Effect of Renal Nerve Denervation for Resistant Hypertension in Thai Patients: A Report of the First Cases Series in Thailand
Nattawut Wongpraparut MD, FACP, FACC*, Damras Tresukosol MD, FAPSIC**, Weeranuj Roubsantisuk MD***, Peera Buranakitjaroen MD***, Chuhakasem Chotivoraniyakul MD**, Rungtiwa Pongakasira BSc**
Affiliation : * Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand ** Her Majesty’s Cardiac center, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand *** Division of Hypertension, Department of Medicine, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
Background : Hypertension is a major contributor to death. A significant portion of the patients is still in resistant hypertension
with current medical treatment. Renal nerve denervation can reduce sympathetic activity, and subsequently reduce BP in
western population.
Objective : To evaluate the effect of renal nerve denervation in treatment of resistant hypertension in Thai patients.
Material and Method: The present study is a case series of the first four Thai patients who underwent renal nerve denervation
at Faculty of Medicine Siriraj Hospital. All patients had resistant hypertension. Baseline medical records, including demographic
data, baseline systolic and diastolic blood pressure (BP), ambulatory BP monitoring, number and dose of anti-hypertensive
medications before and after renal nerve denervation, were recorded. Patients were followed-up at 1 month, 3 month and 6
months after the procedure.
Results : Patients were taking antihypertensive medications ranging from 5 to 8 types of drug classes, but in all cases, their
blood pressure was still not under control at baseline range from 160-190 of systolic BP and 100-120 mean BP. One of the
patients had a history of hemorrhagic stroke as a consequence of un-control hypertension. All of them had blood pressure
reduction immediately at the end of the first 24 hrs, and this was sustained until follow-up at 3-6 months. The mean of systolic
BP reduction is 35.2+ 9.9 mmHg at 3-months follow-up. The mean reduction of the number of anti-hypertensive medications
was 3.5+3.0 at 3-month follow-up.
Conclusion : The authors found that the percutaneous renal nerve denervation was very effective in blood pressure reduction
in these first four cases of Thai patients with resistant hypertension.
Keywords : Resistant hypertension, Renal nerve denervation, Blood pressure reduction, Sleep apnea
