Written by Peter Liu
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Catheter-based renal denervation (RDN) is an effective procedure for reducing blood pressure.
Synopsis
The study aimed to evaluate the efficacy and safety of catheter-based renal denervation in hypertension through a meta-analysis of 10 randomized, sham-controlled trials with 2,478 patients. Using first- and second-generation RDN devices, significant reductions in 24-hour and office systolic blood pressure (SBP) were observed: −4.4 mm Hg (95%CI, −2.7 to −6.1) and −6.6 mm Hg (95%CI, −3.6 to −9.7), respectively. No significant safety concerns or renal function impairments were identified. Limitations include heterogeneity among trials and short follow-up durations. The findings support RDN as an effective adjunct treatment for uncontrolled hypertension with a favorable safety profile. (AI-generated)
Have no sympathy for sympathetic renal nerves in hypertension
In the past decade, renal denervation has emerged as a catheter-based intravascular procedure which appears to be effective for reducing blood pressure. Two devices have obtained FDA approval in the U.S. so far, including a radiofrequency ablation device and an ultrasound ablation device. Notably, there remains limited evidence in several situations, including patients with secondary hypertension, patients with a history of stroke and heart failure, and patients with significant kidney disease. Also, while the reported complications of RDN appear to be predominantly related to vascular access complications, there are limited long-term safety comparisons between patients undergoing RDN compared to those that do not, nor is there clear evidence that RDN results in reduction of hypertension-associated diseases such as stroke, MI, and chronic kidney disease. However, for many patients with resistant hypertension, who regularly have suboptimal blood pressures in their normal lives (i.e. outside of the doctor’s office) despite reasonable attempts at lifestyle modification and antihypertensive medications, RDN appears to be a reasonable treatment option.
Source
Effects of Catheter-Based Renal Denervation in Hypertension: A Systematic Review and Meta-Analysis. Circulation. 2024 Nov 12;150(20):1599-1611. doi: 10.1161/CIRCULATIONAHA.124.069709. Epub 2024 Oct 2. PMID: 39355923
