SOLACI | Latin American Society of Interventional Cardiology

Endovascular ultrasound renal denervation significantly reduces systolic blood pressure when compared against a sham procedure according to this new study presented at ACC 2021 simultaneously published in the Lancet.

Renal denervation reduces ambulatory daily systolic blood pressure by 8 mmHg vs 3 mmHg in the sham procedure branch. This translates into a mean 4.5 mmHg reduction, which results significative (p=0.02).

In addition, there was significant reduction to 24 ambulatory systolic blood pressure, as well as office blood pressure.

Even though all patients included in the study had been treated with a combination of at least 3 drugs (one of them a diuretic) their blood pressure readings still remained over 150 mmHg.

After the disappointing outcomes of SYMPLCITY HTN-3, the technique was considerably improved and there are now studies with positive results. The device used in RADIANCE-HTN TRIO is assisted by ultrasound to apply 2 or 3 7-second circumferential applications to the renal artery.

All eligible patients for this study were changed to a fix drug scheme including a calcium beta blocker, an angiotensin inhibitor, and a thiazide diuretic. If after 4 weeks patients continued to present daily hypertension readings over 135/85 mmHg, they were randomized to ultrasound renal denervation vs. the sham procedure.

989 patients were enrolled, and 69 were finally randomized to denervation and 67 to the sham procedure. This was basically because after 4 weeks researchers were able to reach blood pressure targets.

At 2 months, the active Branch saw a significant reduction of all hypertension variables, including the primary end point of ambulatory daytime blood pressure.

The only adverse event was a femoral access site pseudoaneurysm in the denervation Branch.

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Original Title: Ultrasound renal denervation for hypertension resistant to a triple medication pill (RADIANCE-HTN TRIO): a randomized, multicenter, single-blind, sham-controlled trial.

Reference: Azizi M et al. Presentado en el congreso de la ACC 2021 y publicado simultáneamente en Lancet 2021; Epub ahead of print. DOI:https://doi.org/10.1016/S0140-6736(21)00788-1.