RENAL DENERVATION RAPIDLY RESTORES CIRCULATING PROGENITOR CELLS IN PATIENTS AFFECTED BY RESISTANT HYPERTENSION

Objective: To investigate whether blood pressure (BP) lowering after renal sympathetic denervation (RSD) affects CD34+ cell number in drug-resistant hypertension (R-HTN). Design and method: We enrolled 11 patients with R-HTN, already treated with at least 6 antihypertensive drugs, including a diuretic, at full dosages; patients with offi ce BP of > 160 mmHg (>150 mmHg for type 2 diabetes) were considered eligible for the procedure. Adherence to drug treatment was accurately checked by patient’s general practitioners. Mean age was 61 ± 7.9 years; M: F 8:5. We measured clinic (sphygmomanometer) and ambulatory (Tonoport V GEHealthcare) BP, and heart rate (HR; electrocardiogram), at baseline and 30 days after RSD procedure (Symplicity; Medtronic). 24 h BP recordings and home BP protocols were consulted in addition to offi ce BP measurements at the hospital before enrollment. Results: At T0: SBP: 179.1 ± 9.3mmHg; DBP: 101.2 ± 5.5 mmHg; HR 79.9 ± 9.4; CD34+ cells: 1.66 ± 0.51. At T1 SBP values were reduced on the average of 40.2 mmHg (138.9 ± 7.3; –22.5%, p < 0.001) DBP of 18 mmHg (83.2 ± 3.2; –17.7%, p < 0.001), and HR of 10.4 bpm (67.3 ± 6.0; -17.7%, p < 0.005), and CD34+cell number increased on an average of 0.34 cells /microL (2.0 ± 0.51; +21.2%, p < 0.001). Conclusions: RSD rapidly restores CD34+cell number in patients affected by true R-HTN; if these results will be confi rmed on a larger scale, they could provide new insights about CD34+ cells and pathophysiological aspects of arterial hypertension.