Effect of Arteriovenous Anastomosis on Blood Pressure Reduction in Patients With Isolated Systolic Hypertension Compared With Combined Hypertension
BackgroundOptions 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 patie...
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| Format: | Article |
| Language: | English |
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Wiley
2016-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.004234 |
| _version_ | 1818315187705348096 |
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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 Michael Schmid Ajay Jain Charles Knight Anthony Mathur Peter Balmforth Sandra F. Luitjens Gerard Smits Dhanraj Mungur Aleksander Prejbisz Jacek Kadziela Elżbieta Florczak Joseph Galvin Kyriakos Dimitriadis |
| 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 Michael Schmid Ajay Jain Charles Knight Anthony Mathur Peter Balmforth Sandra F. Luitjens Gerard Smits Dhanraj Mungur Aleksander Prejbisz Jacek Kadziela Elżbieta Florczak Joseph Galvin Kyriakos Dimitriadis |
| author_sort | Christian Ott |
| collection | DOAJ |
| description | BackgroundOptions 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 ResultsThe 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). ConclusionsOur 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 RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT01642498. |
| first_indexed | 2024-12-13T09:01:33Z |
| format | Article |
| id | doaj.art-32ddedfb0ddf411eb67ff3e3f09c5c67 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T09:01:33Z |
| publishDate | 2016-12-01 |
| publisher | Wiley |
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| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-32ddedfb0ddf411eb67ff3e3f09c5c672022-12-21T23:53:09ZengWileyJournal 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. Schmieder21Michael SchmidAjay JainCharles KnightAnthony MathurPeter BalmforthSandra F. LuitjensGerard SmitsDhanraj MungurAleksander PrejbiszJacek KadzielaElżbieta FlorczakJoseph GalvinKyriakos DimitriadisDepartment 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, GermanyBackgroundOptions 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 ResultsThe 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). ConclusionsOur 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 RegistrationURL: 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 Michael Schmid Ajay Jain Charles Knight Anthony Mathur Peter Balmforth Sandra F. Luitjens Gerard Smits Dhanraj Mungur Aleksander Prejbisz Jacek Kadziela Elżbieta Florczak Joseph Galvin Kyriakos Dimitriadis 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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