA, Straznicky N, Esler MD, Lambert GW. Sympathetic activation in chronic renal failure. J Am Soc Nephrol. 2009;20:933–9.PubMedCrossRef

11.

Grassi G, Quarti-Trevano F, Seravalle G, Arenare F, Volpe M, Furiani S, Dell’Oro R, Mancia G. Early sympathetic activation in the initial clinical stages of chronic renal failure. Hypertension. 2011;57:846–51.PubMedCrossRef

12.

Krum H, Sobotka P, Mahfoud F, Böhm M, Esler M, Schlaich M. Device-based antihypertensive therapy: therapeutic modulation of the autonomic nervous system. Circulation. 2011;123:209–15.PubMedCrossRef

13.

Hausberg M, Kosch M, Harmelink P, Barenbrock M, Hohage H, Kisters K, Dietl KH, Rahn KH. Sympathetic nerve activity in end-stage renal disease. Circulation. 2002;106:1974–9.PubMedCrossRef

14.

Löwel H, Meisinger C, Heier M, Hymer H, Alte D, Völzke H. Epidemiologie der art. Hypertonie. Dtsch Med Wochenschr. 2006;131:2586–91.PubMedCrossRef

15.

Calhoun DA, Jones D, Textor S, Goff DC, Murphy TP, Toto RD, White A, Cushman WC, White W, Sica D, Ferdinand K, Giles TD, Falkner B, Carey RM. Resistant hypertension: diagnosis, evaluation, and treatment: a scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Circulation. 2008;117:e510–26.PubMedCrossRef

16.

Daugherty SL, Powers JD, Magid DJ, Tavel HM, Masoudi FA, Margolis KL, O’Connor PJ, Selby JV, Ho PM. Incidence and prognosis of resistant hypertension in hypertensive patients. Circulation. 2012;125:1635–42.PubMedCrossRef

17.

de la Sierra A, Segura J, Banegas JR, Gorostidi M, de la Cruz JJ, Amario P, Oliveras A, Ruilope LM. Clinical features of 8295 patients with resistant hypertension classified on the basis of ambulatory blood pressure monitoring. Hypertension. 2011;57:898–902.PubMedCrossRef

18.

Pimenta E, Calhoun DA. Resistant hypertension. incidence, prevalence, and prognosis. Circulation. 2012;125:1594–6.PubMedCrossRef

19.

Taler SJ, Textor SC, Augustine JE. Resistant hypertension: comparing hemodynamic management to specialist care. Hypertension. 2002;39:982–8.PubMedCrossRef

20.

Ernst ME, Carter BL, Goerdt CJ, Steffensmeier JJ, Phillips BB, Zimmerman MB, Bergus GR. Comparative antihypertensive effects of hydrochlorothiazide and chlorthalidone on ambulatory and office blood pressure. Hypertension. 2006 ;47:352–8.PubMedCrossRef

21.

Sica DA. Chlorthalidone: has it always been the best thiazide-type diuretic? Hypertension. 2006;47:321–2.PubMedCrossRef

22.

Vasan RS, Evans JC, Larson MG, Wilson PW, Meigs JB, Rifai N, Benjamin EJ, Levy D. Serum aldosterone and the incidence of hypertension in nonhypertensive persons. N Engl J Med. 2004;351:33–41.PubMedCrossRef

23.

Chapman N, Dobson J, Wilson S, Dahlöf B, Sever PS, Wedel H, Poulter NR. On behalf of the Anglo-Scandinavian cardiac outcomes trial investigators effect of spironolactone on blood pressure in subjects with resistant hypertension. Hypertension. 2007;49:839–45.PubMedCrossRef

24.

Vaclavik J, Sedlak R, Plachy M, Navratil K, Plasek J, Jarkovsky J, Vaclavik T, Husar R, Kocianova E, Taborsky M. Addition of spironolactone in patients with resistant arterial hypertension (ASPIRANT): a randomized, double-blind, placebo-controlled trial. Hypertension. 2011;57:1069–75.PubMedCrossRef

25.

Saha C, Eckert GJ, Ambrosius WT, Chun TY, Wagner MA, Zhao Q, Pratt JH. Improvement in blood pressure with inhibition of the epithelial sodium channel in blacks with hypertension. Hypertension. 2005;46:481–7.PubMedCrossRef

26.

Hermida RC, Ayala DE, Calvo C, López JE, Mojón A, Fontao MJ, Soler R, Fernández JR. Effects of time of day of treatment on ambulatory blood pressure pattern of patients with resistant hypertension. Hypertension. 2005;46:1053–9.PubMedCrossRef

27.

Page IH, Heuer GJ. A surgical treatment of essential hypertension. J Clin Invest. 1935, 14:22–6.PubMedCrossRef

28.

Bisognano JD, Bakris G, Nadim MK, Sanchez L, Kroon AA, Schafer J, de Leeuw PW, Sica DA. Baroreflex activation therapy lowers blood pressure in patients with resistant hypertension. Results from the double-blind, randomized, placebo-controlled rheos pivotal trial. J Am Coll Cardiol. 2011;58:765–73.PubMedCrossRef

29.

Schlaich M, Sobotka PA, Krum H, Lambert E, Esler MD. Renal sympathetic-nerve ablation for uncontrolled hypertension. N Engl J Med. 2009;361:932–4.PubMedCrossRef

30.

Krum H, Schlaich M, Whitbourn R, Sobotka PA, Sadowski J, Bartus K, et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. Lancet. 2009;373:1275–81.PubMedCrossRef

31.

Mahfoud F, Vonend O, Bruck H, Clasen W, Eckert S, Frye B, Haller H, Hausberg M, Hoppe UC, Hoyer J, Hahn K, Keller T, Krämer BK, Kreutz R, Potthoff SA, Reinecke H, Schmieder R, Schwenger V, Kintscher U, Böhm M, Rump LC. Interventionelle renale Sympathikusdenervation zur Behandlung der therapieresistenten Hypertonie [Expert consensus statement on interventional renal sympathetic denervation for hypertension treatment]. Dtsch Med Wochenschr. 2011;136:2418–24.PubMedCrossRef

32.

Symplicity HTN-2 Investigators. Renal sympathetic denervation in patients with treatment-resistant hypertension (the Symplicity HTN-2 trial): a randomised controlled trial. Lancet. 2010;376:1903–9.CrossRef

33.

Symplicity HTN-1 Investigators. Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months. Hypertension. 2011;57:911–7.CrossRef

34.

Rippy MK, Zarins D, Barman NC, Wu A, Duncan KL, Zarins CK. Catheter-based renal sympathetic denervation: chronic preclinical evidence for renal artery safety. Clin Res Cardiol. 2011;100:1095–101.PubMedCrossRef

35.

Stefanadis C, Toutouzas K, Synetos A, Tsioufis C, Karanasos A, Agrogiannis G, Stefanis L, Patsouris E, Tousoulis D. Chemical denervation of the renal artery by vincristine in swine. A new catheter based technique. Int J Cardiol. 2012 Jan 20. Epub ahead of print.

36.

Sobotka PA, Mahfoud F, Schlaich MP, Hoppe UC, Böhm M, Krum H. Sympatho-renal axis in chronic disease. Clin Res Card. 2011;100:1049–57.CrossRef

37.

Mahfoud F, Schlaich M, Kindermann I, Ukena C, Cremers B, Brandt MC, Hoppe UC, Vonend O, Rump LC, Sobotka PA, Krum H, Esler M, Böhm M. Effect of renal sympathetic denervation on glucose metabolism in patients with resistant hypertension: a pilot study. Circulation. 2011;123:1940–6.PubMedCrossRef

38.

Witkowski A, Prejbisz A, Florczak E, Kądziela J, Śliwiński P, Bieleń P, Michałowska I, Kabat M, Warchoł E, Januszewicz M, Narkiewicz K, Somers VK, Sobotka PA, Januszewicz A. Effects of renal sympathetic denervation on blood pressure, sleep apnea course, and glycemic control in patients with resistant hypertension and sleep apnea. Hypertension. 2011;58:559–65.PubMedCrossRef

39.

Hering D, Mahfoud F, Walton AS, Krum H, Lambert GW, Lambert EA, Sobotka PA, Böhm M, Cremers B, Esler MD, Schlaich MP. Renal denervation in moderate to severe CKD. J Am Soc Nephrol. 2012 May 17;23(7):1250–7.PubMedCrossRef

40.

Di Daniele N, De Francesco M, Violo L, Spinelli A, Simonetti G. Renal sympathetic nerve ablation for the treatment of difficult-to-control or refractory hypertension in a haemodialysis patient. Nephrol Dial Transplant. 2012;27:1689–90.PubMedCrossRef

41.

Linz D, Mahfoud F, Schotten U, Ukena C, Neuberger H-R, Wirth K, Böhm M. Renal sympathetic denervation suppresses postapneic blood pressure rises and atrial fibrillation in a model for sleep apnea. Hypertension. 2012;60(1):172–8.PubMedCrossRef

42.

Mancia G, Grassi G, Giannattasio C, Seravalle G. Sympathetic activation in the pathogenesis of hypertension and progression of organ damage. Hypertension. 1999;34:724–8.PubMedCrossRef

43.

Brandt MC, Mahfoud F, Reda S, Schirmer SH, Erdmann E, Böhm M, Hoppe UC. Renal sympathetic denervation reduces left ventricular hypertrophy and improves cardiac function in patients with resistant hypertension. J Am Coll Cardiol. 2012;59:901–9.PubMedCrossRef

44.

Zile MR, Little WC. Effects of autonomic modulation: more than just blood pressure. J Am Coll Cardiol. 2012;59:910–2.PubMedCrossRef

45.

Ferguson DW, Berg WJ, Sanders JS. Clinical and hemodynamic correlates of sympathetic nerve activity in normal humans and patients with heart failure: evidence from direct microneurographic recordings. J Am Coll Cardiol. 1990;16:1125–34.PubMedCrossRef

46.

Cohn JN, Levine TB, Olivari MT, Garberg V, Lura D, Francis GS, Simon AB, Rector T. Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med. 1984;311:819–23.PubMedCrossRef

47.

Ukena C, Bauer A, Mahfoud F, Schreieck J, Neuberger HR, Eick C, Sobotka PA, Gawaz M, Böhm M. Renal sympathetic denervation for treatment of electrical storm: first-in-man experience. Clin Res Cardiol. 2012;101:63–7.PubMedCrossRef

48.

Himmel F, Bode F, Mortensen K, Reppel M, Franzen K, Schunkert H, Weil J. Sccessful single-sided renal denervation approach in a patient with stenosis of an accessory renal artery. J Clin Hypertens. 2012;14:187–8.CrossRef

49.

Ohkubo T, Kikuya M, Metoki H, Asayama K, Obara T, Hashimoto J, Totsune K, Hoshi H, Satoh H, Imai Y. Prognosis of “masked” hypertension and “white-coat” hypertension detectedby 24-h ambulatory blood pressure monitoring 10-year follow-up from the ohasama study. J Am Coll Cardiol. 2005;46:508–15.

50.

Caulfield M, de Belder M, Cleveland T, Collier D, Deanfield J, Gray H, Knight C, Lobo M, Matson M, Moss J, Poulter N, Simpson I, Tomson C, Williams B. The Joint UK Societies’ consensus statement on renal denervation for resistant hypertension. 2012. http://www.bhsoc.org/docs/The-Joint-UK-Societies'-Consensus-on-Renal-Denervation-for-resistant-hypertension.pdf. Accessed 23 Oct. 2012.

51.

Zweiker R, Slany J. Zeitgemäße Hochdruckdiagnose I: Ambulantes 24-Stunden-Blutdruckmonitoring. Austrian J Hypertens. 2012;16(3):18–24.

52.

Head GA, Mihailidou AS, Duggan KA, Beilin LJ, Berry N, Brown MA, Bune AJ, Cowley D, Chalmers JP, Howe PRC, Hodgson J, Ludbrook J, Mangoni AA, McGrath BP, Nelson MR, Sharman JE, Stowasser M, Ambulatory Blood Pressure Working Group of the High Blood Pressure Research Council of Australia. Definition of ambulatory blood pressure targets for diagnosis and treatment of hypertension in relation to clinic blood pressure: prospective cohort study. BMJ. 2010;340:c1104.PubMedCrossRef

Titel: Clinical application of interventional renal sympathetic denervation: recommendations of the Austrian Society of Hypertension 2012
verfasst von: Priv.-Doz. Dr. Thomas Weber
Univ.-Prof. Dr. Robert Zweiker
Univ.-Prof. Dr. Bruno Watschinger
Dr. Peter Grüner
Dr. Christian Koppelstätter, PhD
Dr. Mathias C. Brandt
Univ.-Prof. Dr. Jörg Horina
Asst. Prof. Dr. Helmut Brussee
Dr. Katharina Hohenstein
Dr. Thomas Lambert
Univ.-Doz. Dr. Johann Auer
Univ.-Prof. Dr. Uta C. Hoppe
Publikationsdatum: 01.11.2012
Verlag: Springer Vienna
Erschienen in: Wiener klinische Wochenschrift / Ausgabe 21-22/2012
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI: https://doi.org/10.1007/s00508-012-0257-3

Springer Medizin Österreich

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