Blood pressure and proinflammatory marker dynamics after renal denervation in patients with resistant hypertension and various severity of coronary atherosclerosis

Abstract

Introduction. Patients with resistant hypertension (RH) associated with coronary heart disease (CHD) and, in particular, with an unfavorable course of coronary atherosclerosis have the highest risk of cardiovascular complications. Tumor necrosis factor-alpha (TNF-α) and high-sensitivity C-reactive protein (hs-CRP) were shown to play a role of independent predictors for the development of such complications. However, the changes in these markers and blood pressure (BP) due to renal denervation (RDN) have not been a subject of investigation in this patient group yet. Objectives. To study changes in BP and proinflammatory markers in patients with RH and CHD after RDN and to compare the indicators depending on the severity of coronary atherosclerosis. Material and Methods. The study analyzed case histories of 35 patients with RH and CHD who underwent a full clinical, instrumental, and laboratory examination before and one year after RDN. Results. We observed a reduction of average 24-hour blood pressure by 15 (0–21) / 7(–3–14) mmHg (p < 0.05), a decrease in TNF-α from 7.8 (6.3; 9.6) to 7.3 (6.8; 8.6) pg/mL (p = 0.044), and a downward trend of hs-CRP values from 2.4 (1.4; 6.0) to 1.8 (1.3; 3.6) mg/L (p = 0.186). Group of patients with unfavorable course of coronary atherosclerosis had higher levels of TNF-α initially (р = 0.040) and a year after RDN (р = 0.038), but no significant changes in BP were observed. Conclusions. Obtained data suggested that the antihypertensive effect of RDN was less pronounced in patients with an unfavorable course of coronary atherosclerosis.