The DENERHTN trial (Renal Denervation for Hypertension) confirmed the efficacy of renal denervation in addition to antihypertensive standard care in patients with resistant hypertension.
This study reports the influence of adherence to treatment to control blood pressure. It included 106 patients with resistant hypertension after four week treatment with indapamide 1.5 mg/day, ramipril 10 mg/day (or irbesartan 300 mg/day) and amlodipine 10 mg/day, randomized to renal denervation and stepped-care of other drugs vs. the same antihypertension treatment.
For stepped-care, patients received spironolactone 25 mg/day, bisoprolol 10 mg/day, prazosin 5 mg/day and rilmenidine 1 mg/day, consecutively added at monthly visits if blood pressure was ≥135/85 mm Hg.
The number of fully adherent patients (20/40 vs. 21/45), partially non-adherent (13/40 vs. 20/45) and completely non-adherent (7/40 vs. 4/45) to antihypertensive drugs resulted similar between the group randomized to renal denervation and the control group, respectively (p=0.3605).
The difference in ambulatory systolic blood pressure between both groups was –6.7 mmHg (p=0.3605) in patients completely adherent and –7.8 mm Hg (p=0.0996) in non-adherent patients.
Conclusion
The prevalence of non-adherence to antihypertension drugs at six months was close to 50%, but did not differ between the renal denervation group and the control group. Regardless of adherence to treatment, renal denervation in addition to standard stepped care with antihypertension drugs resulted in greater reduction of blood pressure compared to standard care.
Original Title: Adherence to Antihypertensive Treatment and the Blood Pressure–Lowering Effects of Renal Denervation in the Renal Denervation for Hypertension (DENERHTN) Trial.
Reference: Michel Azizi et al. Circulation. 2016 Sep 20;134(12):847-57.
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