TRANSCATHETER RENAL DENERVATION IN PATIENTS WITH RESISTANT HYPERTENSION AND TYPE 2 DIABETES MELLITUS HAS BENEFICIAL EFFECTS BEYOND BLOOD PRESSURE REDUCTION

Objective. To evaluate blood pressure (BP) lowering and dynamics of fasting glucose after transcatheter renal denervation (TRD) in patients with true resistant hypertension and type 2 diabetes mellitus (T2DM).

Design and methods. Twenty five patients with essential hypertension and T2DM with systolic BP (SBP) > 150 mmHg were included. Office BP measurement, 24-h ambulatory BP monitoring, renal Doppler ultrasound and assessment of fasting glucose and renal function (creatinine, estimated glomerular filtration rate) were performed at baseline and 6 months after TRD. None of the patients changed the antidiabetic and antihypertensive treatment during follow-up. Fourteen patients completed 6-month follow-up.

Results. TRD led to a significant reduction in systolic and diastolic 24-h BP (-22,7/-9,2 mmHg, p = 0,01/0,02), as well as office BP (-10,4/5,2 mmHg, p = 0,0005/0,01) and did not affect negatively renal function. Ten patients (71 %) were responders with the office SBP reduction > 10 mmHg. TRD was associated with significant reduction in fasting glucose levels  (-2,0 mmol/L, p < 0,05) at 6 month after the procedure and the increase of the number of the patient number with basal glucose level < 7 mmol/L (p = 0,002). At the same time basal glucose levels > 10 mmol/L were not registered after TRD (p = 0,01). Changes in fasting glucose did not correlate with the BP level reduction.

Conclusions. Renal denervation in patients with resistant hypertension and T2DM improves glucose metabolism besides the significant reduction in BP 6 months after the procedure.

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