Gender differences in left ventricular hypertrophy regression after renal denervation in patients with resistant hypertension

Purpose. To study the regression of left ventricular hypertrophy (LVH) in men and women with resistant hypertension (RH) after renal denervation (RDN).

Material and Methods. A total of 84 patients (50% men) with RH were enrolled in the study after signing informed consent. Renal denervation was performed in all patients. Initially and at 6 and 12 months after treatment, patients underwent careful examination. These analyses included office blood pressure (BP) measurement, transthoracic echocardiography (TTE) study with assessments of the left ventricular (LV) wall thickness and LV mass (LVM), and cardiac magnetic resonance (CMR) imaging.

Results. Groups of men and women were comparable in regard to office BP, age, number of administered antihypertensive drugs, and the number of radiofrequency energy applications for RDN. The LVM in the male group was significantly higher than in women due to anatomy differences. According to echocardiography data, the rate of LVH was insignificantly higher in women: 90% in women versus 76% in men, χ² = 0.079. In the presence of a significant and comparable BP reduction, significant regression in the values interventricular wall thickness (by 4.4%, р=0.039) and LVM (by 9.5%, р=0.044) was found in men one year after RND according to data of echocardiography. According to CMR according to CMR, LVM decreased by 11.9% at six months (р=0.039) and by 22.9% at 12 months (р=0.026) after RND. However, no significant changes in LVM were found in women. The extent of LVM regression did not depend on the antihypertensive effect of RDN in either group.

Conclusion. The frequency of LVH was insignificantly higher in women than in men: 90% in women versus 76% in men. One year after RDN, LVH significantly regressed in men, but not in women, and did not depend on degree of BP reduction.

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