Randomized Blinded Placebo-Controlled Trials of Renal Sympathetic Denervation for Hypertension: A Meta-Analysis

• Published in: Cardiovascular revascularization medicine 2022-01, Vol.34, p.112-118
• Main Authors: Ahmad, Yousif, Kane, Christopher, Arnold, Ahran D., Cook, Christopher M., Keene, Daniel, Shun-Shin, Matthew, Cole, Graham, Al-Lamee, Rasha, Francis, Darrel P., Howard, James P.
• Format: Article
• Language: English
• Subjects: Antihypertensive Agents - therapeutic use; Blood Pressure; Clinical; Denervation; Humans; Hypertension; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - surgery; Kidney; Meta-analysis; Randomized Controlled Trials as Topic; Renal denervation; Sympathectomy - adverse effects; Sympathectomy - methods; Treatment Outcome
• ISSN: 1553-8389; 1878-0938; 1878-0938
• DOI: 10.1016/j.carrev.2021.01.031

The efficacy of renal denervation has been controversial, but the procedure has now undergone several placebo-controlled trials. New placebo-controlled trial data has recently emerged, with longer follow-up of one trial and the full report of another trial (which constitutes 27% of the total placebo-controlled trial data). We therefore sought to evaluate the effect of renal denervation on ambulatory and office blood pressures in patients with hypertension. We systematically identified all blinded placebo-controlled randomized trials of catheter-based renal denervation for hypertension. The primary efficacy outcome was ambulatory systolic blood pressure change relative to placebo. A random-effects meta-analysis was performed. 6 studies randomizing 1232 patients were eligible. 713 patients were randomized to renal denervation and 519 to placebo. Renal denervation significantly reduced ambulatory systolic blood pressure (−3.52 mmHg; 95% CI −4.94 to −2.09; p