Abstract:Objective: To investigate the effect of renal sympathetic denervation (RDN) on the morning blood pressure surge in patients with primary hypertension. Methods: A total of 161 patients diagnosed with hypertension in our hospital from January 2017 to June 2019 were collected in this study. According to levels of the morning blood pressure surge, the patients were divided into the morning blood pressure surge group and non-morning blood pressure surge group. All patients were treated with RDN. The morning blood pressure surge before treatment and 1 d, 3 d, 7 d, 1 month, 6 months and 12 months after treatment of the two groups, and 24 h average systolic blood pressure and diastolic blood pressure; the renal function indicators [blood urea nitrogen (BUN), creatinine (Cr), estimated glomerular filtration rate (eGFR)] before treatment and 1 month after treatment; the quality of life before and 6 months after surgery [the short form 36 health survey (SF-36)]; and adverse reactions after surgery were recorded and compared within the 2 groups. Results: Before the treatment, compared with the non-morning blood pressure surge group, the BUN and Cr were significantly increased (P<0.05), and the eGFR was significantly decreased (P<0.05) in the morning blood pressure surge group. After the treatment, the BUN and Cr were significantly reduced (P<0.05), the eGFR was increased (P<0.05) in both groups. There was no significant differences in BUN, Cr and eGFR between the 2 groups (P>0.05). Before treatment, compared with the non-morning blood pressure surge group, the morning blood pressure surge, systolic and diastolic blood pressure of the morning blood pressure surge group were significantly higher (P<0.05). After treatment, the morning blood pressure surge, systolic and diastolic blood pressure of 2 groups were significantly reduced (P<0.05). There was no significant differences in the morning blood pressure surge, systolic and diastolic blood pressure between the 2 groups (P>0.05). Before treatment, compared with the non-morning blood pressure surge group, the SF-36 of the morning blood pressure surge group was significantly reduced (P<0.05). After treatment, the SF-36 of 2 groups were significantly increased (P<0.05). There was no significant differences in the SF-36 between 2 groups (P>0.05). Both groups were followed up for 12 months after the surgery, a few cases had renal artery stenosis and hematoma after RDN, which were cured after symptomatic treatment. Conclusion: RDN can effectively reduce the morning blood pressure surge, systolic and diastolic blood pressure in hypertension patients, and significantly improve the renal function and quality of life for them.
