Adherence to Antihypertensive Treatment and the Blood Pressure–Lowering Effects of Renal Denervation in the Renal Denervation for Hypertension (DENERHTN) Trial

• DOI: 10.1161/circulationaha.116.022922
• Publication Date: 2016-08-31T01:23:15Z
• Authors: Michel Azizi; Helena Pereira; Idir Hamdidouche; Philippe Gosse; Matthieu Monge; Guillaume Bobrie; Pascal Delsart; Claire Mounier-Vé...; Pierre-Yves Courand; Pierre Lantelme; Thierry Denolle; Caroline Dourmap-...; Xavier Girerd; Jean Michel Halimi; Faiez Zannad; Olivier Ormezzano; Bernard Vaïsse; Daniel Herpin; Jean Ribstein; Bernard Chamontin; Jean-Jacques Mourad; Emile Ferrari; Pierre-François P...; Vincent Jullien; Marc Sapoval; Gilles Chatellier; L. Amar; A. Lorthioir; J.-Y. Pagny; G. Claisse; M. Midulla; R. Dauphin; J.P. Fauvel; O. Rouvière; A. Cremer; N. Grenier; Y. Lebras; H. Trillaud; J.F. Heautot; A. Larralde; F. Paillard; P. Cluzel; D. Rosenbaum; D. Alison; M. Claudon; B. Popovic; P. Rossignol; J.P. Baguet; F. Thony; J.M. Bartoli; J. Drouineau; P. Sosner; J.P. Tasu; S. Velasco; H. Vernhet-Kovacsik; B. Bouhanick; H. Rousseau; S. Le Jeune; M. Lopez-Sublet; L. Bellmann; V. Esnault; J.P. Baguet; H. Vernhet-Kovacsik; I. Durand-Zaleski; J.P. Beregi (chair); M. Lièvre; A. Persu
• Keywords: Irbesartan; Amlodipine; Antihypertensive drug; Indapamide

Background: The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure–lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment resistant hypertension at 6 months. We report influence adherence on pressure control. Methods: One hundred six patients with 4 weeks indapamide 1.5 mg/d, ramipril 10 mg/d (or irbesartan 300 mg/d), and amlodipine were randomly assigned plus treatment, or same alone. For spironolactone 25 bisoprolol prazosin 5 rilmenidine 1 sequentially monthly visits if home was ≥135/85 mm Hg after randomization. assessed months by drug screening in urine/plasma samples from 85 patients. Results: numbers fully adherent (20/40 versus 21/45), partially nonadherent (13/40 20/45), completely (7/40 4/45) not different control groups, respectively ( P =0.3605). difference change daytime ambulatory systolic baseline between 2 groups –6.7 =0.0461) –7.8 =0.0996) (partially nonadherent) between-patient variability greater than Conclusions: In trial, prevalence nonadherence drugs high (≈50%) but groups. Regardless resulted decrease Clinical Trial Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT01570777.