DYNAMICS OF GLYCEMIC CONTROL AFTER RENAL DENERVATION IN PATIENTS WITH RESISTANT HYPERTENSION AND TYPE 2 DIABETES MELLITUS

The aim of the study was to evaluatetheglycemic control dynamics depending on degree of blood pressure (BP) reduction and dynamic of TNF-α after 6 and 12 months of Tran catheter renal denervation (TRD) of patients with true resistant hypertension (RH) and type 2 diabetes mellitus (T2DM). Material an...

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Main Authors: A. Yu. Falkovskaya, V. F. Mordovin, S. Ye. Pekarsky, A. Ye. Bayev, G. V. Semke, T. M. Ripp, Ye. S. Kravtchenko, I. V. Zyubanova
Format: Article
Language:English
Published: Siberian State Medical University (Tomsk) 2015-10-01
Series:Бюллетень сибирской медицины
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Online Access:https://bulletin.ssmu.ru/jour/article/view/191
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author A. Yu. Falkovskaya
V. F. Mordovin
S. Ye. Pekarsky
A. Ye. Bayev
G. V. Semke
T. M. Ripp
Ye. S. Kravtchenko
I. V. Zyubanova
author_facet A. Yu. Falkovskaya
V. F. Mordovin
S. Ye. Pekarsky
A. Ye. Bayev
G. V. Semke
T. M. Ripp
Ye. S. Kravtchenko
I. V. Zyubanova
author_sort A. Yu. Falkovskaya
collection DOAJ
description The aim of the study was to evaluatetheglycemic control dynamics depending on degree of blood pressure (BP) reduction and dynamic of TNF-α after 6 and 12 months of Tran catheter renal denervation (TRD) of patients with true resistant hypertension (RH) and type 2 diabetes mellitus (T2DM). Material and methods. Thirty two essentially hypertensive patients with type 2 diabetes mellitus (T2DM) and resistant hypertension were included in single-arm prospective interventional study. Office BP measurement, ambulatory 24-h BP, renal Doppler ultrasound and assessment of renal function (proteinuria, creatinine, eGFR), HbА1c and fasting plasma glucose (FPG) levels, activity of TNF-α were performed at baseline and 6 and 12 months after TRD. On average, patients were taking 4 (3–6) antihypertensive drugs. None of the patients changed the antihypertensive treatments during follow-up. A 6 months follow-up was completed by 27 patients (43–75 years old, 14 male), 12 months follow-up was completed by 26 patients. Results. Renal denervation significantly reduced the systolic office BP (SBP) as well as 24-h SBP (– 27.2/–10.7 mm Hg and–13.4/–10 mm Hg, respectively, p < 0.01 after 6-month follow-up, and –31,7/–12,8 mmHg and –13.4/–10 mm Hg, respectively, p < 0.01 after 12-month follow-up) without any negative effect on renal function. The number of responders with reduction of SBP >10 mmHg according to ABPM were 56% (15/27) after 6-month and 61.5% (16/26) after 12-month follow-up. There were significant reduction of the average HbA1c levels (from (6.9 ± 1.8)% to (5.8 ± 1.5)%, p = 0.04) and nonsignificant decreasing of FPG levels (from 8.7 ± 2.8 to 7.7 ± 2.1 mmol/L, p = 0.07) after 6-month followup. Conspicuously, the responders according to ABPM had significantly higher mean dynamics of HbA1c than the non-responders after 6-month follow-up (–2.4 ± 1.9 and –0.1 ± 0.8%, p = 0.02, respectively) as well as after 12-month follow-up (–0.12 ± 0.98 and 1,26 ± 1.11%, p = 0.04 for HbA1c, and – 0.89 ± 1.9 и 0.85 mmol/L ± 1.19, p = 0.02 for FPG levels). There were significant decreasing of TNF-α after 12-monthfollow-up (from 2.21 (1.54–3.65) to 1.4 (1.11–1.47pg/ml), p = 0.007), without relation to BP and HbA1c dynamics, and response to TRD. There were not the correlations between dynamics of HbA1c and FPG levels with BP reduction and change of TNF-α after 12-month follow-up. Conclusions. Renal denervation of patients with true resistant hypertension and diabetes mellitus type 2 after 6 and 12 months was followed by improved glycemic control, BP reduction and decreasing of mean levels of TNF-α. Glycemic control improvement after the renal denervation was more expressive in the responders.
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spelling doaj-art-e247ef32483446a7988db43b150ea4312025-08-20T04:00:12ZengSiberian State Medical University (Tomsk)Бюллетень сибирской медицины1682-03631819-36842015-10-01145829010.20538/1682-0363-2015-5-82-90189DYNAMICS OF GLYCEMIC CONTROL AFTER RENAL DENERVATION IN PATIENTS WITH RESISTANT HYPERTENSION AND TYPE 2 DIABETES MELLITUSA. Yu. Falkovskaya0V. F. Mordovin1S. Ye. Pekarsky2A. Ye. Bayev3G. V. Semke4T. M. Ripp5Ye. S. Kravtchenko6I. V. Zyubanova7Research Institute for Сardiology, TomskResearch Institute for Сardiology, TomskResearch Institute for Сardiology, TomskResearch Institute for Сardiology, TomskResearch Institute for Сardiology, TomskResearch Institute for Сardiology, TomskResearch Institute for Сardiology, TomskResearch Institute for Сardiology, TomskThe aim of the study was to evaluatetheglycemic control dynamics depending on degree of blood pressure (BP) reduction and dynamic of TNF-α after 6 and 12 months of Tran catheter renal denervation (TRD) of patients with true resistant hypertension (RH) and type 2 diabetes mellitus (T2DM). Material and methods. Thirty two essentially hypertensive patients with type 2 diabetes mellitus (T2DM) and resistant hypertension were included in single-arm prospective interventional study. Office BP measurement, ambulatory 24-h BP, renal Doppler ultrasound and assessment of renal function (proteinuria, creatinine, eGFR), HbА1c and fasting plasma glucose (FPG) levels, activity of TNF-α were performed at baseline and 6 and 12 months after TRD. On average, patients were taking 4 (3–6) antihypertensive drugs. None of the patients changed the antihypertensive treatments during follow-up. A 6 months follow-up was completed by 27 patients (43–75 years old, 14 male), 12 months follow-up was completed by 26 patients. Results. Renal denervation significantly reduced the systolic office BP (SBP) as well as 24-h SBP (– 27.2/–10.7 mm Hg and–13.4/–10 mm Hg, respectively, p < 0.01 after 6-month follow-up, and –31,7/–12,8 mmHg and –13.4/–10 mm Hg, respectively, p < 0.01 after 12-month follow-up) without any negative effect on renal function. The number of responders with reduction of SBP >10 mmHg according to ABPM were 56% (15/27) after 6-month and 61.5% (16/26) after 12-month follow-up. There were significant reduction of the average HbA1c levels (from (6.9 ± 1.8)% to (5.8 ± 1.5)%, p = 0.04) and nonsignificant decreasing of FPG levels (from 8.7 ± 2.8 to 7.7 ± 2.1 mmol/L, p = 0.07) after 6-month followup. Conspicuously, the responders according to ABPM had significantly higher mean dynamics of HbA1c than the non-responders after 6-month follow-up (–2.4 ± 1.9 and –0.1 ± 0.8%, p = 0.02, respectively) as well as after 12-month follow-up (–0.12 ± 0.98 and 1,26 ± 1.11%, p = 0.04 for HbA1c, and – 0.89 ± 1.9 и 0.85 mmol/L ± 1.19, p = 0.02 for FPG levels). There were significant decreasing of TNF-α after 12-monthfollow-up (from 2.21 (1.54–3.65) to 1.4 (1.11–1.47pg/ml), p = 0.007), without relation to BP and HbA1c dynamics, and response to TRD. There were not the correlations between dynamics of HbA1c and FPG levels with BP reduction and change of TNF-α after 12-month follow-up. Conclusions. Renal denervation of patients with true resistant hypertension and diabetes mellitus type 2 after 6 and 12 months was followed by improved glycemic control, BP reduction and decreasing of mean levels of TNF-α. Glycemic control improvement after the renal denervation was more expressive in the responders.https://bulletin.ssmu.ru/jour/article/view/191resistant hypertensiondiabetes mellitusrenal denervation
spellingShingle A. Yu. Falkovskaya
V. F. Mordovin
S. Ye. Pekarsky
A. Ye. Bayev
G. V. Semke
T. M. Ripp
Ye. S. Kravtchenko
I. V. Zyubanova
DYNAMICS OF GLYCEMIC CONTROL AFTER RENAL DENERVATION IN PATIENTS WITH RESISTANT HYPERTENSION AND TYPE 2 DIABETES MELLITUS
Бюллетень сибирской медицины
resistant hypertension
diabetes mellitus
renal denervation
title DYNAMICS OF GLYCEMIC CONTROL AFTER RENAL DENERVATION IN PATIENTS WITH RESISTANT HYPERTENSION AND TYPE 2 DIABETES MELLITUS
title_full DYNAMICS OF GLYCEMIC CONTROL AFTER RENAL DENERVATION IN PATIENTS WITH RESISTANT HYPERTENSION AND TYPE 2 DIABETES MELLITUS
title_fullStr DYNAMICS OF GLYCEMIC CONTROL AFTER RENAL DENERVATION IN PATIENTS WITH RESISTANT HYPERTENSION AND TYPE 2 DIABETES MELLITUS
title_full_unstemmed DYNAMICS OF GLYCEMIC CONTROL AFTER RENAL DENERVATION IN PATIENTS WITH RESISTANT HYPERTENSION AND TYPE 2 DIABETES MELLITUS
title_short DYNAMICS OF GLYCEMIC CONTROL AFTER RENAL DENERVATION IN PATIENTS WITH RESISTANT HYPERTENSION AND TYPE 2 DIABETES MELLITUS
title_sort dynamics of glycemic control after renal denervation in patients with resistant hypertension and type 2 diabetes mellitus
topic resistant hypertension
diabetes mellitus
renal denervation
url https://bulletin.ssmu.ru/jour/article/view/191
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