• F Mahfoud, D Linz, G Mancia, K Narkiewicz, L M Ruilope, M P Schlaich, R E Schmieder, B Williams, and M Böhm.
• 1Universitätskliniken des Saarlandes, Klinik für Innere Medizin III, Homburg/Saar, GERMANY 2Department of Medicine, University of Milano-Bicocca, St. Gerardo Hospital, Monza, ITALY 3Medical University of Gdansk, Department of Hypertension and Diabetology, Gdansk, POLAND 4Hypertension Unit, Department of Nephrology, Hospital 12 de Octubre, Madrid, SPAIN 5School of Medicine and Pharmacology, Royal Perth Hospital Unit, The University of Western Australia, Perth, AUSTRALIA 6Universität Erlangen-Nürnberg, Medizinische Klinik 4, Nuremberg, GERMANY 7Institute of Cardiovascular Sciences, University College London, London, UNITED KINGDOM.
• J. Hypertens. 2015 Jun 1; 33 Suppl 1: e108.

ObjectiveObstructive sleep apnea (OSA) is associated with sympathetic nervous system activation and the development of hypertension. The Global SYMPLICITY Registry is prospectively enrolling real world patients with uncontrolled hypertension including patients with OSA. This analysis compares baseline characteristics and blood pressure (BP) lowering effects of renal denervation in patients with and without OSA.Design And MethodThe Global SYMPL CITY Registry is a prospective, multicentre international registry designed to evaluate the safety and effectiveness of renal denervation in a broad population of patients with uncontrolled hypertension. Baseline characteristics antihypertensive medication use, office and 24-hour ambulatory BP are compared between patients with and without OSA.ResultsIn a 998 patients with complete 6 month follow-up OSA was reported in 116 patients. OSA patients were more likely to be male than patients without OSA (n = 752) (83% vs 56%, p < 0.0001), had a larger body mass index (34 ± 6 kg/m2 vs 30 ± 5 kg/m2, p < 0.0001) and significantly more, left ventricular hypertrophy (25% vs 15%, p = 0.008) atrial fibrillation (19% vs 11%, p = 0.020) and diabetes (52% vs 39%, p = 0.008). OSA patients were taking more antihypertensive medications (4.9 ± 1.4 vs 4.4 ± 1.3, p < 0.001); a higher proportion of aldosterone antagonists (39% vs 20%, p < 0.0001), vasodilators (24% vs 13%, p = 0.001) and alpha 2 agonists (54% vs 36%, p < 0.001). Baseline office systolic BP was 166 ± 23 mm Hg for OSA patients and 163 ± 24 mm Hg for non-OSA patients. At 6 months the office systolic BP was reduced -15.5 ± 24.4 mm Hg in the OSA group and -11.3 ± 25.0 mm Hg in the non-OSA group (both p < 0.0001; p = 0.136 for difference between the groups). Baseline ambulatory 24-hr systolic BP was 156 ± 20 mm Hg in OSA patients and 152 ± 17 in non-OSA patients. At 6 months 24-hour systolic BP declined -4.6 ± 17.1 mm Hg (n = 73, p = 0.023) in the OSA group and -7.1 ± 17.6 mm Hg (p < 0.0001) in the non-OSA group (p = 0.450 for the between group difference).ConclusionsRenal denervation resulted in significant 6-month BP reductions in patients with and without OSA but there was not a significant difference in the BP change between the 2 groups. Data from a larger cohort of 2100 patients will be presented.

17 keywords...

hide…