Renal sympathetic denervation for treatment of resistant hypertension: a meta-analysis

Abstract

Objective To systematically evaluate the effectiveness and safety of renal sympathetic denervation (RSD) for treatment of patients with resistant hypertension. Methods English and Chinese literatures of controlled clinical trials on RSD in treatment of resistant hypertension were searched from the Cochrane Library, PubMed, Web of Science, Wanfang Database and CNKI up to February 2013.Meta-analysis was performed with the selected studies by using software Rev.Man 5.0. Results Seven studies involving 354 cases with RSD and 146 controls were included for analysis.Compared with control group, RSD significantly lower both systolic and diastolic blood pressure in patients with resistant hypertension (systolic, 1 month: MD=-18.04, 95%CI: -19.94--16.14, P<0.01; 3 months: MD=0.01, 95%CI: -28.10--17.98, P<0.01; 6 months: MD=-25.59, 95%CI: -34.08--17.11, P<0.01; diastolic, 1 month: MD=-7.53, 95%CI: -8.60--6.45, P<0.01; 3 months: MD=0.01, 95%CI: -12.5--4.47, P<0.01; 6 months: MD=-10.54, 95%CI: -16.44--4.63, P=0.000 5). In addition, there was no significant difference in adverse reactions between RSD treatment group and control group (OR=1.13, 95%CI: 0.34-3.76, P=0.84). Conclusions Renal sympathetic denervation can effectively reduce blood pressure in patients with resistant hypertension 1-6 months postoperatively, without increase of adverse reactions.The long-term efficacy and safety need to be further observed. Key words: Sympathectomy; Hhypertension; Meta-analysis