Ambulatory arterial stiffness index as a predictor of blood pressure response to renal denervation

BACKGROUND:Renal denervation (RDN) can reduce blood pressure (BP) in patients with resistant hypertension, but less so in patients with isolated systolic hypertension. A possible explanation is that patients with stiffer arteries may have lesser neural contribution to their hypertension. METHOD:We hypothesized that arterial stiffness predicts the response to RDN. From ambulatory BP monitoring (ABPM), ambulatory arterial stiffness index (AASI) was calculated as 1 − the regression slope of DBP versus SBP. RESULTS:In 111 patients with resistant hypertension, RDN reduced office and 24-h SBP after 3, 6, and 12 months (by −11 ± 22, −11 ± 25, −14 ± 21 mmHg for office, and −4 ± 11, −5 ± 12, −5 ± 15 mmHg for 24-h SBP, respectively, P 0.51) showed no change in 24-h SBP at 6 months after RDN (−0.4 ± 12.3 mmHg, P > 0.05), whereas an AASI below 0.51was associated with a marked reduction (−9.3 ± 11.0 mmHg, P