Salt intake and blood pressure response to percutaneous renal denervation in resistant hypertension

the SYMPATHY study group

doi:10.1111/jch.13085

Salt intake and blood pressure response to percutaneous renal denervation in resistant hypertension

the SYMPATHY study group

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

©2017 Wiley Periodicals, Inc.The effect of lowering sympathetic nerve activity by renal denervation (RDN) is highly variable. With the exception of office systolic blood pressure (BP), predictors of the BP-lowering effect have not been identified. Because dietary sodium intake influences sympathetic drive, and, conversely, sympathetic activity influences salt sensitivity in hypertension, we investigated 24-hour urinary sodium excretion in participants of the SYMPATHY trial. SYMPATHY investigated RDN in patients with resistant hypertension. Both 24-hour ambulatory and office BP measurements were end points. No relationship was found for baseline sodium excretion and change in BP 6 months after RDN in multivariable-adjusted regression analysis. Change in the salt intake–measured BP relationships at 6 months vs baseline was used as a measure for salt sensitivity. BP was 8 mm Hg lower with similar salt intake after RDN, suggesting a decrease in salt sensitivity. However, the change was similar in the control group, and thus not attributable to RDN.

Original language	English
Pages (from-to)	1125-1133
Journal	Journal of clinical hypertension
Volume	19
Issue number	11
DOIs	https://doi.org/10.1111/jch.13085
Publication status	Published - 1 Nov 2017
Externally published	Yes

Funding

SYMPATHY is an investigator-driven trial and received unrestricted grants from the Netherlands Organisation for Health Research and Development (ZonMw, No. 837004006), the Dutch Kidney Foundation (Nierstichting Nederland, No. CPI12.02), and Medtronic Inc. Funding information SYMPATHY is an investigator-driven trial and received unrestricted grants from the Netherlands Organisation for Health Research and Development (ZonMw, No. 837004006), the Dutch Kidney Foundation (Nierstichting Nederland, No. CPI12.02), and Medtronic Inc. SYMPATHY investigators and committees—Albert Schweizer Hospital Dordrecht: O Elgersma, AJJ IJsselmuiden, PHM van der Valk, P Smak Gregoor, S Roodenburg. Amphia Hospital, Breda: M Meuwissen, W Dewilde, I Hunze, J den Hollander. Antonius Hospital, Nieuwegein: HH Vincent, B Rensing, WJ Bos, Ivan Weverwijk. Catharina Hospital, Eindhoven: PAL Tonino, BRG Brueren, CJAM Konings, H Hendrix-van Gompel. Isala Clinics, Zwolle: JE Heeg, J Lambert, JJ Smit, A Elvan, A Berends, B de Jager. Hospital group Twente, Almelo: G Laverman, PAM de Vries, A van Balen, M Stoel. Martini Hospital, Groningen: R Steggerda, L Niamut, W Bossen, J Biermann, I Knot. Medical Center Alkmaar, Alkmaar: JOJ Peels, JB de Swart, G Kimman, W Bax, Y van der Meij, J Reekers. Medical Center Haaglanden, The Hague: AJ Wardeh, JHM Groeneveld, C Dille. Medical Center Leeuwarden, Leeuwarden: MH Hemmelder, R Folkeringa, M Sietzema, C Wassenaar. Rijnstate Hospital, Arnhem: K Parlevliet, W Aengevaeren, M Tjon, M Hovens, A van den Berg, H Monajemi. Scheper Hospital, Emmen: FGH van der Kleij, A Schramm, A Wiersum. University Hospital Maastricht, Maastricht: B Kroon, M de Haan, M Das, H Jongen, E Herben, R Rennenberg. University Medical Center Utrecht, Utrecht: PJ Blankestijn, ML Bots, MM Beeftink, E de Beus, B Dijker, GWJ Frederix, RL de Jager, E van Maarseveen, MF Sanders, W Spiering, IS Velikopolskaia, L Vendrig, WL Verloop, EE Vink, EPA Vonken, M Voskuil, GA de Wit. All centers are located in The Netherlands. Executive committee: PJ Blankestijn, ML Bots, E de Beus, RL de Jager, L Vendrig. Steering committee: PJ Blankestijn (chair), ML Bots (vice chair), RL de Jager, L Vendrig, E de Beus, B Dijker, JE Heeg, J Vincent, CB Roes, J Deinum. Data Safety Monitoring Board: AJ Rabelink (chair), J Lenders, R Eijkemans. Monitoring: Julius Clinical

Funders	Funder number
University Medical Center Utrecht
U.S. Environmental Protection Agency
Medtronic
Haaglanden Medisch Centrum
ZonMw	837004006
Nierstichting	CPI12.02

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10.1111/jch.13085

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title = "Salt intake and blood pressure response to percutaneous renal denervation in resistant hypertension",

abstract = "{\textcopyright}2017 Wiley Periodicals, Inc.The effect of lowering sympathetic nerve activity by renal denervation (RDN) is highly variable. With the exception of office systolic blood pressure (BP), predictors of the BP-lowering effect have not been identified. Because dietary sodium intake influences sympathetic drive, and, conversely, sympathetic activity influences salt sensitivity in hypertension, we investigated 24-hour urinary sodium excretion in participants of the SYMPATHY trial. SYMPATHY investigated RDN in patients with resistant hypertension. Both 24-hour ambulatory and office BP measurements were end points. No relationship was found for baseline sodium excretion and change in BP 6 months after RDN in multivariable-adjusted regression analysis. Change in the salt intake–measured BP relationships at 6 months vs baseline was used as a measure for salt sensitivity. BP was 8 mm Hg lower with similar salt intake after RDN, suggesting a decrease in salt sensitivity. However, the change was similar in the control group, and thus not attributable to RDN.",

author = "\{de Beus\}, E. and \{de Jager\}, R.L. and M.M. Beeftink and M.F. Sanders and W. Spiering and E.-J. Vonken and M. Voskuil and M.L. Bots and P.J. Blankestijn and O. Elgersma and A.J.J. Ijsselmuiden and \{van der Valk\}, P.H.M. and \{Smak Gregoor\}, P. and S. Roodenburg and M. Meuwissen and W. Dewilde and I. Hunze and \{den Hollander\}, J. and H.H. Vincent and B. Rensing and W.J. Bos and \{an Weverwijk\}, I. and P.A.L. Tonino and B.R.G. Brueren and C.J.A.M. Konings and H.H.-V. Gompel and J.E. Heeg and J. Lambert and J.J. Smit and A. lvan and A. Berends and \{de Jager\}, B. and G. Laverman and \{de Vries\}, P.A.M. and \{van Balen\}, A. and M. Stoel and R. Steggerda and L. Niamut and W. Bossen and J. Biermann and I. Knot and J.O.J. Peels and \{de Swart\}, J.B. and G. Kimman and W. Bax and \{van der Meij\}, Y. and J. Reekers and A.J. Wardeh and J.H.M. Groeneveld and C. Dille and M.H. Hemmelder and R. Folkeringa and M. Sietzema and C. Wassenaar and K. Parlevliet and W. Aengevaeren and M. Tjon and M. Hovens and \{van den Berg\}, A. and H. Monajemi and \{van der Kleij\}, F.G.H. and A. chramm and A. Wiersum and B. Kroon and \{de Haan\}, M. and M. Das and H. Jongen and E. Herben and R. Rennenberg and P.J. Blankestijn and M.L. Bots and B. Dijker and G.W.J. Frederix and \{de Jager\}, R.L. and \{van Maarseveen\}, E. and M.F. Sanders and W. Spiering and I.S. Velikopolskaia and L. Vendrig and W.L. Verloop and E.E. Vink and E.P.A. Vonken and \{de Wit\}, G.A. and J. Vincent and C.B. Roes and J. Deinum and A.J. Rabelink and J. Lenders and R. Eijkemans and \{the SYMPATHY study group\}",

year = "2017",

month = nov,

day = "1",

doi = "10.1111/jch.13085",

language = "English",

volume = "19",

pages = "1125--1133",

journal = "Journal of clinical hypertension",

issn = "1524-6175",

publisher = "John Wiley and Sons Inc.",

number = "11",

}

TY - JOUR

T1 - Salt intake and blood pressure response to percutaneous renal denervation in resistant hypertension

AU - de Beus, E.

AU - de Jager, R.L.

AU - Beeftink, M.M.

AU - Sanders, M.F.

AU - Spiering, W.

AU - Vonken, E.-J.

AU - Voskuil, M.

AU - Bots, M.L.

AU - Blankestijn, P.J.

AU - Elgersma, O.

AU - Ijsselmuiden, A.J.J.

AU - van der Valk, P.H.M.

AU - Smak Gregoor, P.

AU - Roodenburg, S.

AU - Meuwissen, M.

AU - Dewilde, W.

AU - Hunze, I.

AU - den Hollander, J.

AU - Vincent, H.H.

AU - Rensing, B.

AU - Bos, W.J.

AU - an Weverwijk, I.

AU - Tonino, P.A.L.

AU - Brueren, B.R.G.

AU - Konings, C.J.A.M.

AU - Gompel, H.H.-V.

AU - Heeg, J.E.

AU - Lambert, J.

AU - Smit, J.J.

AU - lvan, A.

AU - Berends, A.

AU - de Jager, B.

AU - Laverman, G.

AU - de Vries, P.A.M.

AU - van Balen, A.

AU - Stoel, M.

AU - Steggerda, R.

AU - Niamut, L.

AU - Bossen, W.

AU - Biermann, J.

AU - Knot, I.

AU - Peels, J.O.J.

AU - de Swart, J.B.

AU - Kimman, G.

AU - Bax, W.

AU - van der Meij, Y.

AU - Reekers, J.

AU - Wardeh, A.J.

AU - Groeneveld, J.H.M.

AU - Dille, C.

AU - Hemmelder, M.H.

AU - Folkeringa, R.

AU - Sietzema, M.

AU - Wassenaar, C.

AU - Parlevliet, K.

AU - Aengevaeren, W.

AU - Tjon, M.

AU - Hovens, M.

AU - van den Berg, A.

AU - Monajemi, H.

AU - van der Kleij, F.G.H.

AU - chramm, A.

AU - Wiersum, A.

AU - Kroon, B.

AU - de Haan, M.

AU - Das, M.

AU - Jongen, H.

AU - Herben, E.

AU - Rennenberg, R.

AU - Blankestijn, P.J.

AU - Bots, M.L.

AU - Dijker, B.

AU - Frederix, G.W.J.

AU - de Jager, R.L.

AU - van Maarseveen, E.

AU - Sanders, M.F.

AU - Spiering, W.

AU - Velikopolskaia, I.S.

AU - Vendrig, L.

AU - Verloop, W.L.

AU - Vink, E.E.

AU - Vonken, E.P.A.

AU - de Wit, G.A.

AU - Vincent, J.

AU - Roes, C.B.

AU - Deinum, J.

AU - Rabelink, A.J.

AU - Lenders, J.

AU - Eijkemans, R.

AU - the SYMPATHY study group

PY - 2017/11/1

Y1 - 2017/11/1

N2 - ©2017 Wiley Periodicals, Inc.The effect of lowering sympathetic nerve activity by renal denervation (RDN) is highly variable. With the exception of office systolic blood pressure (BP), predictors of the BP-lowering effect have not been identified. Because dietary sodium intake influences sympathetic drive, and, conversely, sympathetic activity influences salt sensitivity in hypertension, we investigated 24-hour urinary sodium excretion in participants of the SYMPATHY trial. SYMPATHY investigated RDN in patients with resistant hypertension. Both 24-hour ambulatory and office BP measurements were end points. No relationship was found for baseline sodium excretion and change in BP 6 months after RDN in multivariable-adjusted regression analysis. Change in the salt intake–measured BP relationships at 6 months vs baseline was used as a measure for salt sensitivity. BP was 8 mm Hg lower with similar salt intake after RDN, suggesting a decrease in salt sensitivity. However, the change was similar in the control group, and thus not attributable to RDN.

AB - ©2017 Wiley Periodicals, Inc.The effect of lowering sympathetic nerve activity by renal denervation (RDN) is highly variable. With the exception of office systolic blood pressure (BP), predictors of the BP-lowering effect have not been identified. Because dietary sodium intake influences sympathetic drive, and, conversely, sympathetic activity influences salt sensitivity in hypertension, we investigated 24-hour urinary sodium excretion in participants of the SYMPATHY trial. SYMPATHY investigated RDN in patients with resistant hypertension. Both 24-hour ambulatory and office BP measurements were end points. No relationship was found for baseline sodium excretion and change in BP 6 months after RDN in multivariable-adjusted regression analysis. Change in the salt intake–measured BP relationships at 6 months vs baseline was used as a measure for salt sensitivity. BP was 8 mm Hg lower with similar salt intake after RDN, suggesting a decrease in salt sensitivity. However, the change was similar in the control group, and thus not attributable to RDN.

UR - https://www.scopus.com/pages/publications/85030026916

UR - https://www.scopus.com/pages/publications/85030026916#tab=citedBy

U2 - 10.1111/jch.13085

DO - 10.1111/jch.13085

M3 - Article

SN - 1524-6175

VL - 19

SP - 1125

EP - 1133

JO - Journal of clinical hypertension

JF - Journal of clinical hypertension

IS - 11

ER -

Salt intake and blood pressure response to percutaneous renal denervation in resistant hypertension

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