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Catheter-based renal denervation in patients with uncontrolled hypertension in the absence of antihypertensive medications (SPYRAL HTN-OFF MED): a randomised, sham-controlled, proof-of-concept trial

Overview of attention for article published in The Lancet, August 2017
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (87th percentile)

Mentioned by

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23 news outlets
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106 tweeters
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1 Facebook page

Readers on

mendeley
64 Mendeley
Title
Catheter-based renal denervation in patients with uncontrolled hypertension in the absence of antihypertensive medications (SPYRAL HTN-OFF MED): a randomised, sham-controlled, proof-of-concept trial
Published in
The Lancet, August 2017
DOI 10.1016/s0140-6736(17)32281-x
Pubmed ID
Authors

Townsend, Raymond R, Mahfoud, Felix, Kandzari, David E, Kario, Kazuomi, Pocock, Stuart, Weber, Michael A, Ewen, Sebastian, Tsioufis, Konstantinos, Tousoulis, Dimitrios, Sharp, Andrew S P, Watkinson, Anthony F, Schmieder, Roland E, Schmid, Axel, Choi, James W, East, Cara, Walton, Anthony, Hopper, Ingrid, Cohen, Debbie L, Wilensky, Robert, Lee, David P, Ma, Adrian, Devireddy, Chandan M, Lea, Janice P, Lurz, Philipp C, Fengler, Karl, Davies, Justin, Chapman, Neil, Cohen, Sidney A, DeBruin, Vanessa, Fahy, Martin, Jones, Denise E, Rothman, Martin, Böhm, Michael, Aoki, Jiro, Batson, Bryan, Dangas, George, David, Shukri, Kandzari, David, Patel, Manesh, Patel, Kiritkumar, Singh, Jasvindar, Weber, Thomas, Weil, Joachim, Zeller, Thomas, Ziada, Khaled, Tanabe, Kengo, Wilkins, Robert, Contreras, Johanna, Steigerwalt, Susan, Reedus, Denise, Hoshide, Satoshi, Svetkey, Laura, Rao, Anjani, Brown, Angela, Suppan, Markus, Agdirlioglu, Tolga, Noory, Elias, Chasen, Craig, Raymond R Townsend, Felix Mahfoud, David E Kandzari, Kazuomi Kario, Stuart Pocock, Michael A Weber, Sebastian Ewen, Konstantinos Tsioufis, Dimitrios Tousoulis, Andrew S P Sharp, Anthony F Watkinson, Roland E Schmieder, Axel Schmid, James W Choi, Cara East, Anthony Walton, Ingrid Hopper, Debbie L Cohen, Robert Wilensky, David P Lee, Adrian Ma, Chandan M Devireddy, Janice P Lea, Philipp C Lurz, Karl Fengler, Justin Davies, Neil Chapman, Sidney A Cohen, Vanessa DeBruin, Martin Fahy, Denise E Jones, Martin Rothman, Michael Böhm, Jiro Aoki, Bryan Batson, George Dangas, Shukri David, David Kandzari, Manesh Patel, Kiritkumar Patel, Jasvindar Singh, Thomas Weber, Joachim Weil, Thomas Zeller, Khaled Ziada, Kengo Tanabe, Robert Wilkins, Johanna Contreras, Susan Steigerwalt, Denise Reedus, Satoshi Hoshide, Laura Svetkey, Anjani Rao, Angela Brown, Markus Suppan, Tolga Agdirlioglu, Elias Noory, Craig Chasen

Abstract

Previous randomised renal denervation studies did not show consistent efficacy in reducing blood pressure. The objective of our study was to evaluate the effect of renal denervation on blood pressure in the absence of antihypertensive medications. SPYRAL HTN-OFF MED was a multicentre, international, single-blind, randomised, sham-controlled, proof-of-concept trial. Patients were enrolled at 21 centres in the USA, Europe, Japan, and Australia. Eligible patients were drug-naive or discontinued their antihypertensive medications. Patients with an office systolic blood pressure (SBP) of 150 mm Hg or greater and less than 180 mm Hg, office diastolic blood pressure (DBP) of 90 mm Hg or greater, and a mean 24-h ambulatory SBP of 140 mm Hg or greater and less than 170 mm Hg at second screening underwent renal angiography and were randomly assigned to renal denervation or sham control. Patients, caregivers, and those assessing blood pressure were blinded to randomisation assignments. The primary endpoint, change in 24-h blood pressure at 3 months, was compared between groups. Drug surveillance was done to ensure patient compliance with absence of antihypertensive medication. The primary analysis was done in the intention-to-treat population. Safety events were assessed at 3 months. This study is registered with ClinicalTrials.gov, number NCT02439749. Between June 25, 2015, and Jan 30, 2017, 353 patients were screened. 80 patients were randomly assigned to renal denervation (n=38) or sham control (n=42) and followed up for 3 months. Office and 24-h ambulatory blood pressure decreased significantly from baseline to 3 months in the renal denervation group: 24-h SBP -5·5 mm Hg (95% CI -9·1 to -2·0; p=0·0031), 24-h DBP -4·8 mm Hg (-7·0 to -2·6; p<0·0001), office SBP -10·0 mm Hg (-15·1 to -4·9; p=0·0004), and office DBP -5·3 mm Hg (-7·8 to -2·7; p=0·0002). No significant changes were seen in the sham-control group: 24-h SBP -0·5 mm Hg (95% CI -3·9 to 2·9; p=0·7644), 24-h DBP -0·4 mm Hg (-2·2 to 1·4; p=0·6448), office SBP -2·3 mm Hg (-6·1 to 1·6; p=0·2381), and office DBP -0·3 mm Hg (-2·9 to 2·2; p=0·8052). The mean difference between the groups favoured renal denervation for 3-month change in both office and 24-h blood pressure from baseline: 24-h SBP -5·0 mm Hg (95% CI -9·9 to -0·2; p=0·0414), 24-h DBP -4·4 mm Hg (-7·2 to -1·6; p=0·0024), office SBP -7·7 mm Hg (-14·0 to -1·5; p=0·0155), and office DBP -4·9 mm Hg (-8·5 to -1·4; p=0·0077). Baseline-adjusted analyses showed similar findings. There were no major adverse events in either group. Results from SPYRAL HTN-OFF MED provide biological proof of principle for the blood-pressure-lowering efficacy of renal denervation. Medtronic.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 64 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 64 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 14 22%
Other 12 19%
Student > Master 7 11%
Student > Bachelor 6 9%
Student > Ph. D. Student 6 9%
Other 19 30%
Readers by discipline Count As %
Medicine and Dentistry 43 67%
Unspecified 14 22%
Agricultural and Biological Sciences 2 3%
Neuroscience 2 3%
Arts and Humanities 1 2%
Other 2 3%

Attention Score in Context

This research output has an Altmetric Attention Score of 235. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 April 2018.
All research outputs
#36,863
of 9,723,598 outputs
Outputs from The Lancet
#610
of 26,048 outputs
Outputs of similar age
#2,392
of 253,625 outputs
Outputs of similar age from The Lancet
#50
of 402 outputs
Altmetric has tracked 9,723,598 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 26,048 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 30.8. This one has done particularly well, scoring higher than 97% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 253,625 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 402 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 87% of its contemporaries.