Department of Cardiology, University of Texas Medical Branch, Galveston, TX.
Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX.
Curr Probl Cardiol. 2024 Feb;49(2):102137. doi: 10.1016/j.cpcardiol.2023.102137. Epub 2023 Oct 18.
Resistant hypertension is a condition in which blood pressure remains elevated despite using 3 or more antihypertensive medications. Though contemporary antihypertensive drug therapies have been essential in treating hypertension, in recent years different studies have explored renal denervation (RDN) as an adjunctive or a replacement modality. Here we summarize an open-label, Symplicity HTN 2 trial and 7 randomized, sham-controlled clinical trials: Spyral-HTN OFF MEDS (Spyral Pivotal), Spyral-HTN ON MEDS, RADIANCE-HTN SOLO, RADIANCE-HTN TRIO, RADIANCE II, SYMPLICITY-HTN 1, and SYMPLICITY-HTN 3, which evaluated safety and efficacy of multiple renal denervation systems (RDN) at lowering blood pressure from baseline, and in comparison, to control group. Prior systematic reviews and meta-analyses evinced a modest reduction of ambulatory and office blood; however, these trials and analyses were limited by short-term follow-up. In our updated comprehensive literature review we summarize the short-term, and long-term effects of RDN, based on the latest randomized clinical trials. Our conclusions based on each summary are unanimous with previous literature findings.
抗药性高血压是指尽管使用了 3 种或更多种降压药物，但血压仍居高不下的一种情况。虽然当代降压药物治疗在治疗高血压方面非常重要，但近年来不同的研究已经探索了肾去神经术（RDN）作为辅助或替代治疗方式。在这里，我们总结了一项开放性标签的 Symplicity HTN 2 试验和 7 项随机、假对照临床试验：Spyral-HTN OFF MEDS（Spyral 关键）、Spyral-HTN ON MEDS、RADIANCE-HTN SOLO、RADIANCE-HTN TRIO、RADIANCE II、SYMPLICITY-HTN 1 和 SYMPLICITY-HTN 3，这些试验评估了多种肾去神经系统（RDN）降低血压的安全性和有效性，与对照组相比，这些系统从基线开始降低血压。先前的系统评价和荟萃分析表明，动态和诊室血压有适度降低；然而，这些试验和分析受到短期随访的限制。在我们最新的全面文献综述中，我们根据最新的随机临床试验总结了 RDN 的短期和长期效果。我们基于每个摘要得出的结论与之前的文献研究结果一致。
