Renal Sympathetic Denervation and Quality of Life

Background: Renal sympathetic denervation (RSD) is a promising strategy in the treatment of resistant hypertension. No studies have assessed the effect of RSD on quality of life in our country, which was the aim of this study. Methods: The EuroQol 5 Dimensions questionnaire (EQ 5D 5L) was chosen to evaluate quality of life in 10 patients undergoing RSD, and it was applied before and 3 months after the procedure. Results: Mean age was 47.3 ± 12 years and 90% of the patients were female. Baseline blood pressure was 187 ± 37.5/104 ± 18.5 mmHg and the number of antihypertensive drugs was 7.6 ± 1.3. Before the procedure, the value assigned to health status was 37.5 ± 22.7, increasing at 3 months to 70.5 ± 20.9 (P = 0.01). In the followup, in addition to a decrease in the number of antihypertensive drugs (7.6 ± 1.3 vs. 6 ± 2.2; P = 0.05), a trend towards reduced levels of systolic blood pressure (187 ± 36 mmHg vs 170 ± 44 mmHg; P = 0.10) and diastolic blood pressure (104 ± 18 mmHg vs 98 ± 20 mmHg; P = 0.20) was observed. Health status improvement resulted from a reduction of problems related to mobility, usual activities, pain/discomfort and anxiety/depression. The magnitude of blood pressure reduction was not associated with improved quality in all of the patients. On the other hand, those who had a decrease in the number of antihypertensive drugs reported a better health status. Conclusions: Patients with resistant hypertension have poor health status scores. RSD improved quality of life in most patients. Further studies are required to confirm consistent benefits. DESCRIPTORS: Hypertension. Kidney. Sympathectomy. Quality of life. 1 Cardiologist physician at the Electrophysiology and Heart Arrythmias Medical Section of Instituto Dante Pazzanese de Cardiologia. São Paulo, SP, Brazil. Fellow in research at the Masters of Health Sciences in Clinical Research program of Duke University (Durham, Estados Unidos). 2 Doctor. Interventionist cardiologist physician at the Invasive Cardiology Service of Instituto Dante Pazzanese de Cardiologia. São Paulo, SP, Brazil. 3 Cardiologist physician at the Section of Arterial Hypertension and Nephrology of Instituto Dante Pazzanese de Cardiologia. São Paulo, SP, Brazil. 4 Full professor. Director of the Invasive Cardiology Service of Instituto Dante Pazzanese de Cardiologia. São Paulo, SP, Brazil. 5 Doctor. Head of the Electrophysiology and Heart Arrythmias Medical Section of Instituto Dante Pazzanese de Cardiologia. São Paulo, SP, Brazil. 6 Doctor. Head of the Section of Arterial Hypertension and Nephrology of Instituto Dante Pazzanese de Cardiologia. São Paulo, SP, Brazil. 7 Doctor. Physician at Instituto Brasileiro de Pesquisa Clínica. São Paulo, SP, Brasil. Fellow in research at the Masters of Health Sciences in Clinical Research program of Duke University (Durham, Estados Unidos). 8 Full professor. Director of the Center of Interventions in Heart Structural Diseases of the Instituto Dante Pazzanese de Cardiologia. São Paulo, SP, Brazil. Correspondence to: Luciana Armaganijan. Av. Dr. Dante Pazzanese, 500 – Vila Mariana – São Paulo, SP, Brazil – CEP 04012-180 E-mail: [email protected] Received on: 1/15/2013 • Accepted on: 3/5/2013 Original Article