Ambulatory Blood Pressure Monitoring to Predict Response to Renal Denervation: A Post Hoc Analysis of the RADIANCE-HTN SOLO Study

P Gosse, A Cremer, AJ Kirtane, M D Lobo, M Saxena, Joost Daemen, Y Wang, J Stegbauer, MA Weber, J Abraham, K Kario, S Bangalore, L Claude, Y Liu, M Azizi

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Scopus)


Renal denervation (RDN) is effective in lowering blood pressure (BP) in patients with hypertension. The issue remains how to best identify potential responders. Ambulatory BP monitoring may be useful. Baseline nighttime systolic BP (SBP) ≥136 mm Hg and its variability (SD) ≥12 mm Hg in DENER-HTN trial or 24-hour heart rate ≥73.5 bpm in SPYRAL HTN-OFF MED Trial were shown to predict the BP response to RDN. We applied these criteria to the patients with hypertension in the sham-controlled RADIANCE-HTN SOLO trial to predict the BP response to ultrasound RDN at 2 months while patients were maintained off medications. BP responders were defined as: clinical with 24-hour SBP <130 mm Hg (RDN: 22/64 versus sham: 7/58); meaningful with 24-hour SBP reduction ≥10 mm Hg (RDN: 24/64, sham: 7/58); and extreme with 24-hour SBP reduction above mean+2 SD of the SBP decrease in the sham group, that is, ≥16.5 mm Hg (RDN: 10/64 versus sham: 2/58). The predictive criteria reported above were tested for sensitivity, specificity, and positive and negative predictive values. The predictive value varied according to the definition of response, with the clinical definition being strongly influenced by regression to the mean. Baseline nighttime SBP and its variability, especially when combined, offered good specificity (>90% irrespective of definition) but low sensitivity (from 9.1% to 30% depending on the definition) to predict responders; the heart rate criterion had insufficient predictive value. This analysis suggests the potential role of nighttime SBP and its variability to predict BP response to RDN in patients with hypertension. Registration: URL:; Unique identifier: NCT02649426.

Original languageEnglish
Article numberA30
Pages (from-to)529-536
Number of pages8
JournalHypertension (Dallas, Tex. : 1979)
Issue number2
Publication statusPublished - 1 Feb 2021

Bibliographical note

Funding Information:
The RADIANCE-HTN SOLO study was funded by ReCor Medical (Palo Alto, CA).

Funding Information:
P. Gosse and A. Cremer have received grants support from Recor medical, Ablative Solutions. A.J. Kirtane reports Institutional funding to Columbia University and/or Cardiovascular Research Foundation from Medtronic, Boston Scientific, Abbott Vascular, Abiomed, CSI, Philips, ReCor Medical and personal fees for CME/conference honoraria and travel/meals only. M.D. Lobo has received personal fees from ReCor Medical, Medtronic, CVRx, Ablative Solutions, Vascular Dynamics, ROX Medical and Tarilan Laser Technologies and grants from Medtronic.

Publisher Copyright:
© 2020 American Heart Association, Inc.


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