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Catheter ablation of the renal sympathetic innervations is promising therapy but data is still limited. We aimed to evaluating its effectiveness in a meta-analysis of the available clinical trials.
We searched PubMed, EMBASE, and Cochrane databases up to July 2012. Outcomes studied were 10% or higher reduction in blood pressure and reduction in the number of needed anti-hypertensive agents. We also evaluated renal function and procedure-related complications. We performed fixed effect analysis when I2 up to 40% and P at least 0.10, otherwise we used random effect.
Out of 394 articles four articles presented the studied data and were included in the analysis. There was a total of 270 patients, being 180 submitted to denervation and 90 controls. Patients submitted to renal denervation had when compared to control a 50 fold increase in the odds of having at least 10% blood pressure reduction (Figure 1A) and a 4 fold increase in the odds of being on 3 or less anti-hypertensive (Figure 1B) after six to twelve months, p < 0.0005 and 0.006 respectively. Their decrease in systolic and diastolic-pressures ranged in-between 14 and 36 and 7 and 14 mmHg respectively as compared to controls. There was no deterioration in renal function. There was a 1.1% complication rate including 3 pseudoaneurysm and 1 renal artery dissection, none of them lethal.
Catheter-based renal seems to be a safe and efficacious adjuvant therapy for resistant hypertension.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Renal Denervation: Coming of Age
Abstract Category: 25. Prevention: Hypertension
Presentation Number: 1148-25
- 2013 American College of Cardiology Foundation