Unaltered neurocardiovascular reactions to mental stress after renal sympathetic denervation

• Background: The impact of renal denervation (RDN) on muscle sympathetic nerve activity (MSNA) at rest remains controversial. Mental stress (MS) induces transient changes in sympathetic nerve activity, heart rate (HR) and blood pressure (BP). It is not known whether RDN modifies these changes. Purpose: The main objective was to assess the effect of RDN on MSNA and BP alterations during MS. Methods: In 14 patients (11 included in analysis) with resistant hypertension multi-unit MSNA, BP (Finometer (R)) and HR were assessed at rest and during forced arithmetics at baseline and 6 months after RDN. Results: Systolic office BP decreased significantly 6 months after RDN (185 +/- 29 vs.175 +/- 33 mmHG; p = 0.04). No significant changes in MSNA at rest (68 +/- 5 vs 73 +/- 5 bursts/100hb; p = 0.43) were noted and no significant stress-induced change in group averaged sympathetic activity was found pre- (101 +/- 24%; p = 0.9) or post-intervention (108 +/- 26%; p = 0.37). Stress was associated with significant increases in mean arterial BP (p < 0.01) and HR (p < 0.01) at baseline, reactions which remained unaltered after intervention. We did not note any correlation between sympathetic nerve activity and BP changes after RDN. Conclusion: Thus, in our group of resistant hypertensives we find no support for the hypothesis that the BP-lowering effect of RDN depends on altered neurovascular responses to stress.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

Renal hypertension

multi-unit muscle sympathetic nerve activity

renal

denervation

sympathectomy

arousal

physiology

stress

autonomic

nervous system disorders

blood-pressure reactivity

nerve activity

resistant hypertension

responses

muscle

ablation

arousal

task

htn

Pharmacology & Pharmacy

Cardiovascular System & Cardiology

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ref (ämneskategori)

art (ämneskategori)