Imperial College London
Alternate

ProfessorDarrelFrancis

Faculty of Medicine, National Heart & Lung Institute

Professor of Cardiology
 
 
 
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Contact

 

+44 (0)20 7594 3381d.francis Website

 
 
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Assistant

 

Miss Juliet Holmes +44 (0)20 7594 5735

 
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Location

 

Block B Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Ahmad:2022:10.1016/j.carrev.2021.01.031,
author = {Ahmad, Y and Kane, C and Arnold, AD and Cook, C and Keene, D and Shun-Shin, M and Cole, G and Al-Lamee, R and Francis, D and Howard, J},
doi = {10.1016/j.carrev.2021.01.031},
journal = {Cardiovascular Revascularization Medicine},
pages = {112--118},
title = {Randomized blinded placebo-controlled trials of renal sympathetic denervation for hypertension: a meta-analysis},
url = {http://dx.doi.org/10.1016/j.carrev.2021.01.031},
volume = {34},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundThe efficacy of renal denervation has been controversial, but the procedure has now undergone several placebo-controlled trials. New placebo-controlled trial data has recently emerged, with longer follow-up of one trial and the full report of another trial (which constitutes 27% of the total placebo-controlled trial data). We therefore sought to evaluate the effect of renal denervation on ambulatory and office blood pressures in patients with hypertension.MethodsWe systematically identified all blinded placebo-controlled randomized trials of catheter-based renal denervation for hypertension. The primary efficacy outcome was ambulatory systolic blood pressure change relative to placebo. A random-effects meta-analysis was performed.Results6 studies randomizing 1232 patients were eligible. 713 patients were randomized to renal denervation and 519 to placebo. Renal denervation significantly reduced ambulatory systolic blood pressure (−3.52 mmHg; 95% CI −4.94 to −2.09; p < 0.0001), ambulatory diastolic blood pressure (−1.93 mmHg; 95% CI −3.04 to −0.83, p = 0.0006), office systolic blood pressure size (−5.10 mmHg; 95% CI −7.31 to −2.90, p < 0.0001) and office diastolic pressure (effect size −3.11 mmHg; 95% CI −4.43 to −1.78, p < 0.0001). Adverse events were rare and not more common with denervation.ConclusionsThe totality of blinded, randomized placebo-controlled data shows that renal denervation is safe and provides genuine reduction in blood pressure for at least 6 months post-procedure. If this effect continues in the long term, renal denervation might provide a life-long 10% relative risk reduction in major adverse cardiac events and 7.5% relative risk reduction in all-cause mortality.
AU  - Ahmad,Y
AU  - Kane,C
AU  - Arnold,AD
AU  - Cook,C
AU  - Keene,D
AU  - Shun-Shin,M
AU  - Cole,G
AU  - Al-Lamee,R
AU  - Francis,D
AU  - Howard,J
DO  - 10.1016/j.carrev.2021.01.031
EP  - 118
PY  - 2022///
SN  - 1553-8389
SP  - 112
TI  - Randomized blinded placebo-controlled trials of renal sympathetic denervation for hypertension: a meta-analysis
T2  - Cardiovascular Revascularization Medicine
UR  - http://dx.doi.org/10.1016/j.carrev.2021.01.031
UR  - http://hdl.handle.net/10044/1/87531
VL  - 34
ER  -
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