Title
Renal denervation for uncontrolled and resistant hypertension: Systematic review and network meta-analysis of randomized trials
Date Issued
02 February 2021
Access level
open access
Resource Type
journal article
Author(s)
Silverwatch J.
Marti K.E.
Phan M.T.
Amin H.
Pasupuleti V.
Banach M.
Publisher(s)
MDPI
Abstract
Comparative efficacy and safety of renal denervation (RDN) interventions for uncontrolled (UH) and resistant hypertension (RH) is unknown. We assessed the comparative efficacy and safety of existing RDN interventions for UH and RH. Six search engines were searched up to 1 May 2020. Primary outcomes were mean 24-h ambulatory and office systolic blood pressure (SBP). Secondary outcomes were mean 24-h ambulatory and office diastolic blood pressure (DBP), clinical outcomes, and serious adverse events. Frequentist random-effects network meta-analyses were used to evaluate effects of RDN interventions. Twenty randomized controlled trials (RCTs) (n = 2152) were included, 15 in RH (n = 1544) and five in UH (n = 608). Intervention arms included radiofrequency (RF) in main renal artery (MRA) (n = 10), RF in MRA and branches (n = 4), RF in MRA+ antihypertensive therapy (AHT) (n = 5), ultrasound (US) in MRA (n = 3), sham (n = 8), and AHT (n = 9). RF in MRA and branches ranked as the best treatment to reduce 24-h ambulatory, daytime, and nighttime SBP and DBP versus other interventions (p-scores: 0.83 to 0.97); significant blood pressure effects were found versus sham or AHT. RF in MRA+AHT was the best treatment to reduce office SBP and DBP (p-scores: 0.84 and 0.90, respectively). RF in MRA and branches was the most efficacious versus other interventions to reduce 24-h ambulatory SBP and DBP in UH or RH.
Start page
1
End page
14
Volume
10
Issue
4
Language
English
OCDE Knowledge area
Urología, Nefrología
Sistema cardiaco, Sistema cardiovascular
Subjects
Scopus EID
2-s2.0-85114073708
Source
Journal of Clinical Medicine
ISSN of the container
20770383
Sources of information:
Directorio de Producción Científica
Scopus