An analysis of the blood pressure and safety outcomes to renal denervation in African Americans and Non-African Americans in the SYMPLICITY HTN-3 trial
Flack JM, Bhatt DL, Kandzari DE, Brown D, Brar S, Choi JW, D'Agostino R, East C, Katzen BT, Lee L, Leon MB, Mauri L, O'Neill WW, Oparil S, Rocha-Singh K, Townsend RR, Bakris G. An analysis of the blood pressure and safety outcomes to renal denervation in African Americans and Non-African Americans in the SYMPLICITY HTN-3 trial. J Am Soc Hypertens. 2015 ;9(10):769-779.
J Am Soc Hypertens
SYMPLICITY HTN-3, the first trial of renal denervation (RDN) versus sham, enrolled 26% African Americans, a prospectively stratified cohort. Although the 6-month systolic blood pressure (SBP) reduction in African Americans (AAs) was similar in the RDN group (-15.5 ± 25.4 mm Hg, n = 85 vs. -17.8 ± 29.2, n = 49, P = .641), the sham SBP response was 9.2 mm Hg greater (P = .057) in AAs than non-AAs. In multivariate analyses, sham SBP response was predicted by an interaction between AA and a complex antihypertensive regimen (at least one antihypertensive medication prescribed ≥3 times daily), while in the RDN group, SBP response was predicted by an interaction between AA race and baseline BP ≥ 180 mm Hg. AA race did not independently predict SBP response in either sham or RDN. There appears to be effect modification by race with individual-level patient characteristics in both treatment arms that affect the observed pattern of SBP responses.
Medical Subject Headings
Adult; African Americans; Aged; Antihypertensive Agents; Blood Pressure Monitoring, Ambulatory; Catheter Ablation; Cohort Studies; Female; Humans; Hypertension; Kidney; Male; Medication Adherence; Middle Aged; Multivariate Analysis; Prospective Studies; Sympathectomy; Sympathetic Nervous System; Treatment Outcome