Renal denervation for resistant hypertension

Giuseppe Coppolino; Anna Pisano; Laura Rivoli; Davide Bolignano

doi:10.1002/14651858.CD011499.pub2

Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados
Guías
Temas

Revisiones y protocolos relacionados

Topics

Temas

Figure 1

Study flow diagram.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.1

Comparison 1 Renal denervation vs. sham/standard therapy, Outcome 1 Myocardial infarction.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.2

Comparison 1 Renal denervation vs. sham/standard therapy, Outcome 2 ischaemic stroke.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.3

Comparison 1 Renal denervation vs. sham/standard therapy, Outcome 3 unstable angina.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.4

Comparison 1 Renal denervation vs. sham/standard therapy, Outcome 4 systolic 24‐hour ABPM.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.5

Comparison 1 Renal denervation vs. sham/standard therapy, Outcome 5 diastolic 24‐hour ABPM.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.6

Comparison 1 Renal denervation vs. sham/standard therapy, Outcome 6 systolic office BP.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.7

Comparison 1 Renal denervation vs. sham/standard therapy, Outcome 7 diastolic office BP.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.8

Comparison 1 Renal denervation vs. sham/standard therapy, Outcome 8 serum creatinine.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.9

Comparison 1 Renal denervation vs. sham/standard therapy, Outcome 9 eGFR/creatinine clearance.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.10

Comparison 1 Renal denervation vs. sham/standard therapy, Outcome 10 bradycardia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.11

Comparison 1 Renal denervation vs. sham/standard therapy, Outcome 11 femoral artery pseudoaneurysm.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.12

Comparison 1 Renal denervation vs. sham/standard therapy, Outcome 12 flank pain.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.13

Comparison 1 Renal denervation vs. sham/standard therapy, Outcome 13 hypotensive episodes.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.14

Comparison 1 Renal denervation vs. sham/standard therapy, Outcome 14 hypertensive crisis.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.15

Comparison 1 Renal denervation vs. sham/standard therapy, Outcome 15 hyperkalemia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Renal denervation versus sham denervation or standard treatment
Patient or population: people with resistant hypertension Setting: Outpatient Intervention: renal denervation Comparison: sham denervation or standard treatment
Outcomes	*Illustrative comparative risks (95% CI)**		Effect estimate (95% CI)	No of Participants (studies)	Quality of the evidence (GRADE)
	Assumed risk	Corresponding risk
	Sham denervation/ Standard treatment	Renal denervation
myocardial infarction	14 per 1000	18 per 1000 (6 to 54)	RR 1.31 (0.45 to 3.84)	742 (4 studies)	⊕⊕⊝⊝ low^1,2
ischaemic stroke	12 per 1000	14 per 1000 (4 to 45)	RR 1.15 (0.36 to 3.72)	823 (4 studies)	⊕⊕⊝⊝ low^1,2
unstable angina	20 per 1000	12 per 1000 (2 to 101)	RR 0.63 (0.08 to 5.06)	201 (2 studies)	⊕⊕⊝⊝ low^1,2
systolic 24‐hour ABPM (mmHg)	‐	‐	MD 0.28 (‐3.74 to 4.29)	797 (5 studies)	⊕⊕⊕⊝ moderate¹
diastolic 24‐hour ABPM (mmHg)	‐	‐	MD 0.93 (‐4.50 to 6.36)	756 (4 studies)	⊕⊕⊕⊝ moderate¹
systolic office BP (mmHg)	‐	‐	MD ‐4.08 (‐15.26 to 7.11)	886 (6 studies)	⊕⊕⊕⊝ moderate¹
diastolic office BP (mmHg)	‐	‐	MD ‐1.30 (‐7.30 to 4.69)	845 (5 studies)	⊕⊕⊕⊝ moderate¹
eGFR or creatinine clearance (mL/min/1.73m²)	‐	‐	MD ‐2.09 (‐8.12 to 3.95)	837 (4 studies)	⊕⊕⊕⊝ moderate¹
The assumed risk* is the observed risk in the reference (control) group. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. Legend ABPM: ambulatory blood pressure monitoring; BP: blood pressure; CI: Confidence interval; CV: cardiovascular; NA: information not available (data sparse or absent); eGFR: estimated glomerular filtration rate; MD: mean difference; RR: Risk Ratio. 1. Wide confidence intervals. 2. Only reported by less than half of the studies.

Ir a la tabla de la revisión

Comparison 1. Renal denervation vs. sham/standard therapy

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Myocardial infarction Show forest plot	4	742	Risk Ratio (M‐H, Random, 95% CI)	1.31 [0.45, 3.84]

2 ischaemic stroke Show forest plot	4	823	Risk Ratio (M‐H, Random, 95% CI)	1.15 [0.36, 3.72]

3 unstable angina Show forest plot	2	201	Risk Ratio (M‐H, Random, 95% CI)	0.63 [0.08, 5.06]

4 systolic 24‐hour ABPM Show forest plot	5	797	Mean Difference (IV, Random, 95% CI)	0.28 [‐3.74, 4.29]

5 diastolic 24‐hour ABPM Show forest plot	4	756	Mean Difference (IV, Random, 95% CI)	0.93 [‐4.50, 6.36]

6 systolic office BP Show forest plot	6	886	Mean Difference (IV, Random, 95% CI)	‐4.08 [‐15.26, 7.11]

7 diastolic office BP Show forest plot	5	845	Mean Difference (IV, Random, 95% CI)	‐1.30 [‐7.30, 4.69]

8 serum creatinine Show forest plot	3	736	Mean Difference (IV, Random, 95% CI)	0.01 [‐0.12, 0.14]

9 eGFR/creatinine clearance Show forest plot	4	837	Mean Difference (IV, Random, 95% CI)	‐2.09 [‐8.12, 3.95]

10 bradycardia Show forest plot	3	220	Risk Ratio (M‐H, Random, 95% CI)	6.63 [1.19, 36.84]

11 femoral artery pseudoaneurysm Show forest plot	2	201	Risk Ratio (M‐H, Random, 95% CI)	3.96 [0.44, 35.22]

12 flank pain Show forest plot	2	199	Risk Ratio (M‐H, Random, 95% CI)	4.30 [0.48, 38.28]

13 hypotensive episodes Show forest plot	2	119	Risk Ratio (M‐H, Random, 95% CI)	0.67 [0.07, 6.64]

14 hypertensive crisis Show forest plot	3	722	Risk Ratio (M‐H, Random, 95% CI)	0.71 [0.35, 1.45]

15 hyperkalemia Show forest plot	2	200	Risk Ratio (M‐H, Random, 95% CI)	0.48 [0.01, 21.33]

Comparison 1. Renal denervation vs. sham/standard therapy

Ir a la tabla de la revisión

The Cochrane Library

Scolaris Language Selector Scolaris Language Selector

Idioma de la Revisión Cochrane

Idioma de la web

Scolaris Content Language Banner Portlet Scolaris Content Language Banner Portlet