Renal denervation improves quality of life in hypertension

Oct 22 2012

By Piriya Mahendra, medwireNews Reporter

Renal denervation in patients with treatment-resistant hypertension results in a significantly improved quality of life, a study suggests.

Gavin Lambert (Baker IDI Heart and Diabetes Institute, Melbourne, Australia) and team found that patients with resistant hypertension scored significantly worse in five of the eight Short Form-(SF)36 domain scores and the Mental Component Summary score when compared with a group of unmedicated normotensive individuals and a group of hypertensive medicated individuals with controlled blood pressure (BP) at baseline.

Three months after renal denervation, however, systolic BP was reduced by 16 mmHg and diastolic BP by 6 mmHg from baseline. The SF-36 Summary score for the Mental Component improved by 6 points from baseline, while the Physical Component score was unchanged.

The improvement in Mental Component Summary score was driven by the vitality, social function, role emotion, and mental health domains, which increased by 8, 10, 26, and 7 points, respectively, from baseline.

The Beck Depression Inventory (BDI) score also improved in renal denervation patients from baseline, decreasing significantly by 2.6 points. The authors say this improvement was driven by significant reductions in symptoms of sadness and tiredness, and increased libido.

Lambert and team point out that the magnitude of BP reduction or BP level achieved at 3 months bore no association to change in quality of life. "In this pre- and post-hypothesis generating study, several aspects of quality of life were improved after renal denervation; however, this was not directly associated with the magnitude of BP reduction," they write in Hypertension.

Lambert et al suggest that the improved quality of life observed after renal denervation could be due to the fact that the majority of brain norepinephrine is located in the locus coeruleus, which, together with its hypothalamic and amygdale projections, is functionally linked with behavioral responses involving autonomic activation.

"Whether the improvement in SF-36 and BDI-II that occurred after renal denervation is sustained and has a biological basis associated with reduction in sympathetic tone remains unknown but does merit further attention," they conclude.

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