Detail
Article
Online article
FT
Medvik - BMC
  • Something wrong with this record ?

Renal denervation in comparison with intensified pharmacotherapy in true resistant hypertension: 2-year outcomes of randomized PRAGUE-15 study

J. Rosa, P. Widimský, P. Waldauf, T. Zelinka, O. Petrák, M. Táborský, M. Branny, P. Toušek, K. Čurila, L. Lambert, F. Bednář, R. Holaj, B. Štrauch, J. Václavík, E. Kociánová, I. Nykl, O. Jiravský, G. Rappová, T. Indra, Z. Krátká, J. Widimský,

. 2017 ; 35 (5) : 1093-1099.

Language English Country England, Great Britain

Document type Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial

Persistent link   https://www.medvik.cz/link/bmc17031103

Grant support
NV16-30345A MZ0 CEP Register

OBJECTIVES: The randomized, multicentre study compared the efficacy of renal denervation (RDN) versus spironolactone addition in patients with true resistant hypertension. We present the 24-month data. METHODS: A total of 106 patients with true resistant hypertension were enrolled in this study: 52 patients were randomized to RDN and 54 patients to the spironolactone addition, with baseline SBP of 159 ± 17 and 155 ± 17 mmHg and average number of drugs 5.1 and 5.4, respectively. Two-year data are available in 86 patients. Spironolactone addition, as crossover after 1 year, was performed in 23 patients after RDN, and spironolactone addition followed by RDN was performed in five patients. RESULTS: Similar and comparable reduction of 24-h SBP after RDN or spironolactone addition after randomization was observed, 9.1 mmHg (P = 0.001) and 10.9 mmHg (P = 0.001), respectively. Similar decrease of office blood pressure (BP) was observed, 17.7 mmHg (P < 0.001) versus 14.1 mmHg (P < 0.001), whereas the number of antihypertensive drugs did not differ significantly between groups. Crossover analysis showed nonsignificantly better efficacy of spironolactone addition in 24-h SBP and office SBP reduction than RDN (3.7 mmHg, P = 0.27 and 4.6 mmHg, P = 0.28 in favour of spironolactone addition, respectively). Meanwhile, the number of antihypertensive drugs was significantly increased after spironolactone addition (+0.7, P = 0.001). CONCLUSION: In the settings of true resistant hypertension, spironolactone addition (if tolerated) seems to be of better efficacy than RDN in BP reduction over a period of 24 months. However, by contrast to the 12-month results, BP changes were not significantly greater.

References provided by Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc17031103
003      
CZ-PrNML
005      
20200220101417.0
007      
ta
008      
171025s2017 enk f 000 0|eng||
009      
AR
024    7_
$a 10.1097/HJH.0000000000001257 $2 doi
035    __
$a (PubMed)28118281
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a enk
100    1_
$a Rosa, Ján $u a3rd Department of Medicine, Centre for Hypertension, General University Hospital and First Faculty of Medicine, Charles University bCardiocentre cDepartment of Anaesthesiology, University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University, Prague dDepartment of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, University Hospital Olomouc and Palacký University, Olomouc eCardiocentre, Nemocnice Podlesí, Třinec fDepartment of Radiology gDepartment of Nephrology, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic.
245    10
$a Renal denervation in comparison with intensified pharmacotherapy in true resistant hypertension: 2-year outcomes of randomized PRAGUE-15 study / $c J. Rosa, P. Widimský, P. Waldauf, T. Zelinka, O. Petrák, M. Táborský, M. Branny, P. Toušek, K. Čurila, L. Lambert, F. Bednář, R. Holaj, B. Štrauch, J. Václavík, E. Kociánová, I. Nykl, O. Jiravský, G. Rappová, T. Indra, Z. Krátká, J. Widimský,
520    9_
$a OBJECTIVES: The randomized, multicentre study compared the efficacy of renal denervation (RDN) versus spironolactone addition in patients with true resistant hypertension. We present the 24-month data. METHODS: A total of 106 patients with true resistant hypertension were enrolled in this study: 52 patients were randomized to RDN and 54 patients to the spironolactone addition, with baseline SBP of 159 ± 17 and 155 ± 17 mmHg and average number of drugs 5.1 and 5.4, respectively. Two-year data are available in 86 patients. Spironolactone addition, as crossover after 1 year, was performed in 23 patients after RDN, and spironolactone addition followed by RDN was performed in five patients. RESULTS: Similar and comparable reduction of 24-h SBP after RDN or spironolactone addition after randomization was observed, 9.1 mmHg (P = 0.001) and 10.9 mmHg (P = 0.001), respectively. Similar decrease of office blood pressure (BP) was observed, 17.7 mmHg (P < 0.001) versus 14.1 mmHg (P < 0.001), whereas the number of antihypertensive drugs did not differ significantly between groups. Crossover analysis showed nonsignificantly better efficacy of spironolactone addition in 24-h SBP and office SBP reduction than RDN (3.7 mmHg, P = 0.27 and 4.6 mmHg, P = 0.28 in favour of spironolactone addition, respectively). Meanwhile, the number of antihypertensive drugs was significantly increased after spironolactone addition (+0.7, P = 0.001). CONCLUSION: In the settings of true resistant hypertension, spironolactone addition (if tolerated) seems to be of better efficacy than RDN in BP reduction over a period of 24 months. However, by contrast to the 12-month results, BP changes were not significantly greater.
650    _2
$a dospělí $7 D000328
650    _2
$a senioři $7 D000368
650    _2
$a antihypertenziva $x terapeutické užití $7 D000959
650    _2
$a krevní tlak $7 D001794
650    _2
$a ambulantní monitorování krevního tlaku $7 D018660
650    _2
$a koronární vazospasmus $x terapie $7 D003329
650    _2
$a klinické křížové studie $7 D018592
650    _2
$a kombinovaná farmakoterapie $7 D004359
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a následné studie $7 D005500
650    _2
$a lidé $7 D006801
650    _2
$a hypertenze $x terapie $7 D006973
650    _2
$a ledviny $x inervace $x patofyziologie $7 D007668
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé středního věku $7 D008875
650    _2
$a antagonisté mineralokortikoidních receptorů $x terapeutické užití $7 D000451
650    _2
$a prospektivní studie $7 D011446
650    _2
$a spironolakton $x terapeutické užití $7 D013148
650    12
$a sympatektomie $7 D013562
650    _2
$a výsledek terapie $7 D016896
655    _2
$a srovnávací studie $7 D003160
655    _2
$a časopisecké články $7 D016428
655    _2
$a multicentrická studie $7 D016448
655    _2
$a randomizované kontrolované studie $7 D016449
700    1_
$a Widimský, Petr
700    1_
$a Waldauf, Petr
700    1_
$a Zelinka, Tomáš
700    1_
$a Petrák, Ondřej
700    1_
$a Táborský, Miloš
700    1_
$a Branny, Marian
700    1_
$a Toušek, Petr
700    1_
$a Čurila, Karol
700    1_
$a Lambert, Lukáš
700    1_
$a Bednář, František
700    1_
$a Holaj, Robert
700    1_
$a Štrauch, Branislav
700    1_
$a Václavík, Jan
700    1_
$a Kociánová, Eva
700    1_
$a Nykl, Igor
700    1_
$a Jiravský, Otakar
700    1_
$a Rappová, Gabriela
700    1_
$a Indra, Tomáš $7 xx0236186
700    1_
$a Krátká, Zuzana
700    1_
$a Widimský, Jiří
773    0_
$w MED00002723 $t Journal of hypertension $x 1473-5598 $g Roč. 35, č. 5 (2017), s. 1093-1099
856    41
$u https://pubmed.ncbi.nlm.nih.gov/28118281 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y a $z 0
990    __
$a 20171025 $b ABA008
991    __
$a 20200220101821 $b ABA008
999    __
$a ok $b bmc $g 1254696 $s 992130
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2017 $b 35 $c 5 $d 1093-1099 $i 1473-5598 $m Journal of hypertension $n J Hypertens $x MED00002723
GRA    __
$a NV16-30345A $p MZ0
LZP    __
$a Pubmed-20171025

Find record

Citation metrics

Archiving options