| Abstract [eng] |
Arterial hypertension (AH) is a major risk factor for cardiovascular disease, stroke, disability, and overall mortality., however, some patients are still failing to meet their target blood pressure values. The aim of this research was the need for detailed examination and selection of patients with resistant hypertension, optimal selection of medication and / or intervention treatment, and monitoring of these patients emerged. In the prospective (n = 34) (2017-2020) part of the study pharmacological treatment was adjusted using broadly used methods and novel chest wall resistance measurement technique. Retrospective part (n = 72) included analysis of patients who underwent sympathetic renal artery denervation procedure in 2012-2017. There was a statistically significant blood pressure (BP) reduction in after 6 months in groups. However, decrease in systolic BP was significantly higher in interventional group -33.8 mm Hg (± 3.01) vs. -26.6 mm Hg (± 4.32) (p = 0.02). Significant reduction of left ventricular hypertrophy and arterial stiffness at 6 months also was observed only in interventional group. Chest wall resistance measurements can help specify the predominant circulatory mechanism, suspect non-compliance with medication regimen, and prescribe a more patient-tailored treatment. We observed negative association between polypharmacy and comorbidities with BP control and arterial stiffness indices. In our study the most common cause of insufficient BP control was non-compliance with medication regimen. So, catheter-based renal artery sympathetic denervation is effective and safe way independent of a patient’s medication regimen to improve arterial blood pressure control for at least 48 months that reduce target organ damage. |
