The Italian registry of renal denervation

Intrduction: Studies performed in resistant hypertensive patients (RH) have shown the antihypertensive effects of renal denervation. The Italian Registry of Renal Denervation (RID) was designed to collect data on the effects of the procedure on 1) clinic (cBP) and ambulatory blood pressure (24h-BP), 2) different markers of organ damage and 3) the safety of the procedure. Methods: Data were collected through a computerized register with online access values of cBP, 24h-BP, resuts of laboratory tests and data on organ damage. These measurements were performed before, 1, 3, 6, 12, 18 and 24 month following the procedure. 20 centers are currently involved in RID. Results: Since the beginning of the registry 51 procedures have been performed. Preliminary data show that patients undergoing renal denervation had a mean age of 61.3±2.7 years, a M/F ratio of 0.53, and a body mass index of 29.5±1.2 kg/m2 with a high cardiovascular risk profile. Baseline cBP was 194.5±5.4/107.1±3.8 mmHg, despite the daily average use of 6.0±0.5 medications. The corresponding values of 24h-BP amounted to 147.1±6.9/77.5±2.6mmHg. After 1, 3 and 6 months from the procedure the values of cBP are respectively equal to 152.5±7.4/88.1±4.6, 157.4±9.9/93.3±5.7 and 156.6±10.0/84.9±7.0 mmHg (P <0.01 for systolic BP), without significant changes in heart rate. The magnitude of reduction in the 24h-BP is significantly less than that of the cBP, on average 10.3±4.4/6.0±1.8 mmHg less. No complication in the short or long-term period related to renal denervation was reported. Conclusions: The data of the RID will allow you to define the effectiveness of the cBP and 24h-BP of the procedure and its effects on organ damage and cardiovascular risk profile. The preliminary results collected so far, while confirming the effectiveness of the procedure found on the cBP in international studies highlight the need for careful assessment of the 24h-BP response to the procedure to better define its effects on blood pressure.