Catheter-Based Renal Denervation For Resistant Hypertension:a Meta-Analysis Of Randomized Controlled Trials

Objective Catheter-based renal denervation (RDN), as a novel approach to treat resistant hypertension, has been evaluated in multiple studies. However, these researches'results are inconsistent. The aim of this meta-analysis was to explore the effectiveness of RDN on lowing BP in resistant hypertension compared with medicine therapy.Method We searched PubMed, OVID, Web of Science, and Cochrane Collaboration database on controlled trials related to treating resistant hypertension by RDN, with duration of follow-up at least 6 months. The final search was conducted on February 1,2015. The endpoint of this study was the decrease of blood pressure at 6 months after RDN.Results Five prospective randomized controlled studies with 772 resistant hypertensive patients were enrolled into this meta-analysis. All eligible patients received optimized medical therapy. This meta-analysis showed that neither office systolic blood pressure (BP) (-9.42mmHg, 95%CI:-19.62-0.78, P=0.07) nor ambulatory systolic BP (-3.12mmHg, 95%CI:-7.4-1.17, P=0.15) in RDN group was significantly decreased compared with those in medicine therapy group at 6-month follow-up. However, office diastolic BP (-5.00mmHg,95%CI:-7.93--2.08, P< 0.05)?ambulatory diastolic BP (-2.99mmHg,95%CI:-3.43--2.56, P< 0.05) in RDN group were significantly decreased compared with those in medicine therapy group.Conclusion This meta-analysis suggested that the decrease of systolic BP in RDN was no superior to that in medical therapy group, but diastolic BP decreased much more significant in RDN group than that in medical therapy group in patients with resistant hypertension at 6-month follow-up. In other words,the RDN was superior to that in medical therapy group.