Hypertension

Safety and Efficacy of Renal Denervation in Patients Taking Antihypertensive Medications

J Am Coll CardiolPublished Randomised controlled trial

Primary result · Change in mean 24-h ambulatory SBPResult — go to the resultTreatment difference −1.9 mm Hg 95% CI −4.4 to 0.5

Authors' conclusion

There was no significant difference between groups in the primary analysis. However, multiple secondary endpoint analyses favored RDN over sham control.

Study context

Population
Patients with uncontrolled hypertension prescribed 1 to 3 antihypertensive medications
Participants
206 vs 131
Comparison
Radiofrequency renal denervation (RDN) vs sham control procedure
  • RDNn = 206
  • Sham controln = 131reference
Primary endpoint
Baseline-adjusted change in mean 24-hour ambulatory SBP between groups
Follow-up
6 months
Methodological detailsprospective, sham-controlled, patient- and assessor-blinded, 56 clinical centers worldwide, Bayesian trial design
  • Prospective
  • Sham-controlled
  • Patient- and assessor-blinded
  • 56 clinical centers worldwide
  • Bayesian trial design

Primary result

Change in mean 24-h ambulatory SBP

Treatment difference

−1.9 mm Hg

95% CI −4.4 to 0.5

P = 0.12

Change by group

RDN

−6.5

mean change · ± 10.7 · mm Hg

Sham control

−4.5

mean change · ± 10.3 · mm Hg

RDN vs Sham control
treatment difference −1.9 mm Hg (95% CI −4.4 to 0.5); P = 0.12

As reported in the abstract

No significant difference between groups in the primary efficacy analysis (Bayesian); posterior probability of superiority
0.51
Bayesian treatment difference
−0.03 mm Hg [95% CI: −2.82 to 2.77 mm Hg]

Secondary outcomes

OutcomeAdjusted treatment difference (mm Hg)P value
Office SBP · 6 months−4.9P = 0.0015

Night-time blood pressure (BP) and win ratio

Night-time BP reductions and win ratio analysis favored RDN

Safety

Adverse safety events among 253 assessed patients
1

Original publication

Safety and Efficacy of Renal Denervation in Patients Taking Antihypertensive Medications. J Am Coll Cardiol. Published 7 November 2023. doi:10.1016/j.jacc.2023.08.045

Summarised from the published abstract; every number is checked against it

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