What is the clinical evidence from this study?

Study design: RCT. Population: resistant hypertension (n=125). Intervention: Radiofrequency-based renal denervation vs. Spironolactone and Dapagliflozin. Primary outcome: Reduction in office systolic blood pressure at 1 year (p=<0.001).

What question did this study set out to answer?

This study compares the effectiveness of renal denervation with pharmacological treatments in managing resistant hypertension.

June 3, 2026

The Effect of Radiofrequency-Based Renal Denervation on Blood Pressure Values in Patients With Resistant Hypertension: One-Year Follow-Up

Q: What are the key findings of this study?

Radiofrequency-based renal denervation reduced office systolic blood pressure by 6.32 mmHg at 1 year, which was less effective than spironolactone (-12.64 mmHg) (p<0.001).

Q: What question did this study set out to answer?

This study compares the effectiveness of renal denervation with pharmacological treatments in managing resistant hypertension.

Key Result

Radiofrequency-based renal denervation reduced office systolic blood pressure by 6.32 mmHg at 1 year, which was less effective than spironolactone (-12.64 mmHg) (p<0.001).

Key Points

This study compares the effectiveness of renal denervation with pharmacological treatments in managing resistant hypertension.
125 patients with resistant hypertension were enrolled and randomized into three groups: spironolactone, dapagliflozin, and renal artery denervation.
All patients received standardized pharmacological treatment for 4 weeks prior to randomization and were monitored at baseline, 6, and 12 months.
At 12 months, spironolactone reduced office SBP by -12.64 mmHg, significantly more than dapagliflozin (-5.42 mmHg) and renal denervation (-6.32 mmHg), p < 0.001.
Office DBP reductions were also greater with spironolactone (-4.7 mmHg) compared to dapagliflozin (-2.52 mmHg) and renal denervation (-3.96 mmHg), p < 0.001.

Study Design

Type

RCT (n=125)

Structured PICO

Does radiofrequency-based renal denervation reduce blood pressure compared to spironolactone or dapagliflozin in patients with resistant hypertension?

Population

125 patients with resistant hypertension confirmed after 4 weeks of standardized pharmacological treatment, followed for 12 months.

Intervention

Radiofrequency-based renal denervation (performed in main renal arteries and branches) added to standardized pharmacological treatment

Comparator

Spironolactone or dapagliflozin added to standardized pharmacological treatment

Outcome

Reduction in office systolic and diastolic blood pressure, and 24-hour ambulatory blood pressure at 12 monthssurrogate

Spironolactone remains the most effective adjunctive therapy for resistant hypertension, providing superior blood pressure reduction compared to dapagliflozin and renal denervation at 1 year.

Main Result

Absolute Event Rate: -6.32% vs -12.64%

p-value: p=<0.001

Abstract

Objective: Comparative evaluation of the effectiveness of radiofrequency-based renal denervation versus pharmacological treatment in reducing blood pressure in patients with resistant hypertension. Design and method: The study enrolled 125 patients with resistant hypertension who, over a period of 4 weeks, received standardized pharmacological treatment. After confirmation of treatment resistance, the patients were randomized into three research groups according to the therapy added to the previously administered regimen: Group I – Spironolactone, Group II – Dapagliflozin, Group III – renal artery denervation. Patients underwent evaluation at baseline, 6 and 12 months. Renal denervation was performed in the main renal arteries and their branches. Results: Office SBP and DBP values, comparably elevated at baseline, demonstrated a statistically significant reduction beginning at the 6-month evaluation across all study groups, with the maximum effect observed at the end of follow-up. At one year of monitoring, office SBP showed a superior reduction in the spironolactone group (-12.64 ± 0.16 mmHg) compared with dapagliflozin (-5.42 ± 0.09 mmHg) and renal denervation (-6.32± 0.15 mmHg), p < 0.001. A similar pattern was noted for office DBP (-4.7 ± 0.12 mmHg in Group I versus -2.52 ± 0.16 mmHg in Group II and -3.96 ± 0.16 mmHg in Group III, p < 0.001). SBP m/24 h demonstrated a reduction across all three study groups at the 6-month evaluation. By the end of the study, this reduction amounted to -11.26 ± 0.21 mmHg in Group I compared with - 4.44 ± 0.12 mmHg in Group II and -5.84 ± 0.14 mmHg in Group III, p < 0.001. Spironolactone maintained superior efficacy relative to dapagliflozin and renal denervation. In contrast, ambulatory DBP reductions were comparable at 6 months, but by 12 months spironolactone and renal denervation proved superior to dapagliflozin. Conclusions: Renal denervation proved effective in lowering blood pressure in patients with resistant hypertension. Overall, mineralocorticoid receptor blockade with spironolactone remains the most effective adjunctive therapy for resistant hypertension, while renal denervation may serve as a complementary option in selected patients.

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