Adherence to Antihypertensive Treatment and the Blood Pressure–Lowering Effects of Renal Denervation in the Renal Denervation for Hypertension (DENERHTN) Trial
| العنوان: | Adherence to Antihypertensive Treatment and the Blood Pressure–Lowering Effects of Renal Denervation in the Renal Denervation for Hypertension (DENERHTN) Trial |
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| المؤلفون: | Michel Azizi, Helena Pereira, Idir Hamdidouche, Philippe Gosse, Matthieu Monge, Guillaume Bobrie, Pascal Delsart, Claire Mounier-Véhier, Pierre-Yves Courand, Pierre Lantelme, Thierry Denolle, Caroline Dourmap-Collas, Xavier Girerd, Jean Michel Halimi, Faiez Zannad, Olivier Ormezzano, Bernard Vaïsse, Daniel Herpin, Jean Ribstein, Bernard Chamontin, Jean-Jacques Mourad, Emile Ferrari, Pierre-François Plouin, Vincent Jullien, Marc Sapoval, Gilles Chatellier, L. Amar, A. Lorthioir, J.-Y. Pagny, G. Claisse, M. Midulla, R. Dauphin, J.P. Fauvel, O. Rouvière, A. Cremer, N. Grenier, Y. Lebras, H. Trillaud, J.F. Heautot, A. Larralde, F. Paillard, P. Cluzel, D. Rosenbaum, D. Alison, M. Claudon, B. Popovic, P. Rossignol, J.P. Baguet, F. Thony, J.M. Bartoli, J. Drouineau, P. Sosner, J.P. Tasu, S. Velasco, H. Vernhet-Kovacsik, B. Bouhanick, H. Rousseau, S. Le Jeune, M. Lopez-Sublet, L. Bellmann, V. Esnault, I. Durand-Zaleski, J.P. Beregi (chair), M. Lièvre, A. Persu |
| المساهمون: | Université Claude Bernard Lyon 1 (UCBL), Université de Lyon |
| المصدر: | Circulation Circulation, American Heart Association, 2016, 134 (12), pp.847-857. ⟨10.1161/CIRCULATIONAHA.116.022922⟩ |
| بيانات النشر: | HAL CCSD, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Nervous system, Male, medicine.medical_specialty, Sympathetic nervous system, [SDV]Life Sciences [q-bio], Medication adherence, Blood Pressure, 030204 cardiovascular system & hematology, Kidney, Medication Adherence, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), medicine, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Antihypertensive Agents, ComputingMilieux_MISCELLANEOUS, Denervation, business.industry, Blood Pressure Determination, Blood Pressure Monitoring, Ambulatory, Middle Aged, 3. Good health, Surgery, medicine.anatomical_structure, Blood pressure, Treatment Outcome, Anesthesia, Hypertension, Female, Blood pressure lowering, Cardiology and Cardiovascular Medicine, business |
| الوصف: | Background: The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure–lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment for resistant hypertension at 6 months. We report the influence of adherence to antihypertensive treatment on blood pressure control. Methods: One hundred six patients with hypertension resistant to 4 weeks of treatment with indapamide 1.5 mg/d, ramipril 10 mg/d (or irbesartan 300 mg/d), and amlodipine 10 mg/d were randomly assigned to renal denervation plus standardized stepped-care antihypertensive treatment, or the same antihypertensive treatment alone. For standardized stepped-care antihypertensive treatment, spironolactone 25 mg/d, bisoprolol 10 mg/d, prazosin 5 mg/d, and rilmenidine 1 mg/d were sequentially added at monthly visits if home blood pressure was ≥135/85 mm Hg after randomization. We assessed adherence to antihypertensive treatment at 6 months by drug screening in urine/plasma samples from 85 patients. Results: The numbers of fully adherent (20/40 versus 21/45), partially nonadherent (13/40 versus 20/45), or completely nonadherent patients (7/40 versus 4/45) to antihypertensive treatment were not different in the renal denervation and the control groups, respectively ( P =0.3605). The difference in the change in daytime ambulatory systolic blood pressure from baseline to 6 months between the 2 groups was –6.7 mm Hg ( P =0.0461) in fully adherent and –7.8 mm Hg ( P =0.0996) in nonadherent (partially nonadherent plus completely nonadherent) patients. The between-patient variability of daytime ambulatory systolic blood pressure was greater for nonadherent than for fully adherent patients. Conclusions: In the DENERHTN trial, the prevalence of nonadherence to antihypertensive drugs at 6 months was high (≈50%) but not different in the renal denervation and control groups. Regardless of adherence to treatment, renal denervation plus standardized stepped-care antihypertensive treatment resulted in a greater decrease in blood pressure than standardized stepped-care antihypertensive treatment alone. Clinical Trial Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT01570777. |
| اللغة: | English |
| تدمد: | 0009-7322 1524-4539 |
| DOI: | 10.1161/CIRCULATIONAHA.116.022922⟩ |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::79a8f5a63d0a7c3a693a3fb4efd984a3 https://hal.archives-ouvertes.fr/hal-03149133 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....79a8f5a63d0a7c3a693a3fb4efd984a3 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 00097322 15244539 |
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| DOI: | 10.1161/CIRCULATIONAHA.116.022922⟩ |