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Abstract 4140260: Efficacy and Safety of Radiofrequency-Based Renal Denervation on Resistant Hypertensive Patients: A Systematic Review and Meta-Analysis

2024; Lippincott Williams & Wilkins; Volume: 150; Issue: Suppl_1 Linguagem: Inglês

10.1161/circ.150.suppl_1.4140260

1524-4539

Luis Eduardo Rodrigues Sobreira, Clara Rocha Dantas, Fernando Baía Bezerra, Vitor Kendi Tsuchiya Sano, Artur de Oliveira Macena Lôbo, M. Jorge Cardoso, Francinny Alves Kelly, Francisco Cézar Aquino de Moraes, Fernanda Marciano Consolim‐Colombo,

Cardiovascular Disease and Adiposity

Introduction: New therapies for resistant hypertension (RH), including renal denervation (RDN), have been studied. Aim: Access the safety and effectiveness of radiofrequency-based RDN vs pharmacological treatment for RH. Methods: A thorough literature search was conducted across PubMed, EMBASE, and the Cochrane databases, focusing on studies that compared the effects of radiofrequency-based RDN versus pharmacological treatment for RH. Treatment effects for binary and continuous endpoints were pooled and used, respectively, odds-ratio (OR) and mean differences (MD) with 95% confidence intervals (CI) to analyze continuous outcomes. Results: All the 10 included studies were randomized controlled trials, they involved 1.182 patients, and 682 received radiofrequency-based RDN. The follow-up period ranged from 6 to 84 months. Analysis revealed that the RDN group had a significant reduction in office systolic blood pressure (BP) (MD: -9.5 mmHg; 95% CI: -16.81 to -2.29; P=0.01), office diastolic BP (MD: -5.1 mmHg; 95% CI: -8.42 to -2.80; P<0.001), 24 h systolic BP (MD: -4.8 mmHg; 95% CI: -7.26 to -2.42; P<0.001). For 24 h diastolic BP RDN did not have a significant reduction (MD: -2.3 mmHg; 95% CI: -4.19 to -0.52; P=0.012). The heterogeneity between the studies was high, visible in the funnel and Baujat plots. The OR was non-significant for non-serious adverse events, but also clinically significant for hypertensive crises and strokes for the RDN group. Conclusions: While the pharmacological regimen of 3 or more anti-hypertensive, including a diuretic, still be the first-line option for RH treatment, our results support that radiofrequency-based RDN is superior in reducing global BP and is safe.