基于导管的脏缩对高血压的影响:系统性审查和元分析
medRxiv : the preprint server for health sciences
|July 1, 2024
概括
导管式脏缩 (RDN) 有效降低高血压患者的血压. 这一元分析证实RDN是安全的,没有增加并发症风险,支持其作为附加疗法的使用.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 高血压管理 高血压管理
背景情况:
- 基于导管的脏缩 (RDN) 试验在有效性和安全性方面产生了混合的结果.
- 高血压仍然是一个重大的全球健康挑战,需要创新的治疗策略.
研究的目的:
- 对随机化,模拟控制试验进行全面的元分析,评估第一代和第二代高血压RDN器件.
- 评估RDN在高血压患者中的疗效和安全结果.
主要方法:
- 系统地搜索MEDLINE和Cochrane图书馆的文献,寻找符合条件的随机对照试验.
- 总结数据的研究水平,双对,随机效应的元分析,包括疗效 (24小时和办公室SBP/DBP) 和安全终点.
- 包括10项试验,包括2478名高血压患者,接受过或未接受过抗高血压药物的治疗.
主要成果:
- 与假冒手术相比,RDN显著降低了24小时缩血压4.4 mmHg,办公室缩血压6.6 mmHg (两者p<0.00001).
- 扩张性血压的降低也显著: -2.6 mmHg (24小时) 和 -3.5 mmHg (办公室) (分别p<0.00001和p=0.0003).
- 没有观察到安全结果的显著差异,包括血管并发症,动脉狭窄,高血压危机或全因死亡. 功能 (eGFR) 变化在不同组之间是可比的.
结论:
- 与假冒手术相比,以导管为基础的脏缩安全有效地降低了门诊和办公室的抽缩和放缩血压.
- 对于精心挑选的患有失控高血压的患者来说,RDN是一种可行的附加治疗选择,与当前的临床指南保持一致.
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