High nighttime and early morning blood pressure (BP) have been associated with greater risk for cardiovascular events than high clinic or daytime BP. BP is typically highest in the rising hours, when morning activities typically begin. We examined the effect of renal denervation on morning (6:00-8:59 AM), daytime (9:00 AM-8:59 PM), and nighttime (1:00-5:59 AM) ambulatory BP. @entity1 data from 2 prospective, randomized controlled trials of @entity1 with treatment-resistant, uncontrolled @entity101 , one conducted in a US population (Renal Denervation in @entity1 With Uncontrolled Hypertension [SYMPLICITY @entity29073 ]) and the other in a Japanese population (SYMPLICITY HTN-Japan [HTN-Japan]), were analyzed. @entity1 in SYMPLICITY @entity29073 and HTN-Japan were prescribed a similar number of baseline antihypertensive medications (5.2  1.4 versus 4.9  1.6, P=0.28), but the classes prescribed and changes in prescription varied by study. Among @entity1 treated with renal denervation, although the number of ablation treatments were similar in both studies (11.2  2.8 versus 11.5  1.9, P=0.55), @entity1 in SYMPLICITY @entity29073 were less likely to receive at least 1 four-quadrant ablation treatment (25% versus 82%, P<0.001). In SYMPLICITY @entity29073 , compared with controls (n=159), @entity1 treated with renal denervation (n=325) experienced a significantly greater change in morning (-7.3  19.8 mm Hg, P<0.001) and nighttime (-6.1  18.2 versus -1.6  19.7 mm Hg, P=0.02) but not daytime systolic BP (-7.2  16.2 versus -6.4  18.6 mm Hg, P=0.67). This same trend was observed in the pooled analysis with HTN-Japan. Reduction of BP during these high-risk periods might provide cardiovascular protection in drug-resistant @entity101 @entity1 , although this will need to be proved in future randomized trials. CLINICAL TRIAL REGISTRATION: URL: www.clinicaltrials.gov; Unique identifiers: NCT01418261 (SYMPLICITY @entity29073 ) and NCT01644604 (HTN-Japan).

Effect of Catheter-Based Renal Denervation on Morning and Nocturnal Blood Pressure: Insights From SYMPLICITY XXXX and SYMPLICITY HTN-Japan.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'Patient'] @entity29073 :: ('3347', 'Gene') :: ['HTN-3'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension', 'hypertensive']
@entity29073 :: (3347,Gene) :: ['HTN-3']
