50. Effectiveness of Renal Denervation in Patients with Resistant Hypertension: An Umbrella and Mapping Review

Abstract

Background: Resistant hypertension is a condition when blood pressure remains high despite the routine consumption of three antihypertensive agents, including diuretics. Due to the unwanted side effects of antihypertensive agents, non-pharmacology therapy such as renal denervation can be chosen as alternative management, even though this modality still remain controversial. This umbrella review appraises published meta-analyses of observational, controlled trial, and randomized controlled trial (RCT) for the efficacy of renal denervation in hypertension. Objective: The aim of this umbrella review is to provide an overview of the efficacy of controversial renal denervation as an alternative management in the case of resistant hypertension. Method: Eight databases were searched was the beginning of 2012 to the 15th of January 2023. Thirteen meta-analyses were included. Non-English languages, wrong study type, wrong population, and wrong study outcomes were excluded. Result: Eight of thirteen meta-analyses showed significant benefits of renal denervation in reducing blood pressure. Furthermore, one of which showed that the efficacy of renal denervation is better than pharmacological therapy in lowering the blood pressure in resistant hypertension. No significant benefit of renal denervation was found in any other meta-analyses, nonetheless, it was safe to use. Conclusion: Despite various results from multiple meta-analyses, this umbrella review reveals that renal denervation is beneficial in lowering the blood pressure in resistant hypertension. Further research using long-term follow-up and big-scale subjects is needed to confirm this result.