Efficacy of ultrasound renal denervation reducing blood pressure: a systematic review and meta-analysis

Ultrasound renal denervation (uRDN) has emerged as an innovative therapeutic approach for the treatment of hypertension. However, its efficacy compared to medication remains uncertain. We aimed to assess the efficacy profile of uRDN vs sham groups focusing on its impact on daytime ambulatory blood pressure, 24-hour blood pressure, home blood pressure and office blood pressure.

We conducted a systematic search across Embase, PubMed, and Cochrane Library databases from their inception up 1 November 2024 to identify randomized controlled trials evaluating the efficacy of uRDN. Statistical analyses were performed using RevMan 6.3 software, utilizing the mean and standard deviation method to calculate mean differences with a 95% confidence interval (95%CI).

A total of 4 studies were included in the final analysis with 642 patients. uRDN significantly reduced daytime ambulatory systolic blood pressure (SBP) (-5.12 mmHg; 95%CI, -6.07 to -4.16; P ≤ .00001), 24-h SBP (-4.87 mmHg; 95%CI, -6.53 to -3.21]; P ≤ .00001), office SBP (-5.03 mmHg; 95%CI, -6.27 to -3.79; P ≤ .00001) and showed a decrease in patient medication 6 months after the procedure.

Using uRDN leads to a lower blood pressure in patients within 2 months following the procedure. Additionally, after 6 months a significant decrease in drug use is observed.This meta-analysis protocol was registered on PROSPERO on 7 July 2024 (CRD42024562852).