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Effect of Arteriovenous Anastomosis on Blood Pressure Reduction in Patients With Isolated Systolic Hypertension Compared With Combined Hypertension
Ott, Christian ;  Lobo, Melvin D. ;  Sobotka, Paul A. ;  Mahfoud, Felix ;  Stanton, Alice ;  Cockcroft, John ;  Sulke, Neil ;  Dolan, Eamon ;  van der Giet, Markus

HaupttitelEffect of Arteriovenous Anastomosis on Blood Pressure Reduction in Patients With Isolated Systolic Hypertension Compared With Combined Hypertension
AutorOtt, Christian
AutorLobo, Melvin D.
AutorSobotka, Paul A.
AutorMahfoud, Felix
AutorStanton, Alice
AutorCockcroft, John
AutorSulke, Neil
AutorDolan, Eamon
Autorvan der Giet, Markus
Seitenzahl9 S.
Freie Schlagwörterarteriovenous anastomosis; combined hypertension; isolated systolic hypertension; treatment resistant hypertension
DDC610 Medizin und Gesundheit
Auch erschienen inJournal of the American Heart Association.- 5 (2016), 12, Artikel Nr. e004234
ZusammenfassungBackground: Options for interventional therapy to lower blood pressure (BP) in patients with treatment‐resistant hypertension include renal denervation and the creation of an arteriovenous anastomosis using the ROX coupler. It has been shown that BP response after renal denervation is greater in patients with combined hypertension (CH) than in patients with isolated systolic hypertension (ISH). We analyzed the effect of ROX coupler implantation in patients with CH as compared with ISH.

Methods and Results: The randomized, controlled, prospective ROX Control Hypertension Study included patients with true treatment‐resistant hypertension (office systolic BP ≥140 mm Hg, average daytime ambulatory BP ≥135/85 mm Hg, and treatment with ≥3 antihypertensive drugs including a diuretic). In a post hoc analysis, we stratified patients with CH (n=31) and ISH (n=11). Baseline office systolic BP (177±18 mm Hg versus 169±17 mm Hg, P=0.163) and 24‐hour ambulatory systolic BP (159±16 mm Hg versus 154±11 mm Hg, P=0.463) did not differ between patients with CH and those with ISH. ROX coupler implementation resulted in a significant reduction in office systolic BP (CH: −29±21 mm Hg versus ISH: −22±31 mm Hg, P=0.445) and 24‐hour ambulatory systolic BP (CH: −14±20 mm Hg versus ISH: −13±15 mm Hg, P=0.672), without significant differences between the two groups. The responder rate (office systolic BP reduction ≥10 mm Hg) after 6 months was not different (CH: 81% versus ISH: 82%, P=0.932).

Conclusions: Our data suggest that creation of an arteriovenous anastomosis using the ROX coupler system leads to a similar reduction of office and 24‐hour ambulatory systolic BP in patients with combined and isolated systolic hypertension.

Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01642498.
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Fachbereich/EinrichtungMedizinische Fakultät Charité - Universitätsmedizin Berlin
Erscheinungsjahr2016
Dokumententyp/-SammlungenWissenschaftlicher Artikel
SpracheEnglisch
RechteCreative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Anmerkungen des AutorsDer Artikel wurde in einer reinen Open-Access-Zeitschrift publiziert.
Erstellt am14.02.2017 - 08:17:05
Letzte Änderung14.02.2017 - 08:21:46
 
Statische URLhttp://edocs.fu-berlin.de/docs/receive/FUDOCS_document_000000026331
DOI10.1161/JAHA.116.004234
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