Effect of Arteriovenous Anastomosis on Blood Pressure Reduction in Patients With Isolated Systolic Hypertension Compared With Combined Hypertension
Background 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 pati...
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Wiley
2016-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.004234 |
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| author | Christian Ott Melvin D. Lobo Paul A. Sobotka Felix Mahfoud Alice Stanton John Cockcroft Neil Sulke Eamon Dolan Markus van der Giet Joachim Hoyer Stephen S. Furniss John P. Foran Adam Witkowski Andrzej Januszewicz Danny Schoors Konstantinos Tsioufis Benno J. Rensing Manish Saxena Benjamin Scott G. André Ng Stephan Achenbach Roland E. Schmieder |
| author_facet | Christian Ott Melvin D. Lobo Paul A. Sobotka Felix Mahfoud Alice Stanton John Cockcroft Neil Sulke Eamon Dolan Markus van der Giet Joachim Hoyer Stephen S. Furniss John P. Foran Adam Witkowski Andrzej Januszewicz Danny Schoors Konstantinos Tsioufis Benno J. Rensing Manish Saxena Benjamin Scott G. André Ng Stephan Achenbach Roland E. Schmieder |
| author_sort | Christian Ott |
| collection | DOAJ |
| description | Background 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. |
| format | Article |
| id | doaj-art-32ddedfb0ddf411eb67ff3e3f09c5c67 |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2016-12-01 |
| publisher | Wiley |
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| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-32ddedfb0ddf411eb67ff3e3f09c5c672025-08-20T03:29:31ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802016-12-0151210.1161/JAHA.116.004234Effect of Arteriovenous Anastomosis on Blood Pressure Reduction in Patients With Isolated Systolic Hypertension Compared With Combined HypertensionChristian Ott0Melvin D. Lobo1Paul A. Sobotka2Felix Mahfoud3Alice Stanton4John Cockcroft5Neil Sulke6Eamon Dolan7Markus van der Giet8Joachim Hoyer9Stephen S. Furniss10John P. Foran11Adam Witkowski12Andrzej Januszewicz13Danny Schoors14Konstantinos Tsioufis15Benno J. Rensing16Manish Saxena17Benjamin Scott18G. André Ng19Stephan Achenbach20Roland E. Schmieder21Department of Nephrology and Hypertension Friedrich‐Alexander University Erlangen‐Nürnberg (FAU) Erlangen GermanyWilliam Harvey Research Institute Barts NIHR Cardiovascular Biomedical Research Unit Queen Mary University of London United KingdomROX Medical San Clemente CAKlinik für Innere Medizin III Universitätsklinikum des Saarlandes Homburg/Saar GermanyMolecular and Cellular Therapeutics Royal College of Surgeons in Ireland Medical School Dublin IrelandCardiolgy Department Wales Heart Research Institute Cardiff United KingdomCardiology Department Eastbourne District General Hospital East Sussex United KingdomDepartment of Medicine for the Elderly Connolly Hospital Dublin IrelandDepartment of Endocrinology and Nephrology Universitätsmedizin Berlin Berlin GermanyDepartment of Internal Medicine and Nephrology Universitätsklinikum Gießen und Marburg GmbH Marburg GermanyDepartment of Cardiology East Sussex Healthcare NHS Trust East Sussex United KingdomCardiac Department Royal Brompton Hospital London United KingdomInstitute of Cardiology Warsaw PolandInstitute of Cardiology Warsaw PolandDepartment of Cardiology Universitair Ziekenhuis Brussel Brussels BelgiumDepartment of Cardiology Hippokration General Hospital of Athens GreeceDepartment of Cardiology St. Antonius Ziekenhuis Nieuwegein the NetherlandsWilliam Harvey Research Institute Barts NIHR Cardiovascular Biomedical Research Unit Queen Mary University of London United KingdomDepartment of Cardiology ZNA ‐ Cardio Middelheim Antwerp BelgiumDepartment of Cardiovascular Sciences University of Leicester Glenfield Hospital/NIHR Leicester Cardiovascular Biomedical Research Leicester United KingdomDepartment of Cardiology Friedrich‐Alexander University Erlangen‐Nürnberg (FAU) Erlangen GermanyDepartment of Nephrology and Hypertension Friedrich‐Alexander University Erlangen‐Nürnberg (FAU) Erlangen GermanyBackground 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.https://www.ahajournals.org/doi/10.1161/JAHA.116.004234arteriovenous anastomosiscombined hypertensionisolated systolic hypertensiontreatment resistant hypertension |
| spellingShingle | Christian Ott Melvin D. Lobo Paul A. Sobotka Felix Mahfoud Alice Stanton John Cockcroft Neil Sulke Eamon Dolan Markus van der Giet Joachim Hoyer Stephen S. Furniss John P. Foran Adam Witkowski Andrzej Januszewicz Danny Schoors Konstantinos Tsioufis Benno J. Rensing Manish Saxena Benjamin Scott G. André Ng Stephan Achenbach Roland E. Schmieder Effect of Arteriovenous Anastomosis on Blood Pressure Reduction in Patients With Isolated Systolic Hypertension Compared With Combined Hypertension Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease arteriovenous anastomosis combined hypertension isolated systolic hypertension treatment resistant hypertension |
| title | Effect of Arteriovenous Anastomosis on Blood Pressure Reduction in Patients With Isolated Systolic Hypertension Compared With Combined Hypertension |
| title_full | Effect of Arteriovenous Anastomosis on Blood Pressure Reduction in Patients With Isolated Systolic Hypertension Compared With Combined Hypertension |
| title_fullStr | Effect of Arteriovenous Anastomosis on Blood Pressure Reduction in Patients With Isolated Systolic Hypertension Compared With Combined Hypertension |
| title_full_unstemmed | Effect of Arteriovenous Anastomosis on Blood Pressure Reduction in Patients With Isolated Systolic Hypertension Compared With Combined Hypertension |
| title_short | Effect of Arteriovenous Anastomosis on Blood Pressure Reduction in Patients With Isolated Systolic Hypertension Compared With Combined Hypertension |
| title_sort | effect of arteriovenous anastomosis on blood pressure reduction in patients with isolated systolic hypertension compared with combined hypertension |
| topic | arteriovenous anastomosis combined hypertension isolated systolic hypertension treatment resistant hypertension |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.004234 |
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