Eva Kociánová, Jan Václavík, Miloš Táborský, Monika Kamasová, David Richter, Albert Louis, Tomáš Václavík, Jiří Jarkovský
Introduction: At present there are just few data on which procedure should be used in treatment of patients with renal hypertension. The aim of the work is to compare catheter-based renal denervation or addition of spironolactone for affection of blood pressure (BP). Methodology: Retrospectively we compared 2 cohorts of patients with resistant arterial hypertension treated by both methods. The efficacy of spironolactone after 8 weeks of treatment was evaluated in comparison with placebo in 150 patients who completed observation within the randomized study ASPIRANT-EXT. Efficacy of catheter-based renal denervation was evaluated in 19 patients who completed minimum 6-month monitoring after a denervation realised in our department. Results: The average decrease of BP after addition of spironolactone was 17.6/7.4 mm Hg, after renal denervation 16.3/6.7 mm Hg. The average decrease of BP in the out-patient monitoring was after spironolactone 12.6/5.5 mm Hg, after renal denervation 7.9/3.6 mm Hg. Conclusion: Addition of spironolactone in patients with resistant arterial hypertension leads in our clinical practice to more marked decrease of blood pressure than in catheter-based renal denervation, especially in ambulatory monitoring.