Long-Term Blood Pressure Reductions Following Catheter-Based Renal Denervation: A Systematic Review and Meta-Analysis

Area of Science:

• Cardiology
• Nephrology
• Interventional Radiology

Background:

• Renal denervation is an established adjunctive therapy for hypertension.
• Long-term data are crucial for assessing the durability and safety of renal denervation.
• Previous studies provide up to 36-month follow-up from randomized trials and up to 10 years from observational studies.

Purpose of the Study:

• To analyze study-level data and quantify ambulatory blood pressure (BP) reduction from renal denervation.
• To evaluate the long-term efficacy and safety of renal denervation up to 10 years.

Main Methods:

• A systematic review of 4 observational studies (up to 10-year follow-up) and 2 randomized controlled trials (up to 36-month follow-up).
• Extraction and statistical comparison of study-level data.

Main Results:

• Sham-adjusted ambulatory systolic BP reduction of -12.7±4.5 mm Hg in randomized trials (36-month follow-up; P=0.05).
• Ambulatory systolic BP reduction of -14.8±3.4 mm Hg in observational studies (mean 7.7±2.8 years follow-up; P=0.0051).
• Estimated glomerular filtration rate changes were consistent with age-related decline; antihypertensive drug burden remained stable.

Conclusions:

• Renal denervation provides significant and clinically meaningful reductions in ambulatory systolic BP.
• The benefits are observed up to 36 months in randomized trials and up to 10 years in observational studies.
• Renal denervation is safe for renal function and does not increase antihypertensive drug burden.