Abstract: SA-PO348
Long-Term Efficacy of Renal Denervation in Patients with Resistant Hypertension: A Meta-Analysis of Randomized Controlled Trials
Session Information
- Hypertension, CVD, and the Kidneys: Clinical Research
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Menghrajani, Rajiv Hans Solita, Lincoln Medical Center, Bronx, New York, United States
- Almanzar, Mirtha Camila, Lincoln Medical Center, Bronx, New York, United States
- Matabang, Maria Angela, Lincoln Medical Center, Bronx, New York, United States
- Aparece, John Paul B., Texas Tech University Health Sciences Center El Paso, El Paso, Texas, United States
- Lerma, Edgar V., University of Illinois Chicago College of Medicine, Chicago, Illinois, United States
Background
Resistant hypertension, defined as blood pressure (BP) that remains elevated despite the concurrent use of three antihypertensive agents of different classes, represents a significant challenge in clinical practice. The persistent elevation of BP in these patients is associated with an increased risk of cardiovascular events and mortality. Renal denervation (RDN), a minimally invasive procedure targeting the sympathetic nerves within the renal arteries, has emerged as a promising intervention. This study aims to determine the long-term efficacy of RDN in controlling BP in patients with resistant hypertension.
Methods
Electronic databases were searched until March 2024. Three reviewers screened the abstracts, reviewed the full texts, and appraised the quality of the included studies using the PRISMA guidelines. The primary outcomes were decrease in systolic BP at 6 months and 36 months.
Results
Out of 145 articles retrieved, 15 RCTs were included in the meta-analysis (n = 1564). At 6 months, there was a mean difference of -2.24 mmHg [-4.65, 0.17] p = 0.07 in the ambulatory systolic BP, while the office-measured systolic BP showed a mean difference of -1.62 mmHg [-4.51, 1.26] p = 0.27. There is moderate heterogeneity for both the ambulatory and office-measured systolic BP, I2 = 61% and I2 = 42%, respectively.
At 36 months, there was a mean difference of -7.40 [-10.39, -4.41] p < 0.00001 in the ambulatory systolic BP, while there was a mean difference of -13.15 [-17.55, -8.76] p <0.00001 in the office measured systolic BP. The heterogeneity for both ambulatory and office-measured at 36 months was 0%.
Conclusion
RDN decreases office and ambulatory-measured systolic BP in resistant hypertension at both 6 and 36 months. However, this effect is only statistically significant in the long term basis (36 months). Studies with longer follow-up can further establish RDN’s long term effect.
SBP at 6 months
SBP at 36 months