Effect of renal denervation for patients with isolated systolic hypertension:a systematic review and meta-analysis  

作　　者：Le LI Yu-Long XIONG Bin TU Shang-Yu LIU Zhen-Hao ZHANG Zhao HU Yan YAO 

机构地区：[1]Department of Cardiology,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China

出　　处：《Journal of Geriatric Cardiology》2023年第2期121-129,共9页老年心脏病学杂志（英文版）

基　　金：the National Natural Science Foundation of China(No.81970285).

摘　　要：BACKGROUND Renal denervation(RDN)is a promising treatment based on catheter intervention for patients with refractory hypertension.However,the effect in patients with isolated systolic hypertension(ISH)remains controversial.The aim of this meta-analysis was to determine the blood pressure lowing effect of RDN in patients with ISH compared with combined systolic/diastolic hypertension(CH)patients.METHODS PubMed,Embase,Cochrane and ClinicalTrials.gov were searched for prospective clinical studies that included RDN.The outcomes of interest were the change of 24-hour ambulatory systolic blood pressure(SBP)from baseline.We used the fixed effects model to calculate weighted mean difference(WMD)with 95%confidence interval(CI).RESULTS Six trials were included,with 1405 participants,including 597 patients with ISH and 808 patients with CH.Mean follow-up was five months.The reduction of 24-hour ambulatory SBP was significantly greater for the CH patients than the ISH patients(WMD=3.89,95%CI:2.32–5.45,P<0.0001).RDN also showed a greater reduction in office SBP in the CH patients compared to the ISH patients(WMD=10.24,95%CI:4.24–15.74,P=0.0003).And the effect was independent of age,length of follow-up,and ablation device.CONCLUSIONS RDN provides superior blood pressure control in the CH patients compared with the ISH patients,and the CH patients may be the best suitable population for which RDN is indicated.

关 键 词：PATIENTS HYPERTENSION SYSTOLIC 

分 类 号：R544.1[医药卫生—心血管疾病]