Impact of drug adherence on blood pressure response to alcohol-mediated renal denervation

Figures & data

Table 1. Baseline characteristics.

Characteristics	All patients (N = 45)
Age, years	55.2 ± 9.7
Male gender	62% (28/45)
BMI, kg/m^2	30.7 ± 5.8
eGFR (CKD-EPI formula), mL/min/1.73 m^2	85 ± 16
Chronic kidney disease (eGFR <60 mL/min/1.73m^2)	2% (1/45)
Type 2 diabetes	33% (15/45)
Hyperlipidemia	49% (22/45)
Coronary artery disease	9% (4/45)
Peripheral vascular occlusive disease	7% (3/45)
Heart failure	4% (2/45)
Prior myocardial infarction	4% (2/45)
Cerebrovascular accident/transient ischaemic attack	7% (3/45)
Office systolic/diastolic BP, mmHg	169/99 ± 15/13
24-h ambulatory systolic/diastolic BP, mmHg	151/89 ± 14/12
Mean number of antihypertensive medications	5.1 ± 1.5
Medication class
ACE inhibitor	29% (13/45)
Angiotensin 2 receptor blocker	73% (33/45)
Calcium channel blocker	84% (38/45)
Diuretics	98% (44/45)
Spironolactone	42% (20/45)
Beta-blocker	76% (34/45)
Centrally acting alpha agonist	44% (20/45)
Direct acting vasodilator	29% (13/45)
Renin inhibitor	4% (2/45)
Other	9% (4/45)

Data are percentages, or mean ± SD.

ACE: angiotensin-converting enzyme; BMI: body mass index; BP: blood pressure; CKD-EPI: Chronic Kidney Disease Epidemiology Collaboration; eGFR: estimated glomerular filtration rate; SD: standard deviation.

Figure 1. Systolic ambulatory (a) and office (b) blood pressure 1, 3, 6, and 12 months after renal denervation. Mean reductions in 24-h systolic ambulatory (ASBP) (a) and office (OSBP) (b) blood pressure over time.

Table 2. Adherence to antihypertensive medication during the study.

	Baseline (N = 45)	1 Month (N = 43)	3 Months (N = 44)	6 Months (N = 43)	12 Months (N = 41)
Non-adherent	10 (22)	9 (21)	8 (18)	11 (26)	7 (17)
Partially adherent	7 (16)	11 (26)	9 (21)	6 (14)	13 (32)
Fully adherent	28 (62)	23 (53)	27 (61)	26 (60)	21 (51)
Adherence* (%)	78.3 ± 34.5	75.2 ± 34.4	82.3 ± 26.5	79.0 ± 31.7	82.0 ± 24.2
Fully adherent (≥80%)	30 (67)	26 (62)	30 (70)	13 (34)
Non-adherent (<80%)	15 (33)	16 (38)	13 (30)	27 (66)

Values are mean ± standard deviation (SD) or n (%).

*p = 0.596 from Friedman test for non-parametric related variables.

Table 3. Change in antihypertensive medication adherence during the study.

	1 Month (N = 43)	3 Months (N = 44)	6 Months (N = 43)	12 Months (N = 41)
Improved adherence	6 (14)	12 (27)	9 (21)	9 (22)
No change in adherence	26 (60)	21 (48)	21 (49)	20 (49)
Worse adherence	11 (26)	11 (25)	13 (30)	12 (29)

Values are N (%).

Figure 2. Change in 24-h systolic ambulatory blood pressure at 6 and 12 months vs. adherence. (a) Change in 24-h systolic ambulatory blood pressure in fully, partially, and non-adherent subjects. (b) Change in 24-h systolic ambulatory blood pressure presented by subjects who were ≥80 and <80% adherent to antihypertensive treatment and by worse, no change, and improved adherence.

Table 4. Responder analysis of change in antihypertensive medication adherence during the study.

	Responder	Non-responder	Overall
Improved adherence at 6 months n (%)	7 (24)	1 (8)	9 (21)
No change in adherence at 6 months n (%)	13 (45)	8 (67)	21 (49)
Worse adherence at 6 months n (%)	9 (31)	3 (25)	13 (30)
p = 0.37
Improved adherence at 6 months n (%)	7 (24)	1 (8)	9 (21)
No change in adherence or worse adherence at 6 months n (%)	22 (76)	11 (92)	34 (79)
p = 0.40
Improved adherence at 12 months n (%)	6 (26)	2 (13)	9 (22)
No change in adherence at 12 months n (%)	12 (52)	7 (47)	20 (49)
Worse adherence at 12 months n (%)	5 (22)	6 (40)	12 (29)
p = 0.41
Improved adherence at 12 months n (%)	6 (26)	2 (13)	9 (22)
No change in adherence or worse adherence at 12 months n (%)	17 (74)	13 (87)	32 (78)
p = 0.44

Responder is defined as a reduction in systolic ambulatory blood pressure of ≥5 mmHg.