Evaluation of the efficacy of adrenergic neurons inhibition through various surgical and therapeutic regimens on controlling blood pressure and circadian rhythm in patients with uncontrolled hypertension

Hany Akeel Al-Hussaniy; Ali Anwar Al-kuraishy; Husam Jamal Jalil

doi:10.5281/zenodo.7434813

Authors

Hany Akeel Al-Hussaniy Faculty of Pharmacy, Bilad Alrafidain University College, Diyala, 32001, Iraq https://orcid.org/0000-0003-2647-8574
Ali Anwar Al-kuraishy Department of Surgery, Al-Karama Hospital, Baghdad Health Department, Karkh, Iraq https://orcid.org/0000-0001-6817-0223
Husam Jamal Jalil Department of Surgery, Al-Karama Hospital, Baghdad Health Department, Karkh, Iraq https://orcid.org/0000-0003-3772-2253

DOI:

https://doi.org/10.5281/zenodo.7434813

Keywords:

Adrenergic blockers, renal denervation, uncontrolled hypertension

Abstract

Objective: Resistant hypertension treatment is one of the most challenging medical issues that are difficult to treat, even nowadays with advanced medical techniques and advances, even combination therapy is not effective for resistant hypertension treatment or uncontrolled hypertension surgeons may give the resolving for this issue. Such a treatment is also Renal denervation – the technique developed ten years earlier that includes interrupting the renal adrenergic fibers efferent and afferent with radiofrequency energy. Using this technique, we wanted to know the effectiveness of blocking the adrenal activity by various therapeutic regimens in decreasing the variability of blood pressure and circadian diurnal profile in patients with resistant hypertension.

Materials and methods: A total of 80 patients with resistant HTN without comorbidities were enrolled in the study, these patients undergo surgical treatment of hypertension.

Results: The pathological profile "non-dipper" for NOCTURNAL blood pressure was documented in most patients at the initial stage: in group I -20 (80%), in group II -17 (68%), and in group III -19 (76%). After 3 months of evaluation, the number of subjects with this pathological profile increases in the treatment groups with Clonidine (21 (84%) patients) and Bisoprolol (19 (76% patients)) due to their rebound from the more aggressive profiles "night-picker" and "over-dipper", in the group treated by Renal denervation there was a reduction in this number (18 (72%) patients).

Conclusions: The data obtained have illustrated the antihypertensive efficacy of both medical and surgical treatment; however, renal denervation has a clearly superior effect.

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