Skin sodium content as a predictor of blood pressure response to renal denervation

Günes-Altan M, Schmid A, Kannenkeril D, Linz P, Ott C, Bosch A, Schiffer M, Uder M, Schmieder R (2023)

Publication Type: Journal article

Publication year: 2023

Journal

Hypertension Research Nature Publishing Group: Open Access Hybrid Model Option A

Abstract

Patients with treatment resistant hypertension (TRH) are known to have elevated sodium (Na) content in muscle and skin. Renal denervation (RDN) emerged as an adjacent therapeutic option in this group of patients. This analysis aimed at evaluating whether tissue Na content predicts blood pressure (BP) response after RDN in patients with TRH. Radiofrequency-device based RDN was performed in 58 patients with uncontrolled TRH. Office and 24-h ambulatory BP were measured at baseline and after 6 months. To assess tissue Na content Na magnetic resonance imaging (Na-MRI) was performed at baseline prior to RDN. We splitted the study cohort into responders and non-responders based on the median of systolic 24-h ambulatory blood pressure (ABP) reduction after 6 months and evaluated the association between BP response to RDN and tissue Na content in skin and muscle. The study was registered at http://www.clinicaltrials.gov (NCT01687725). Six months after RDN 24-h ABP decreased by −8.6/−4.7 mmHg. BP-Responders were characterized by the following parameters: low tissue sodium content in the skin (p = 0.040), female gender (p = 0.027), intake of aldosterone antagonists (p = 0.032), high baseline 24-h night-time heart rate (p = 0.045) and high LDL cholesterol (p < 0.001). These results remained significant after adjustment for baseline 24-h systolic BP. Similar results were obtained when the median of day-time and night-time ABP reduction after 6 months were used as cut-off criteria for defining BP response to RDN. We conclude that in addition to clinical factors including baseline 24-h ABP Na-MRI may assist to select patients with uncontrolled TRH for RDN treatment. [Figure not available: see fulltext.].

Authors with CRIS profile

Merve Günes-Altan Department of Radiation Oncology Axel Schmid Institute of Radiology Peter Linz Institute of Radiology Christian Ott Department of Medicine 4 – Nephrology and Hypertension Agnes Bosch Department of Medicine 4 – Nephrology and Hypertension Mario Schiffer Lehrstuhl für Innere Medizin IV Michael Uder Lehrstuhl für Diagnostische Radiologie Roland Schmieder Professur für Innere Medizin (Nephrologie)

How to cite

APA:

Günes-Altan, M., Schmid, A., Kannenkeril, D., Linz, P., Ott, C., Bosch, A.,... Schmieder, R. (2023). Skin sodium content as a predictor of blood pressure response to renal denervation. Hypertension Research. https://doi.org/10.1038/s41440-023-01450-4

MLA:

Günes-Altan, Merve, et al. "Skin sodium content as a predictor of blood pressure response to renal denervation." Hypertension Research (2023).

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