Arterial Hypertension, Resistant Arterial Hypertension
Conditions
Keywords
Arterial hypertension, Microcirculation, Sympathetic nervous system
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.
Interventions
PROCEDURERenal sympathetic denervation
Transcutaneous renal sympathetic denervation
Sponsors
National Institute of Cardiology, Laranjeiras, Brazil
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Inclusion criteria
* Resistant arterial hypertension under pharmacological treatment
Exclusion criteria
* secondary arterial hypertension * renal dysfunction * severe kidney disease * congestive heart failure
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cutaneous microvascular reactivity | Before and one, three, six and twelve months after intervention | Evaluation of microvascular reactivity using laser speckle contrast imaging |
| Cutaneous microvascular flow | Before and one, three, six and twelve months after intervention | Evaluation of the microvascular flow using laser speckle contrast imaging |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cutaneous capillary density | Before and one, three, six and twelve months after intervention | Evaluation of cutaneous capillary density and reactivity using video-capillaroscopy |
Countries
Brazil
Outcome results
None listed