PP.26.24

Abstract

Objective: To systematically evaluate the efficiency and safety of renal sympathetic denervation for resistant hypertension. Design and method: Such databases as The Cochrane Library, PubMed, EMbase, CBM and CNKI were electronically searched for relevant studies from inception to July 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria as well as the methods recommended by the Cochrane Collaboration, extracted data, and assessed the methodological quality of the included studies. Then, meta analysis was performed using RevMan 5.2 software. Results: Four randomized controlled trialsand totally 1649 patients. The results of meta-analysis suggested that there was a reduction in mean systolic and diastolic blood pressure at 3 months of - 22.39 mmHg and - 6.75 mmHg. And a reduction in mean systolic and diastolic blood pressure at 6 months of – 17.93 mmHg and – 9.33 mmHg (902 patients). The results showed RSD was superior to the medical therapy in reducing mean systolic blood pressure and mean diastolic blood pressure. In observation studies, there was a reduction in mean systolic and diastolic BP at 3 months of – 24.35 mm Hg and – 9.45mmHg (–12.33 to –6.58 mmHg), and there was a reduction in mean systolic and diastolic BP at 6 months of–27.25mmHg (– 33.1 to – 21.39mmHg) and –10.25 mmHg (–12.59 to –7.92 mmHg), The results showed great reduction of mean systolic blood pressure, diastolic blood pressure after RSD (p < 0.01). There was no significant difference in the effect of RSD with 6 kinds of catheters. No obvious damages were discovered after RSD besides 4 femoral pseudoaneurysms. Conclusions: Based on current evidence, RSD performed better than medical therapy in the treatment of resistant hypertension patients, and performed more security. However, due to the quality of the included studies, the clinical effects of RSD on RH patients need to be confirmed by large-scale and multicenter randomized controlled trials in the future.