title: The effect of renal denervation on resistant hypertension: Meta-analysis of randomized controlled clinical trials.
abstract: BACKGROUND
  This meta-analysis was conducted to evaluate the efficiency of renal denervation (RDN) on resistant hypertension.
  
  
  METHODS
  PubMed, EMBASE, and the Cochrane Central database were searched for eligible randomized controlled clinical trials (RCTs). Changes from the baseline of the office blood pressure and the 24-h ambulatory blood pressure were extracted.
  
  
  RESULTS
  Nine RCTs were included. RDN reduced the mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) by -8.23 mm Hg (95%CI: -16.86, 0.39) and -3.77 mm Hg (95%CI: -7.21, -0.32), respectively, compared with the control. In the population with a baseline SBP more than 170 mm Hg, the RDN reduced SBP by -17.77 mm Hg (95%CI: -33.73, -1.82) and DBP by -7.51 mm Hg (95%CI: -12.58, -2.44). In the subgroup with no medication adjustment, the RDN reduced SBP by -15.56 mm Hg (95%CI: -26.33, -4.80) and DBP by -6.89 mm Hg (95%CI: -9.99, -3.79). The proportion of patients with SBP decrease of 10 mm Hg or more and the controlled office BP were not different between two groups. RDN reduced 24-h mean SBP and DBP by -3.34 mm Hg (95%CI: -5.30, -1.38) and -1.56 mm Hg (95%CI: -2.71, -0.41), respectively. The SBPs in the subgroups with higher baseline SBP and with no medication adjustment were significantly decreased after the HTN-3 was omitted.
  
  
  CONCLUSIONS
  Radiofrequency RDN in a randomized manner did not have superiority compared with medical treatment at 6-month follow-up in general population. Current evidence provides insufficient evidence to support the use of such RDN strategy in the treatment of resistant hypertension. The result could not be used to extrapolate other strategies' effect.
authors.affiliation: a Department of Cardiology , The Second Affiliated Hospital of Chongqing Medical University , Chongqing , China.
authors.forename: Yuanqing
authors.initials: Y
authors.lastname: Yao
authors.affiliation: b Department of Cardiolgy , The First Affiliated Hospital of Xiamen University , Xiamen , Fujian , China.
authors.forename: Dengqing
authors.initials: D
authors.lastname: Zhang
authors.affiliation: a Department of Cardiology , The Second Affiliated Hospital of Chongqing Medical University , Chongqing , China.
authors.forename: Jun
authors.initials: J
authors.lastname: Qian
authors.affiliation: a Department of Cardiology , The Second Affiliated Hospital of Chongqing Medical University , Chongqing , China.
authors.forename: Shimin
authors.initials: S
authors.lastname: Deng
authors.affiliation: a Department of Cardiology , The Second Affiliated Hospital of Chongqing Medical University , Chongqing , China.
authors.forename: Yuwen
authors.initials: Y
authors.lastname: Huang
authors.affiliation: a Department of Cardiology , The Second Affiliated Hospital of Chongqing Medical University , Chongqing , China.
authors.forename: Jing
authors.initials: J
authors.lastname: Huang
mesh_terms: D000959:Antihypertensive Agents / Q000494:pharmacology; D018660:Blood Pressure Monitoring, Ambulatory; D004351:Drug Resistance; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D007668:Kidney / Q000294:innervation; D016032:Randomized Controlled Trials as Topic; D013562:Sympathectomy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: Meta-analysis; radiofrequency ablation; randomized controlled clinical trials; renal denervation; resistant hypertension