Effect of Renal Denervation for the Management of Heart Rate in Patients With Hypertension: A Systematic Review and Meta-Analysis.

ABSTRACT:

Objective

The effect of renal denervation (RDN) on heart rate (HR) in patients with hypertension had been investigated in many studies, but the results were inconsistent. This meta-analysis was performed to evaluate the efficacy of RDN on HR control.

Methods

Databases, such as PubMed, EMBASE, Cochrane, and ClinicalTrials.gov, were searched until September 2021. Randomized controlled trials (RCTs) or non-RCTs of RDN in hypertensive patients with outcome indicators, such as HR, were selected. Weighted mean difference (WMD) was calculated for evaluating the changes in HR from baseline using fixed-effects or random-effects models. The Spearman's correlation coefficients were used to identify the relationship between the changes of HR and systolic blood pressure (SBP).

Results

In the current meta-analysis, 681 subjects from 16 individual studies were included. This study showed that RDN could reduce office HR in patients with hypertension [WMD = -1.93 (95% CI: -3.00 to -0.85, p < 0.001)]. In addition, 24-h HR and daytime HR were decreased after RDN [WMD = -1.73 (95% CI: -3.51 to -0.31, p = 0.017) and -2.67 (95% CI: -5.02 to -0.32, p = 0.026) respectively], but nighttime HR was not significantly influenced by RDN (WMD = -2.08, 95% CI: -4.57 to 0.42, p = 0.103). We found that the reduction of HR was highly related to the decrease of SBP (r = 0.658, p < 0.05).

Conclusion

Renal denervation could reduce office, 24-h, and daytime HR, but does not affect nighttime HR. And the effect is highly associated with blood pressure (BP) control.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42021283065.

SUBMITTER: Li L 

PROVIDER: S-EPMC8801499 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature