Journal
JOURNAL OF THE AMERICAN SOCIETY OF HYPERTENSION
Volume 9, Issue 10, Pages 769-779Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jash.2015.08.001
Keywords
Renal denervation; African American; uncontrolled apparent treatment-resistant hypertension
Categories
Funding
- Medtronic
- Amarin
- AstraZeneca
- Bristol-Myers Squibb
- Eisai
- Ethicon Endo-Surgery
- Forest Laboratories, Inc
- Ischemix
- Roche
- Sanofi
- The Medicines Company
- Edwards LifeSciences
- St. Jude Medical
- Abbott Vascular
- Boston Scientific
- Cordis (Johnson Johnson)
- Eli Lilly and Company
- Daiichi Sankyo
- Abiomed
- Direct Flow
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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 aims that affect the observed pattern of SBP responses. (C) 2015 American Society of Hypertension. All rights reserved.
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