Differences in patient and physician perspectives on pharmaceutical therapy and renal denervation for the management of hypertension

J Hypertens. 2021 Jan;39(1):162-168. doi: 10.1097/HJH.0000000000002592.

Abstract

Objective: To study patient and physician attitudes to pharmaceutical therapy and renal denervation for the management of hypertension.

Methods: Data were analyzed from 19 market research studies in Western Europe and the United States conducted between 2010 and 2019 to obtain quantitative and qualitative perspectives. The analysis incorporated insights from 2768 patients and the experiences of 1902 physicians either actively performing or interested to perform device procedures, or hypertension specialists who would refer patients for a device-based intervention.

Results: Referring cardiologists and proceduralists were more likely to recommend the renal denervation procedure to patients with higher BP levels and a greater number of antihypertensive medications. Physicians perceived patient reluctance towards a procedure as an important obstacle to recommending renal denervation as a treatment option for uncontrolled hypertension. Patient interest in the renal denervation procedure did not correlate with BP severity (P = NS), and the highest preference for the procedure was in patients diagnosed with hypertension but not receiving treatment (P < 0.001). Patients who perceived high BP as a major problem (P = 0.029) and those who experienced side effects attributed to their BP medications (P = 0.006) had a higher preference for renal denervation.

Conclusion: Patients with hypertension often regard the choice of renal denervation to lower BP differently from physicians. A considerable proportion of hypertensive patients, especially those not taking medications, may prefer a device-based approach to reduce their BP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antihypertensive Agents / pharmacology
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure
  • Denervation
  • Humans
  • Hypertension* / drug therapy
  • Hypertension* / surgery
  • Kidney
  • Pharmaceutical Preparations*
  • Physicians*
  • Sympathectomy
  • Treatment Outcome

Substances

  • Antihypertensive Agents
  • Pharmaceutical Preparations