Abstract 9910: Effect of Renal Denervation in Resistant Hypertension: A Meta-Analysis of Randomized Controlled Trials

Abstract

Introduction: Resistant hypertension is defined as blood pressure that remains ≥ 140/90 mm Hg despite adherence to at least three maximally tolerated doses of antihypertensive medications, including a diuretic. Catheter based renal denervation has been studied as one of the interventions for blood pressure control in such patients. Data comparing renal denervation versus sham procedure have shown disparate results. This meta-analysis summarizes the current evidence on the effect of sham controlled renal denervation on the treatment of resistant hypertension. Methods: Embase, Pubmed and Cochrane Central databases were searched from inception until May 30, 2021. RCTs comparing catheter based renal denervation with a sham control were included. Outcomes assessed were change in 24h ambulatory systolic blood pressure, change in 24h ambulatory diastolic blood pressure, change in office systolic blood pressure, and change in office diastolic blood pressure. Weighted mean differences (WMD) were calculated and pooled into a random effects model meta-analysis. Results: Seven studies with 1,264 participants were included in the analysis. Catheter based renal denervation was associated with significant decrease in ambulatory systolic blood pressure (WMD: -3.76; 95% CI: -2.44 to -5.09, p value <.00001) and ambulatory diastolic blood pressure (WMD: -1.78; 95% CI: -0.84 to -2.72, p value=0.0002) compared with sham. The reduction in office systolic and office diastolic blood pressure was also significantly greater with catheter renal denervation than sham control (WMD: -5.95; 95% CI: -3.93 to -7.97; p value<0.00001 and WMD: -3.54; 95% CI: -2.35 to -4.72; p value<0.00001). Conclusions: There was significant benefit of renal denervation for resistant hypertension for all the studied outcomes. Based on this data, compliant patients with resistant hypertension who are maxed on lifestyle and pharmacological management may benefit from catheter based renal denervation.