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Abstract: PO1762

Clinical Event Reductions in Hypertension Patients with and Without CKD Treated with Renal Denervation: A Model-Based Estimate Based on Data from the Global SYMPLICITY Registry

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention


  • Schmieder, Roland E., Universitatsklinikum Erlangen, Erlangen, Bayern, Germany
  • Mahfoud, Felix, Universitat des Saarlandes, Saarbrucken, Saarland, Germany
  • Williams, Bryan, University College London, London, London, United Kingdom
  • Mancia, Giuseppe, Universita degli Studi di Milano-Bicocca, Milano, Lombardia, Italy
  • Narkiewicz, Krzysztof, Gdanski Uniwersytet Medyczny, Gdansk, Poland
  • Ruilope, Luis M., Facultad de Ciencias Medicas 10 de Octubre, La Habana, La Habana, Cuba
  • Schlaich, Markus P., The University of Western Australia, Perth, Western Australia, Australia
  • Böhm, Michael, Universitat des Saarlandes, Saarbrucken, Saarland, Germany
  • Pietzsch, Jan B., Wing Tech, Inc., Menlo Park, California, United States

Estimates of clinical event reductions following renal denervation (RDN) were modelled for patients with and without chronic kidney disease (CKD) based on 3-year follow-up data from the Global SYMPLICITY Registry (GSR).


CKD (eGFR<60 ml/min/1.73m2; n=630) and No CKD (eGFR ≥60 ml/min/1.73m2; n=1,860) cohorts of the GSR were analyzed. Reductions in office systolic blood pressure (oSBP) at 6, 12, 24, and 36 months follow-up were averaged and relative risks (RR) for death, cardiovascular (CV) death, myocardial infarction (MI), stroke, and new-onset end-stage renal disease (ESRD) were obtained from published meta-regression analysis of randomized trials of blood pressure lowering in hypertensive patients. Using the derived RRs, clinical event estimates for maintained baseline oSBP were calculated, facilitating estimation of 36-month absolute event reductions and resulting numbers needed to treat (NNT) for the individual endpoints.


Baseline oSBP and oSBP reductions for the CKD and No CKD cohorts were 163.6 ± 25.7; -11.1 and 166.7 ± 24.6; -15.5 mmHg, respectively. RR ranged from 0.65 for stroke in the No CKD cohort to 0.93 for death in the CKD cohort. There was a numerically higher absolute reduction in major adverse cardiac events (MACE: composite of CV death, MI and stroke) within 3 years of RDN treatment in the CKD vs. No CKD patients (4.0% vs. 3.2%, p=0.12), in part due to higher overall 3-year MACE rates observed in CKD patients (18.8% vs. 11.7%, p<0.001) (Table).


Model-based projections provide a directional estimate of the potential clinical events avoided following RDN treatment and suggest clinically meaningful risk reduction in patients with and without CKD.

Observed and projected events for the CKD and No CKD cohorts
GSR-observed (36M)Calculated RRCalculated control (BL oSBP)Calculated NNTGSR-observed (36M)Calculated RRCalculated control (BL oSBP)Calculated NNT
CV death5.2%0.875.9%1312.2%0.832.6%229
New-onset ESRD6.4%0.926.9%1850.2%0.910.3%4,170

BL: baseline; 36M: 36 months


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