Systematic Review and Meta-Analysis of Second-Generation Sham-Controlled Randomized Trials of Renal Denervation Therapy for Patients with Hypertension.

IF 3.1 Q2 PERIPHERAL VASCULAR DISEASE
Clara Rocha Dantas, Artur De Oliveira Macena Lôbo, Artur Menegaz De Almeida, Francisco Cezar Aquino De Moraes, Vitor Kendi Tsuchiya Sano, Francinny Alves Kelly
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引用次数: 0

Abstract

Introduction: Renal denervation has been associated with substantial and sustained blood pressure reduction and is considered to serve as an alternative treatment for patients with resistant hypertension. However, the first published SHAM-controlled trial assessing RDN safety and efficacy showed no difference between groups.

Aim: We aimed to perform a meta-analysis quantifying the magnitude of blood pressure decrease secondary to renal denervation in patients with resistant hypertension.

Methods: Databases were searched for RCTs that compared RDN therapy to SHAM procedure and reported the outcomes of (1) 24-hour ambulatory blood pressure; (2) Office systolic blood pressure; (3) Daytime systolic blood pressure; and (4) Night-time systolic blood pressure. Mean differences with 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was examined with I² statistics. P values of < 0.05 were considered statistically significant. Statistical analyses were performed using RStudio 4.2.3.

Results: Nine studies and 1622 patients were included. The AMBP [MD -3.72 95%CI -5.44, -2.00 p < 0.001; I²=34%] and DSBP [MD -4.10 95%CI -5.84, -2.37 p < 0.001; I²=0%] were significantly reduced in the RDN arm. ODBP [MD -6.04 95%CI -11.31, -0.78 p = 0.024; I²=90%] and NSBP [MD -1.81 95%CI -3.90, 0.27 p = 0.08; I²=0%] did not reach a statistically significant difference between groups.

Conclusion: Renal denervation demonstrates greater efficacy in reducing 24-hour ambulatory and daytime systolic blood pressure in patients diagnosed with resistant hypertension.

高血压患者肾脏去神经支配疗法第二代假对照随机试验的系统性回顾和元分析》(Systematic Review and Meta-Analysis of Second-Generation Sham-Controlled Randomized Trials of Renal Denervation Therapy for Patients with Hypertension)。
导言:肾脏去神经化与血压持续大幅降低有关,被认为是抵抗性高血压患者的替代治疗方法。目的:我们旨在进行一项荟萃分析,量化抵抗性高血压患者接受肾脏神经支配治疗后血压下降的幅度:我们在数据库中搜索了将 RDN 治疗与 SHAM 程序进行比较的 RCT,并报告了以下结果:(1) 24 小时非卧床血压;(2) 办公室收缩压;(3) 白天收缩压;(4) 夜间收缩压。采用随机效应模型计算平均差及 95% 置信区间 (CI)。异质性用 I² 统计量进行检验。结果的 P 值:共纳入 9 项研究和 1622 名患者。AMBP[MD-3.72 95%CI -5.44, -2.00 p 结论:肾脏去神经化在降低确诊为抵抗性高血压患者的 24 小时动态血压和日间收缩压方面具有更高的疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.70
自引率
3.30%
发文量
57
期刊介绍: High Blood Pressure & Cardiovascular Prevention promotes knowledge, update and discussion in the field of hypertension and cardiovascular disease prevention, by providing a regular programme of independent review articles covering key aspects of the management of hypertension and cardiovascular diseases. The journal includes:   Invited ''State of the Art'' reviews.  Expert commentaries on guidelines, major trials, technical advances.Presentation of new intervention trials design.''Pros and Cons'' or round tables on controversial issues.Statements on guidelines from hypertension and cardiovascular scientific societies.Socio-economic issues.Cost/benefit in prevention of cardiovascular diseases.Monitoring of healthcare systems.News and views from the Italian Society of Hypertension (including abstracts).All manuscripts are subject to peer review by international experts. Letters to the editor are welcomed and will be considered for publication.
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