{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:14:07Z","timestamp":1788502447840,"version":"build-2803163510"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Renal denervation (RDN) has demonstrated blood pressure (BP) \u2013 lowering efficacy in resistant hypertension; however, response heterogeneity remains incompletely understood. Obesity is associated with sympathetic overactivity and may influence the BP response to RDN. We evaluated BP changes following Symplicity Spyral RDN in a real-world cohort stratified by obesity status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a retrospective single-center cohort study including patients with resistant hypertension who underwent radiofrequency RDN using the Symplicity Spyral system at Sabah Al-Ahmad Cardiac Center in Kuwait between March 2023 and August 2024. BP was assessed at baseline, immediate postprocedure, and at 6 months. The primary outcome was change in systolic and diastolic BP at 6 months and the comparison between obese and nonobese patients. Secondary outcomes included time to achieving BP targets and clinical predictors of target achievement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 50 patients underwent RDN (mean age: 61.7 years); 32 were obese, and 18 were nonobese. In the overall cohort, systolic BP (SBP) decreased from 163.7 \u00b1 24.6 mmHg at baseline to 129.4 \u00b1 13.5 mmHg at 6 months (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and diastolic BP decreased from 86.7 \u00b1 16.6 mmHg to 75.9 \u00b1 8.2 mmHg (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0004). Repeated measures analysis of covariance demonstrated significant SBP changes over time (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) with no overall between-group difference by obesity status; however, a significant time \u00d7 body mass index category interaction was observed for SBP (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.038). Kaplan\u2013Meier analysis showed a median time of 2 months to BP target achievement in both the groups. In multivariable logistic regression, dyslipidemia was independently associated with lower odds of BP target achievement (odds ratio: 0.17, 95% confidence interval: 0.03\u20130.80;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.036).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this real-world cohort, Symplicity Spyral RDN was associated with significant BP reduction at 6 months in both obese and nonobese patients. Obesity status did not appear to diminish overall BP-lowering efficacy, although SBP response trajectory differed over time. In exploratory multivariable analysis, dyslipidemia was associated with lower odds of BP target achievement<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/heartviews.heartviews_169_25","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:00:13Z","timestamp":1788501613000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Effect of Renal Denervation on Resistant Hypertension in Obese and Nonobese Patients: Insights from Kuwait"],"prefix":"10.4103","volume":"27","author":[{"given":"Yahya E.","family":"Alansari","sequence":"first","affiliation":[{"name":"Medical Department, College of Medicine, Kuwait University, Kuwait City, Kuwait"},{"name":"Sabah Al-Ahmad Cardiac Center, Ministry of Health, Kuwait City, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Alawadi","sequence":"additional","affiliation":[{"name":"Sabah Al-Ahmad Cardiac Center, Ministry of Health, Kuwait City, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Budour","family":"Almandeel","sequence":"additional","affiliation":[{"name":"Sabah Al-Ahmad Cardiac Center, Ministry of Health, Kuwait City, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nader","family":"Alasousi","sequence":"additional","affiliation":[{"name":"Sabah Al-Ahmad Cardiac Center, Ministry of Health, Kuwait City, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad A.","family":"Aljarallah","sequence":"additional","affiliation":[{"name":"Sabah Al-Ahmad Cardiac Center, Ministry of Health, Kuwait City, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Alsaber","sequence":"additional","affiliation":[{"name":"American University of Kuwait, Kuwait City, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Rajan","sequence":"additional","affiliation":[{"name":"Sabah Al-Ahmad Cardiac Center, Ministry of Health, Kuwait City, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1]]},"reference":[{"key":"R1-20260904","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1016\/S0140-6736(20)30752-2","article-title":"Global burden of 87 risk factors in 204 countries and territories, 1990\u20132019: A systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Murray","year":"2020","journal-title":"The lancet"},{"key":"R2-20260904","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1093\/eurheartj\/ehy339","article-title":"2018 ESC\/ESH guidelines for the management of arterial hypertension","volume":"39","author":"Williams","year":"2018","journal-title":"Eur Heart 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