Evaluation of Systemic Microvascular Density and Endothelial Function in Patients With Resistant Hypertension After Renal Sympathetic Denervation
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Arterial Hypertension
- Sponsor
- National Institute of Cardiology, Laranjeiras, Brazil
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- Cutaneous microvascular reactivity
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
It has been proposed that the modulation of the activity of the sympathetic nervous system, through renal sympathetic denervation, besides reducing blood pressure, would promote an improvement in vascular reactivity and consequent improvement of macro and microcirculation.
The present study aimed to investigate the influence of the renal sympathetic denervation on the skin microvascular function of patients presenting with resistant arterial hypertension.
Detailed Description
Arterial hypertension is still a serious public health problem with considerable social and economic impact. Arterial hypertension is the result from a complex interaction between environmental and genetic factors that initiate and perpetuate elevated blood pressure. Studies show that about 10% of patients undergoing treatment have resistant hypertension, defined as high blood pressure refractory to at least three antihypertensive drugs. It is known that the sympathetic nervous system plays a fundamental role in the pathophysiology of hypertension, contributing to metabolic and vascular changes. The sympathetic nervous system has also a major role in the pathophysiology of arterial hypertension. Arterial hypertension has also been associated with functional microcirculatory alterations as well as systemic microvascular endothelial dysfunction in hypertensive patients, confirmed by different microcirculatory flowmetry techniques. In this context, it has been proposed that the modulation of the sympathetic nervous system through renal sympathetic denervation, besides reducing blood pressure, would promote an improvement in vascular reactivity and consequent improvement of macro and microcirculation. The present study aimed to investigate the influence of the renal sympathetic denervation on the skin microvascular function of patients with resistant hypertension.
Investigators
Eduardo Tibirica, MD, PhD
MD, PhD
National Institute of Cardiology, Laranjeiras, Brazil
Eligibility Criteria
Inclusion Criteria
- •Resistant arterial hypertension under pharmacological treatment
Exclusion Criteria
- •secondary arterial hypertension
- •renal dysfunction
- •severe kidney disease
- •congestive heart failure
Outcomes
Primary Outcomes
Cutaneous microvascular reactivity
Time Frame: Before and one, three, six and twelve months after intervention
Evaluation of microvascular reactivity using laser speckle contrast imaging
Cutaneous microvascular flow
Time Frame: Before and one, three, six and twelve months after intervention
Evaluation of the microvascular flow using laser speckle contrast imaging
Secondary Outcomes
- Cutaneous capillary density(Before and one, three, six and twelve months after intervention)