Predictors of blood pressure response to ultrasound renal denervation in the RADIANCE-HTN SOLO study

Manish Saxena*, Roland E. Schmieder, Ajay J. Kirtane, Felix Mahfoud, Joost Daemen, Jan Basile, Philipp Lurz, Philippe Gosse, Kintur Sanghvi, Naomi D.L. Fisher, Lars C. Rump, Atul Pathak, Peter J. Blankestijn, Anthony Mathur, Yale Wang, Michael A. Weber, Andrew S.P. Sharp, Michael J. Bloch, Neil C. Barman, Lisa ClaudeYang Song, Michel Azizi, Melvin D. Lobo

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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The blood pressure (BP) lowering response to renal denervation (RDN) remains variable with about one-third of patients not responding to ultrasound or radiofrequency RDN. Identification of predictors of the BP response to RDN is needed to optimize patient selection for this therapy. This is a post-hoc analysis of the RADIANCE-HTN SOLO study. BP response to RDN was measured by the change in daytime ambulatory systolic blood pressure (dASBP) at 2 months post procedure. Univariate regression was used initially to assess potential predictors of outcome followed by multivariate regression analysis. In the univariate analysis, predictors of response to RDN were higher baseline daytime ambulatory diastolic blood pressure (dADBP), the use of antihypertensive medications at screening, and presence of orthostatic hypertension (OHTN) whilst the presence of untreated accessory arteries was a negative predictor of response. Multivariate analysis determined that dADBP and use of antihypertensive medications were predictors of response to RDN with a trend for OHTN to predict response. Obese females also appeared to be better responders to RDN in an interaction model. RDN is more effective in patients with elevated baseline dADBP and those with OHTN, suggesting increased peripheral vascular resistance secondary to heightened sympathetic tone. These assessments are easy to perform in clinical setting and may help in phenotyping patients who will respond better to RDN.

Original languageEnglish
Pages (from-to)629-639
Number of pages11
JournalJournal of Human Hypertension
Issue number7
Publication statusPublished - 24 May 2021

Bibliographical note

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

Publisher Copyright:
© 2021, The Author(s).


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