Effects of Renal Sympathetic Denervation on Blood Pressure, Sleep Apnea Course, and Glycemic Control in Patients With Resistant Hypertension and Sleep Apnea
Witkowski A et al. – Catheter–based renal sympathetic denervation lowered BP in patients with refractory hypertension and obstructive sleep apnea, which was accompanied by improvement of sleep apnea severity. There are also accompanying improvements in glucose tolerance. Renal sympathetic denervation may conceivably be a potentially useful option for patients with comorbid refractory hypertension, glucose intolerance, and obstructive sleep apnea, although further studies are needed to confirm these proof–of–concept data.Methods
- Authors studied 10 patients with refractory hypertension and sleep apnea (7 men and 3 women; median age: 49.5 years) who underwent renal denervation and completed 3–month and 6–month follow–up evaluations, including polysomnography and selected blood chemistries, and BP measurements.
- Antihypertensive regimens were not changed during the 6 months of follow–up.
- 3 and 6 months after the denervation, decreases in office systolic and diastolic BPs were observed (median: –34/–13 mm Hg for systolic and diastolic BPs at 6 months; both P<0.01).
- Significant decreases were observed in plasma glucose concentration 2 hours after glucose administration (median: 7.0 versus 6.4 mmol/L; P=0.05) and in hemoglobin A1C level (median: 6.1% versus 5.6%; P<0.05) at 6 months, as well as a decrease in apnea–hypopnea index at 6 months after renal denervation (median: 16.3 versus 4.5 events per hour; P=0.059).