Monday, March 05, 2012


Renal denervation, for the treatment of resistant hypertension continues to show good benefits and results. last Nov, at the fall meeting of AHA ( American Heart association ) annual scientific meeting, the 2 year results of Simplicity II- HTN, 2 year results were presented and they continue to show good control of blood pressure, after two years.
In the 6th March 2012 issue of the Journal of the American College of Cardiology, Dr Mathias Brandt and colleagues from the Paracelsus Medical University, Salzburg, Austria, published the echocardiographic substudy of the Simplicity II - NTH study. They analyse the baseline, 1 month and 6 months echo of 46 patients and 18 controls, who were part of the Simplicity II study. They found that after 6 months there were significant reduction in LV mass, LV diastolic function and also a significant reduction in Pro-BNP. These findings show that renal denervation, besides having an effect of BP reduction, may also have longterm morbidity and mortality benefits.
This is indeed interesting, I was quite surprised and the 17% reduction in LV mass after 6 months. We just do not get such good results with drugs. We all know that LV mass is a predictor of outcome in hypertensive patients. The less the LV mass the better.
However, we are all awaiting the results of other ongoing studies. In my talking to leaders in this field of hypertension, it appears that not all centers get as good a result as in Simplicity II.
We are also awaiting longer term data of renal denervation ,as it would appear that once a certain group of nerve fibres are severed. the body will try and reconnect the sympathetic system, so that bodily functions can be maintained, hypertension being an example of deranged BP control.
However, as renal denervation has proven safe, it appears to have a promising future. This is also evident by the fact that besides Medtronic ( Ardian machine ), other companies are also jumping into the fray, to get their machines ready for use, when this Renal Denervation gets the approval of the Health authorities, like the FDA.

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