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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.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\u003EHypertension is responsible for a significant number of preventable deaths relative to other treatable conditions, such as diabetes, breast cancer, and cervical cancer [National Committee for Quality Assurance 2003]. This article presents results from a study showing that antihypertensive medication use was reduced following renal denervation in Afro-Caribbean descendants.\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\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\u003ECardiology Clinical Trials\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\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\u003ECardiology \u0026amp; Cardiovascular Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EHypertension is responsible for a significant number of preventable deaths relative to other treatable conditions, such as diabetes, breast cancer, and cervical cancer [National Committee for Quality Assurance 2003]. A. F. L. Liqui Lung, MD, Stichting Teaching Hospital, Willemstad, Curacao Island, presented results from a study showing that antihypertensive medication use was reduced following renal denervation in Afro-Caribbean descendants.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThis was a pilot study conducted among 6 subjects of Afro-Caribbean descent from Curacao Island. The objectives of the study were to assess the safety and efficacy of renal artery ablation in an Afro-Caribbean population and to determine whether medication use could be reduced as a result of the procedure. In addition to being of Afro-Caribbean descent, subjects were required to have hypertension that was resistant to 4 classes of hypertensive drugs, including aldosterone blocking agents, and to be between 18 and 75 years old, with no renal artery stenosis \u0026gt; 5 mm, no calcification or accessory arteries, no secondary hypertension, and an estimated glomerular filtration rate \u0026gt; 45 mL\/min. All patients had left ventricular hypertrophy diagnosed by echocardiography and evidence of microalbuminuria, putting them at high risk for cardiovascular problems.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EOf the 10 patients who met the study criteria, 6 were selected for participation and flown to the Netherlands for the ablations. Participants had a mean body mass index (BMI) of 42.73 kg\/m\u003Csup\u003E2\u003C\/sup\u003E and were a mean age of 60 years. Four patients had type 2 diabetes; 5, dyslipidemia; 1, paroxysmal atrial fibrillation; and 1, asthma.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EAll patients had renal nerve stimulation done before and following denervation with the electrophysiology stimulation catheter for evaluation of position and to obtain the results of denervation. The EnligHTN Renal Denervation System (St. Jude Medical, Inc.) was used for renal denervation through right femoral access and under sedation. The system delivers radiofrequency energy from an ablation catheter to create lesions along the renal nerves with the hypothesis that it may lower blood pressure.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThere was no change in day or night blood pressure, BMI, or HbA1C 6 months after ablation. A positive response was defined as a 50% lowering of medication dose. For the majority of antihypertensive drugs that the patients were taking, patients either stopped taking them altogether or reduced their dose or frequency. Four of the 6 patients had a positive response. \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E shows the percentage drop in medication use after ablation for each patient in the study.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/14792\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/14792\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14792\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EPercentage Drop in Medication Use After Renal Denervation.\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-8\u0022\u003EThere were no complications. Dose reductions were required for 2 patients immediately after the intervention and for 1 patient within 48 hours of intervention due to hypotension. Neither of the patients (patients 3 and 4) with a BMI \u0026gt; 50 had a positive response.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EDr. Liqui Lung concluded that the pilot results suggest that renal denervation with the EnligHTN catheter may be safe and allow a reduction in antihypertensive medication in patients of Afro-Caribbean decent with drug-resistant hypertension who have a BMI \u0026lt;50 kg\/m\u003Csup\u003E2\u003C\/sup\u003E, dyslipidemia, and diabetes. The promising results of this pilot study will require verification in well-powered, placebo-controlled trials. Results of the blinded controlled SYMPLICITY HTN-3 trial, which showed no difference in blood pressure after renal denervation, provide cautionary data stressing the importance of controlled assessments of renal denervation strategies before wider adoption.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 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\/14\/24\/18.2.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?nzovze\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzovze\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}