Retinal microperfusion after renal denervation in treatment-resistant hypertensive patients

Clin Res Cardiol. 2015 Sep;104(9):782-9. doi: 10.1007/s00392-015-0845-0. Epub 2015 Apr 28.


Background: High pulsatile pressure and flow in the arteries causes microvascular damage, and hence increased cardio-, and cerebrovascular complications. With advanced stages of hypertensive disease, an exaggerated pulsatile retinal capillary flow (RCF) has been shown, but data about interventional effect are missing.

Methods: Fifty-one patients with true treatment-resistant hypertension (TRH) underwent renal denervation (RDN) using the Symplicity Flex(™) catheter and were followed for 12 months. RCF was assessed non-invasively using Scanning laser Doppler flowmetry (SLDF) before, 6 (6 M), and 12 (12 M) months after RDN. RCF was measured in systole and diastole and pulsed RCF (difference of RCF in systole minus diastole) was calculated. In addition, flicker light-induced vasodilation (representing vasodilatory capacity) was assessed.

Results: Systolic and diastolic office blood pressure (BP) as well as 24-h ABPM decreased significantly 6 M and 12 M after RDN, compared to baseline values (all p < 0.001). There was a significant reduction of pulsed RCF 6 M (231 ± 81 versus 208 ± 68 AU, p = 0.046) and 12 M (194 ± 72 AU, p = 0.001) after RDN, whereas the mean RCF was unchanged. Moreover, there was a significant increase of flicker light-induced vasodilation after RDN (p = 0.043).

Conclusion: In hypertensive patients with TRH, we observed a decrease of pulsed RCF 6 M and 12 M after RDN and an increase of vasodilatory capacity, in parallel to decreases in BP and heart rate. The reduction of pulsed RCF after RDN implies a decrease of shear stress on the vascular wall by the pulsed blood flow. This and the increment of vasodilatory capacity suggest an improvement of retinal (and potentially cerebral) microcirculation.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use
  • Autonomic Denervation*
  • Blood Flow Velocity
  • Blood Pressure Monitoring, Ambulatory
  • Blood Pressure* / drug effects
  • Capillaries / physiopathology*
  • Drug Resistance
  • Female
  • Heart Rate
  • Humans
  • Hypertension / diagnosis
  • Hypertension / physiopathology
  • Hypertension / surgery*
  • Kidney / innervation*
  • Laser-Doppler Flowmetry
  • Male
  • Microcirculation*
  • Middle Aged
  • Photic Stimulation
  • Pulsatile Flow
  • Regional Blood Flow
  • Retinal Vessels / physiopathology*
  • Time Factors
  • Treatment Outcome
  • Vasodilation


  • Antihypertensive Agents