Impact of renal artery denervation on insulin resistance in patients with resistant hypertension

Влияние денервации почечных артерий на инсулинорезистентность у пациентов с резистентной артериальной гипертензией
Abdurashid Mussayev 1 2, Marat Aripov 1, Serik Alimbayev 1, Gulnara Zhussupova 2
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1 «National research cardiac surgery center», Astana, Kazakhstan
2 Astana Medical University, кафедра кардиологии, Astana, Kazakhstan
J CLIN MED KAZ, Volume 4, Issue 38, pp. 25-29.
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ABSTRACT

The aim: To study the effect of renal artery denervation on blood pressure and insulin resistance in patients with resistant hypertension.
Methods: Sixty-three patients underwent denervation of the renal arteries with resistant hypertension. We investigate blood pressure, glucose tolerant test, HOMA-IR and the level of glucose in blood.
Results: It showed a significant reduction in office systolic (-36,1 ± 22,2 mm Hg; P <0.0001) and diastolic (-22,3 ± 14,2 mm Hg; P <0.0001) blood pressure; no statistically significant reduction in glucose tolerant test (6,7 ± 2,5 to 6,1 ± 1,9; P = 0,25). Insulin resistance index fell from an average of 3,0 ± 4,6 baseline to 2,5 ± 3,7 (p = 0.007) at 12 months after denervation of the renal arteries.
Conclusions: renal artery denervation is a safe and effective method of treatment for resistant hypertension, which also has a positive effect on glucose metabolism.
Keywords: resistant hypertension, renal artery denervation, insulin resistance

CITATION

Mussayev A, Aripov M, Alimbayev S, Zhussupova G. Impact of renal artery denervation on insulin resistance in patients with resistant hypertension. Journal of Clinical Medicine of Kazakhstan. 2015;4(38):25-9.

REFERENCES

  • Ram C.V.S. Hypertension: A Clinical Guide, 2014, CRC Press, pp. 12-29.
  • Lilly L.S.,School H.M. Pathophysiology of Heart Disease: A Collaborative Project of Medical Students and Faculty. 2011: Wolters Kluwer/Lippincott Williams & Wilkins.
  • Shulutko B.I. Arterial’naja gipertenzija.Sankt-Peterburg. Izd-vo «Renkor», 2001, No.1: p. 381.
  • de la Sierra A., et al. Clinical differences between resistant hypertensives and patients treated and controlled with three or less drugs. Journal of hypertension, 2012, No.30(6): pp. 1211-1216.
  • Persell S.D. Prevalence of resistant hypertension in the United States, 2003–2008. Hypertension, 2011, No.57(6), pp. 1076- 1080.
  • Huggett R.J., et al. Impact of type 2 diabetes mellitus on sympathetic neural mechanisms in hypertension. Circulation, 2003, No.108(25), pp. 3097-3101.
  • Dibona G.F., The sympathetic nervous system and hypertension recent developments. Hypertension, 2004, No. 43(2), pp. 147-150.
  • Stein C.J., Colditz G.A. The epidemic of obesity. The Journal of Clinical Endocrinology & Metabolism, 2004, No.89(6), pp. 2522-2525.
  • Matthews D., et al. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia, 1985, No.28(7), pp. 412-419.
  • Chobanian A.V., et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. Jama, 2003, 289(19), pp. 2560-2571.
  • Committee I.E. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes care, 2009, No.32(7), pp. 1327-1334.
  • Krum H. et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-ofprinciple cohort study. The Lancet, 2009, No.373(9671), pp. 1275-1281.
  • Bhatt D.L. et al. A controlled trial of renal denervation for resistant hypertension. New England Journal of Medicine, 2014, No.370(15), pp. 1393-1401.
  • Esler M.D. et al. Renal sympathetic denervation for treatment of drug-resistant hypertension one-year results from the Symplicity HTN-2 randomized, controlled trial. Circulation, 2012, No.126(25), pp 2976-2982.
  • Krum H. et al. Percutaneous renal denervation in patients with treatment-resistant hypertension: final 3-year report of the Symplicity HTN-1 study. The Lancet, 2014. No. 383(9917), pp. 622-629. 
  • Masuo K. et al. Sympathetic nerve hyperactivity precedes hyperinsulinemia and blood pressure elevation in a young, nonobese Japanese population. American journal of hypertension, 1997, No.10(1), pp. 77-83.
  • Grassi G. et al. Neuroadrenergic and reflex abnormalities in patients with metabolic syndrome. Diabetologia, 2005, No. 48(7), pp. 1359-1365.
  • Collaboration E.R.F. The Emerging Risk Factors Collaboration: analysis of individual data on lipid, inflammatory and other markers in over 1.1 million participants in 104 prospective studies of cardiovascular diseases. European journal of epidemiology, 2007, No. 22(12), pp.839-869.
  • Seshasai S.R.K. et al. Diabetes mellitus, fasting glucose, and risk of cause-specific death. The New England journal of medicine, 2011, No. 364(9), pp. 829.
  • Fuller J. et al. Coronary-heart-disease risk and impaired glucose tolerance The Whitehall Study. The Lancet, 1980, No. 315(8183), pp.1373-1376.
  • Dickinson, S. and J. Brand-Miller, Glycemic index, postprandial glycemia and cardiovascular disease. Current opinion in lipidology, 2005, No.16(1), pp. 69-75.
  • Lima N.K. et al. Prevalence of insulin resistance and related risk factors for cardiovascular disease in patients with essential hypertension. American journal of hypertension, 2009, No.22(1), pp.106-111.