Kwok, CS, Loke, YK, Pradhan, S, Keavney, B, El-Omar, M and Mamas, MA ORCID: (2014) Renal denervation and blood pressure reduction in resistant hypertension: a systematic review and meta-analysis. Open Heart, 1 (1). e000092 -?.

Renal denervation and blood pressure reduction in resistant hypertension: a systematic review and meta-analysis..pdf - Published Version
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OBJECTIVE: The objective of this study is to evaluate the efficacy and safety of renal denervation in patients with resistant hypertension. METHODS: We searched MEDLINE and EMBASE for studies that evaluated the use of catheter-based renal sympathetic denervation compared to a control group and reported blood pressure results at follow-up. Data was extracted from relevant studies and pooled estimates for blood pressure were determined using the inverse variance method for meta-analysis with mean difference. RESULTS: We identified 12 studies (three randomised controlled trials (n=688), eight prospective observational studies (n=478) and one observational study with matched controls (n=310)). Data from SYMPLICITY HTN-3, the only high-quality blinded randomised control trial suggests that there is no significant difference in change in systolic (-2.30 95% CI -6.90 to 2.30 mm Hg) or diastolic (-1.96 95% CI -4.98 to 1.06 mm Hg) blood pressure at 6 months. The pooled data from two unblinded trials of lower quality showed significant reduction in change in systolic (-27.36 95% CI -37.08 to -24.61 mm Hg) and diastolic blood pressure (-9.62 95% CI -14.51 to -4.72 mm Hg). In terms of safety, SYMPLICITY HTN-3 found no significant differences between treatment and control group in terms of death, myocardial infarction, new onset renal disease, stroke and hypertensive emergencies. CONCLUSIONS: In conclusion, while poor quality unblinded studies provide evidence that renal denervation using catheter-based systems is effective in reducing systolic and diastolic blood pressure in resistant hypertension, the largest randomised controlled trial to date (SYMPLICITY HTN-3) failed to demonstrate any benefit.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via BMJ Publishing Group at - please refer to any applicable terms of use of the publisher.
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine and Health Sciences > Institute for Science and Technology in Medicine
Related URLs:
Depositing User: Symplectic
Date Deposited: 09 Jul 2015 15:05
Last Modified: 22 Jun 2018 14:38

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