An analysis of the blood pressure and safety outcomes to renal denervation in African Americans and Non-African Americans in the SYMPLICITY HTN-3 trial

被引:34
|
作者
Flack, John M. [1 ]
Bhatt, Deepak L. [2 ]
Kandzari, David E. [3 ]
Brown, David [4 ]
Brar, Sandeep [5 ]
Choi, James W. [6 ]
D'Agostino, Ralph [7 ]
East, Cara [6 ]
Katzen, Barry T. [7 ]
Lee, Lilian [5 ]
Leon, Martin B. [8 ,9 ]
Mauri, Laura [10 ]
O'Neill, William W. [11 ]
Oparil, Suzanne [12 ]
Rocha-Singh, Krishna [13 ]
Townsend, Raymond R. [14 ]
Bakris, George [15 ]
机构
[1] So Illinois Univ, Div Gen Med, Dept Med, Hypertens Sect, Springfield, IL 62794 USA
[2] Harvard Univ, Brigham & Womens Hosp, Heart & Vasc Ctr, Sch Med, Boston, MA 02115 USA
[3] Piedmont Heart Inst, Div Cardiol, Dept Med, Atlanta, GA USA
[4] Heart Hosp Baylor Plano, Cardiovasc Div, Dept Med, Plano, TX USA
[5] Medtron CardioVasc, Clin Dept, Santa Rosa, CA USA
[6] Heart & Vasc Hosp, Baylor Soltero Cardiovasc Res Ctr, Dallas, TX USA
[7] Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02215 USA
[8] Columbia Univ, Dept Med, Div Cardiol, New York Presbyterian Hosp,Med Ctr, New York, NY USA
[9] Cardiovasc Res Fdn, New York, NY USA
[10] Harvard Clin Res Inst, Div Cardiol, Dept Med, Boston, MA USA
[11] Henry Ford Detroit Hosp, Div Cardiol, Dept Med, Detroit, MI USA
[12] Univ Alabama Birmingham, Dept Med, Div Cardiovasc Dis, Birmingham, AL 35294 USA
[13] St Johns Hosp, Prairie Heart Inst, Springfield, IL USA
[14] Univ Penn, Dept Med, Div Renal, Perelman Sch Med, Philadelphia, PA 19104 USA
[15] Univ Chicago Med, Hypertens Dis Ctr, Chicago, IL USA
关键词
Renal denervation; African American; uncontrolled apparent treatment-resistant hypertension; TREATMENT-RESISTANT HYPERTENSION; UNITED-STATES; SYMPATHETIC DENERVATION; DISEASE; CIRCULATION; PREVALENCE; ETHNICITY; ADHERENCE; SYSTEM; HEALTH;
D O I
10.1016/j.jash.2015.08.001
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
SYMPLICITY HTN-3, the first trial of renal denervation (RDN) versus sham, enrolled 26% African Americans, a prospectively stratified cohort. Although the 6-month systolic blood pressure (SBP) reduction in African Americans (AAs) was similar in the RDN group (-15.5 +/- 25.4 mm Hg, n = 85 vs. -17.8 +/- 29.2, n = 49, P =.641), the sham SBP response was 9.2 mm Hg greater (P =.057) in AAs than non-AAs. In multivariate analyses, sham SBP response was predicted by an interaction between AA and a complex antihypertensive regimen (at least one antihypertensive medication prescribed >= 3 times daily), while in the RDN group, SBP response was predicted by an interaction between AA race and baseline BP >= 180 mm Hg. AA race did not independently predict SBP response in either sham or RDN. There appears to be effect modification by race with individual-level patient characteristics in both treatment aims that affect the observed pattern of SBP responses. (C) 2015 American Society of Hypertension. All rights reserved.
引用
收藏
页码:769 / 779
页数:11
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