Effects of Catheter-Based Renal Denervation in Hypertension: A Systematic Review and Meta-Analysis
Authors' conclusion
RDN safely reduces ambulatory and office systolic blood pressure/diastolic blood pressure versus a sham procedure in the presence and absence of antihypertensive medications.
Study context
- Population
- Patients with hypertension, off or on antihypertensive treatment
- Participants
- 2,478 patients10 RCTs
- Comparison
- Renal denervation (RDN) vs sham
- Outcome
- 24-hour and office SBP and DBP reduction, RDN vs sham
Methodological detailssham-controlled, study-level, pairwise, random-effects
- Sham-controlled
- Study-level
- Pairwise
- Random-effects
Pooled result
As reported in the abstract
RDN vs ShamDifference, mm Hg (95% CI)P value
24-hour SBP reduction
4.4(2.7–6.1)
P < 0.00001Office SBP reduction
6.6(3.6–9.7)
P < 0.000124-hour DBP
−2.6(−3.6 to −1.5)
P < 0.00001Office DBP
−3.5(−5.4 to −1.6)
P = 0.0003Further pooled results
24-hour and office SBP reduction, trials with vs without concomitant antihypertensive medication
- No difference (24-hour SBP)
- P for interaction, 0.62
- No difference (office SBP)
- P for interaction, 0.73
Safety
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Vascular complications, renal artery stenosis, hypertensive crisis, all-cause deathRDNvs ShamVascular complications | 1.69 (0.57–5.0) | P = 0.34 | |
| Vascular complications, renal artery stenosis, hypertensive crisis, all-cause deathRDNvs ShamRenal artery stenosis | 1.50 (0.06–36.97) | P = 0.80 | |
| Vascular complications, renal artery stenosis, hypertensive crisis, all-cause deathRDNvs ShamHypertensive crisis | 0.65 (0.30–1.38) | P = 0.26 | |
| Vascular complications, renal artery stenosis, hypertensive crisis, all-cause deathRDNvs ShamAll-cause death | 1.76 (0.34–9.20) | P = 0.50 | |
| 0.050.21520Odds ratio (log scale) |
Change in renal function (eGFR)
- Comparable between groups
- P for interaction, 0.84
Original publication
Effects of Catheter-Based Renal Denervation in Hypertension: A Systematic Review and Meta-Analysis. Circulation. Published 2 October 2024. doi:10.
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