Impact of Antihypertensive Medication Changes After Renal Denervation Among Different Patient Groups: SPYRAL HTN-ON MED

作者：Raymond R. Townsend, Keith C. Ferdinand, David E. Kandzari, Kazuomi Kario, Felix Mahfoud, Michael A. Weber, Roland Erich Schmieder, Stuart Pocock, Konstantinos P Tsioufis, Shukri W. David, Susan Patricia Steigerwalt, Antony Walton, Ingrid Hopper, Barry D. Bertolet, Faisal Sharif, Karl Fengler, Martin P. Fahy, Douglas A. Hettrick, Sandeep Kaur Brar, Michael C Böhm · 发表于：Hypertension · 年份：2024 · DOI：10.1161/hypertensionaha.123.22251 · 被引用次数：32 · 研究领域：Blood Pressure and Hypertension Studies、Chronic Kidney Disease and Diabetes、Sodium Intake and Health

BACKGROUND: The SPYRAL HTN-ON 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)trial showed significant office and nighttime systolic blood pressure (BP) reductions in patients with hypertension following renal denervation (RDN) compared with sham-control patients, despite similar 24-hour BP reductions. We compared antihypertensive medication and BP changes among prespecified subpopulations. METHODS: The multicenter, randomized, sham-controlled, blinded SPYRAL HTN-ON MED trial (n=337) evaluated BP changes after RDN compared with a sham procedure in patients with hypertension prescribed 1 to 3 antihypertensive drugs. Most patients (n=187; 54%) were enrolled outside the United States, while 156 (46%) US patients were enrolled, including 60 (18%) Black Americans. RESULTS: Changes in detected antihypertensive drugs were similar between RDN and sham group patients in the outside US cohort, while drug increases were significantly more common in the US sham group compared with the RDN group. Patients from outside the United States showed significant reductions in office and 24-hour mean systolic BP at 6 months compared with the sham group, whereas BP changes were similar between RDN and sham in the US cohort. Within the US patient cohort, Black Americans in the sham control group had significant increases in medication burden fr...