Study on ultrasound-guided renal denervation combined with losartan in the treatment of obesity-related hypertension

Xie Jianrong; Lei Xingwang; Tan Shuangxiu; Jiang Xiujuan

doi:10.3969/j.issn.1674-3245.2025.03.010

Abstract：Objective To investigate the clinical efficacy and safety of ultrasound-guided renal denervation combined with losartan in the treatment of obesity-related hypertension.Methods 120 obesity-related hypertensive patients admitted to our hospital from October 2023 to July 2024 were randomly divided into control group(n=60)and observation group(n=60)according to random number table method.The control group was treated with losartan,and the observation group was treated with ultrasound-guided renal denervation on the basis of the control group.Blood pressure(systolic and diastolic blood pressure,24-hour dynamic systolic and diastolic blood pressure)was compared between the two groups before treatment and 3 months after treatment,and body mass index(BMI)and sympathetic nerve activity(plasma norepinephrine level)were compared between the two groups before treatment,1 month and 3 months after treatment.Renal function indicators(serum creatinine,urea nitrogen and glomerular filtration rate)and quality of life(SF-36)were compared before treatment and 3 months after treatment,and adverse reactions were recorded between the two groups during treatment.Results After three months of treatmen,compared with the control group,SBP,DBP,24h-ABPM SBP and 24h-ABPM DBP in observation group were lower after treatment(t=3.328,4.586,4.979 and 5.506,P＜0.001).At 1 month and 3 months,the BMI of the observation group was lower than those of the control group(t=4.397,6.569,P＜0.05).Plasma norepinephrine levels of the observation group were lower than those of the control group(t=6.536,10.067,P＜0.05).After 3 months of treatment,serum creatinine and urea nitrogen of the observation group were(85.37±7.87)μmol/L and(5.27±0.84)mmol/L,respectively,which were lower than those of the control group(92.61±9.59)μmol/L and(6.08±0.97)mmol/L(t=4.521,4.890,P＜0.05);The glomerular filtration rate was(95.87±12.27)mL/min,which was higher than that of the control group(91.15±11.27)mL/min(t=2.194,P＜0.05).Three months after treatment,the SF-36 score of the observation groupwas,higher than that of the control groups(85.29±13.37 vs 79.84±12.25,t=2.328,P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(8.34％vs.10.02％)(x2=0.100,P=0.752).Conclusion Ultrasound-guided renal denervation combined with losartan is effective in the treatment of obesity hypertension,which can effectively reduce blood pressure and improve renal function without increasing procedural risks.