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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EIt has been shown that renal denervation (RDN; also called renal nerve ablation) can lower blood pressure (BP) in patients with resistant hypertension and that this effect can be maintained to more than 24 months [Symplicity HTN-1 Investigators. \u003Cem\u003EHypertens\u003C\/em\u003E 2011]. However, there are few data about the effect of RDN on organs and the sympathetic nervous system. This article presents data from a study to determine whether RDN has an effect on inflammation and endothelial function in patients with resistant hypertension.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ERenal Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHypertension \u0026amp; Kidney Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHypertensive Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Radiology\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ERenal Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHypertension \u0026amp; Kidney Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology \u0026amp; Cardiovascular Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHypertensive Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Radiology\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EIt has been shown that renal denervation (RDN; also called renal nerve ablation) can lower blood pressure (BP) in patients with resistant hypertension and that this effect can be maintained to more than 24 months [Symplicity HTN-1 Investigators. \u003Cem\u003EHypertens\u003C\/em\u003E 2011]. However, there are few data about the effect of RDN on organs and the sympathetic nervous system. There is an independent association between hypertension and inflammatory markers, but it is unknown whether treatment of one of these conditions impacts the other and whether lowering BP can also reduce vascular inflammation.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ENina Eikelis, MD, Baker IDI Heart \u0026amp; Diabetes Institute, Melbourne, Australia, presented data from a study to determine whether RDN has an effect on inflammation and endothelial function in patients with resistant hypertension.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EAssessments were conducted at baseline and at 3 months after RDN in 63 patients with resistant hypertension (male, 64%; mean age, 61 years). At baseline, patients had a high body mass index (BMI; 32.3 kg\/m\u003Csup\u003E2\u003C\/sup\u003E), and were taking an average of 4.6 antihypertensive medications.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EBP was significantly reduced from baseline (169\/90 mm Hg) to 3 months (156\/84 mm Hg; p\u0026lt;0.001), but there was no significant change in HR.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThere were no significant changes from baseline to 3 months in the reactive hyperemia index, which is a measure of endothelial function, and the augmentation index, which is an indirect measure of arterial stiffness.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThere were also no significant differences from baseline to 3 months in plasma renin activity, which is an indirect measure of angiotensin I production, and the level of the inflammatory markers.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003ELeptin levels did not significantly change from baseline to 3 months. The levels of nonesterified fatty acid (NEFA), a metabolic biomarker, were significantly reduced (from 1 to 0.4 mEq\/L; p\u0026lt;0.001), but there were no significant reductions in body weight, BMI, or waist-to-hip ratio.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EIn explaining the high baseline NEFA levels in this patient population that has resistant hypertension and high BMI, it should be noted that NEFA has been implicated in elevated BP, particularly in animal studies [Sarafidis PA, Bakris GL. \u003Cem\u003EJ Hum Hypertens\u003C\/em\u003E 2007]. Furthermore, the levels of NEFA tend to be higher in overweight and obese persons as it is primarily released from adipose tissue [Heptulla R et al. \u003Cem\u003EJ Clin Endiocrinol Metab\u003C\/em\u003E 2001; Koutsari C, Jensen MD. \u003Cem\u003EJ Lipid Res\u003C\/em\u003E 2006].\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003ENEFA and insulin levels seem to have an inverse relationship, said Prof. Eikelis. Therefore, it is perhaps no surprise that in the present study, NEFA levels significantly decreased while insulin levels significant increased from baseline (21 uU\/mL) to 3 months (28 uU\/mL; p\u0026lt;0.01).\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003EWhole body noradrenaline spillover, a measure of whole body sympathetic activity, did not change significantly over the 3 months. However, Prof. Eikelis noted that sympathetic responses are regionalized and global measures lack precision. When looking at regional sympathetic activity, there were significant reductions from baseline to 3 months and to 6 weeks in muscle and kidney sympathetic activity, respectively (p\u0026lt;0.05 for both).\u003C\/p\u003E\u003Cp id=\u0022p-12\u0022\u003EStudy findings show that while RDN led to significant reductions in office BP, and muscle and renal sympathetic activity, there were no significant changes in endothelial function and inflammatory markers. There was a significant reduction in NEFA, without changes in body weight, and this may be an indirect measure showing reduction or withdrawal of nervous activity from adipose tissue.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2013 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/13\/9\/8.2.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nznue1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}