Peer-Reviewed Journal Details
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Daniels, F,De Freitas, S,Smyth, A,Garvey, J,Judge, C,Gilmartin, JJ,Sharif, F
2017
February
Sleep Medicine
Effects of renal sympathetic denervation on blood pressure, sleep apnoea severity and metabolic indices: a prospective cohort study
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Optional Fields
Denervation Blood pressure Sleep apnoea Metabolic POSITIVE AIRWAY PRESSURE RESISTANT HYPERTENSION CARDIOVASCULAR EVENTS INSULIN SENSITIVITY GLUCOSE-METABOLISM CONTROLLED-TRIAL CPAP INFLAMMATION ASSOCIATION MORTALITY
30
180
184
Background: Catheter-based renal sympathetic denervation RSD) significantly reduces blood pressure in patients with resistant hypertension, who commonly have obstructive sleep apnoea OSA). These patients are considered particularly responsive to the antihypertensive effects of RSD, but additional benefits of metabolic control on sleep apnoea severity have not been thoroughly investigated.Methods: The effect of RSD was evaluated prospectively in a cohort of patients with OSA apnoea ehypopnea index AHI) >= 15 events per hour and an Epworth Sleepiness Scale ESS) score <= 9) and treatment resistant hypertension. Changes in blood pressure, polysomnographic parameters and metabolic indices were evaluated at baseline and six months post procedure.Results: At baseline, mean office blood pressure was 166.3/92.8 14.5/11.7) mmHg and mean ambulatory blood pressure was 154.0/87.3 11.9/8.5) mmHg. At six months post RSD, mean office blood pressure reduced by 6.6/6.5 1.9/2.0) mmHg p < 0.05) and mean ambulatory blood pressure reduced by 8.3/6.2 2.3/2.0) p < 0.05). The mean AHI at baseline was 21.3 events/h and 20.5 events/h at six months post RSD, with a mean reduction of 0.9 events/h 95% CI -0.7-1.6, p = 0.39). Glucose at two hours/2 h following tolerance testing reduced by 1.14 mmol/L 95% CI 0.22-2.06, p = 0.03) but changes in other metabolic indices were not statistically significant.Conclusion: In patients with resistant hypertension and OSA, RSD resulted in modest improvements in blood pressure control, but no significant changes in sleep apnoea severity. Our study showed small increments in glucose tolerance but no significant changes in other markers of carbohydrate or lipid metabolism. (C) 2016 Elsevier B.V. All rights reserved.
10.1016/j.sleep.2016.09.014
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