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.
机构:
Univ Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USAUniv Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USA
Mufarrih, Syed Hamza
Qureshi, Nada Qaisar
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Univ Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USAUniv Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USA
Qureshi, Nada Qaisar
Khan, Mohammed Saud
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Univ Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USAUniv Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USA
Khan, Mohammed Saud
Kazimuddin, Mohammed
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Univ Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USAUniv Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USA
Kazimuddin, Mohammed
Secemsky, Eric
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机构:
Beth Israel Deaconess Med Ctr, Harvard Med Sch, Dept Med, Div Cardiovasc Med, Boston, MA USAUniv Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USA
Secemsky, Eric
Bloch, Michael J.
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机构:
Renown Inst Heart & Vasc Hlth, Vasc Care, Reno, NV USA
Univ Nevada, Reno Sch Med, Dept Med, Div Cardiovasc Dis, Reno, NV USAUniv Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USA
Bloch, Michael J.
Giri, Jay
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Univ Penn, Perelman Sch Med, Dept Med, Div Cardiovasc Dis, Philadelphia, PA USAUniv Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USA
Giri, Jay
Cohen, Debbie
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机构:
Univ Penn, Perelman Sch Med, Dept Med, Div Nephrol, Philadelphia, PA USAUniv Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USA
Cohen, Debbie
Swaminathan, Rajesh V.
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Duke Univ, Duke Clin Res Inst, Dept Med, Div Cardiovasc Med,Med Ctr, Durham, NC USAUniv Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USA
Swaminathan, Rajesh V.
Feldman, Dmitriy N.
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机构:
Weill Cornell Med Coll, Dept Med, Div Cardiovasc Med, New York, NY USAUniv Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USA
Feldman, Dmitriy N.
Alaswad, Khaldoon
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Henry Ford Hlth, Dept Med, Div Cardiovasc Med, Detroit, MI USAUniv Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USA
Alaswad, Khaldoon
Kirtane, Ajay
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Columbia Univ, Dept Med, Div Cardiovasc Med, Irving Med Ctr, New York, NY USAUniv Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USA
Kirtane, Ajay
Kandzari, David
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Dept Med, Div Cardiovasc Med, Piedmont Healthcare, Atlanta, GA USAUniv Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USA
Kandzari, David
Aronow, Herbert D.
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Henry Ford Hlth, Dept Med, Div Cardiovasc Med, Detroit, MI USAUniv Kentucky, Dept Internal Med, Div Cardiovasc Med, Bowling Green, KY USA
Aronow, Herbert D.
JOURNAL OF THE AMERICAN HEART ASSOCIATION,
2024,
13
(16):
机构:
Sinai Hosp Baltimore, Dept Med, 2401 W Belvedere Ave, Baltimore, MD 21215 USASinai Hosp Baltimore, Dept Med, 2401 W Belvedere Ave, Baltimore, MD 21215 USA
Singh, Sahib
Rout, Amit
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机构:
Univ Louisville, Div Cardiol, Louisville, KY USASinai Hosp Baltimore, Dept Med, 2401 W Belvedere Ave, Baltimore, MD 21215 USA
Rout, Amit
Garg, Aakash
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St Peters Hlth Partners, Cardiol Associates Schenectady, New York, NY USASinai Hosp Baltimore, Dept Med, 2401 W Belvedere Ave, Baltimore, MD 21215 USA