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Hypertension Research
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Novel approaches to define responders to interventional treatment in hypertension: insights from the SPYRAL HTN-OFF and HTN-ON MED trials

Authors: Schmieder, Roland E.; Hettrick, Douglas A.; Böhm, Michael; Kandzari, David E.; Kario, Kazuomi; Mahfoud, Felix; Tsioufis, Konstantinos; +3 Authors

Novel approaches to define responders to interventional treatment in hypertension: insights from the SPYRAL HTN-OFF and HTN-ON MED trials

Abstract

AbstractMultiple sham-controlled clinical trials have demonstrated significant reductions in both office and 24-h blood pressure (BP) following radiofrequency renal denervation (RDN) in the uncontrolled hypertension population. Notably, the blood pressure response varies widely within individual participants, thus showing a clinical need to identify potential RDN “responders” prior to the procedure. Despite multiple analytic efforts, no single parameter, aside from baseline blood pressure, has been consistently associated with BP reduction following RDN. However, this failure may be due to limitations in empiric definitions of responders. Indeed, commonly applied responder definitions based on the difference between two point-in-time BP measurements are fraught due to visit-to-visit variability in office and 24-h blood pressure endpoints. Several factors should be considered to develop a more clinically useful operational definition of procedural response including relative changes in office and 24-h BP, consideration of the temporal response to RDN, as well as adjustment for baseline BP. The current evidence may provide incentives for future expert consensus to precisely define responders to hypertension treatments.

Keywords

Treatment Outcome, mini-review ; Humans [MeSH] ; Hypertension/physiopathology [MeSH] ; Hypertension/surgery [MeSH] ; Treatment Outcome [MeSH] ; Mini Review ; Sympathectomy/methods [MeSH] ; Kidney/physiopathology [MeSH] ; Hypertension/drug therapy [MeSH] ; Kidney/innervation [MeSH] ; Renal denervation ; Blood Pressure/physiology [MeSH] ; Blood pressure variability ; Hypertension/therapy [MeSH] ; Responders ; Antihypertensive Agents/therapeutic use [MeSH], Mini Review, Hypertension, Humans, Blood Pressure, Sympathectomy, Kidney, Antihypertensive Agents

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    popularity
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
3
Top 10%
Average
Average
Green
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