Renal denervation yielded a significantly greater 12-month reduction in 24-hour ambulatory SBP compared to pharmacological optimization (-30.5 vs -16.6 mmHg; difference -13.2 mmHg, P<0.001).
RCT (n=120)
1:1
No
Does renal denervation reduce 24-hour ambulatory SBP compared to pharmacological optimization in adults with uncontrolled hypertension despite triple therapy?
Renal denervation significantly reduces ambulatory blood pressure, improves control rates, and lowers medication burden compared to pharmacological optimization in patients with resistant hypertension.
Effect estimate: Difference -13.2 mmHg (95% CI -18.1 to -8.3)
Absolute Event Rate: -30.5% vs -16.6%
p-value: p=<0.001
Uncontrolled hypertension persists as a major cardiovascular threat in Uzbekistan, where resistant cases challenge standard pharmacological approaches. This prospective randomized controlled trial, conducted at the Republican Specialized Scientific-Practical Medical Center of Cardiology in Tashkent from January 2024 to December 2025, compared renal denervation (RDN) versus pharmacological optimization (PO) in 120 adults with office SBP ≥160 mmHg despite triple therapy. Patients were randomized 1:1; RDN used Symplicity Spyral™ ablation, while PO involved up-titration to five agents. Primary endpoint was 12-month change in 24-hour ambulatory SBP. Baseline traits were balanced (mean age 59 years, SBP 172 mmHg). RDN yielded a -30.5 mmHg SBP drop versus -16.6 mmHg for PO (between-group difference -13.2 mmHg, 95% CI -18.1 to -8.3, P<0.001), with superior responder rates (82% vs. 52%, P<0.001) and control (<130/80 mmHg: 58% vs. 27%). Drug burden fell to 2.8 versus 4.6 agents (P<0.001), with quality-of-life gains (+0.12 vs. +0.05 EQ-5D, P=0.002). Safety was comparable (serious AEs: 9% vs. 13%). RDN shows marked efficacy and simplification in this real-world Uzbek cohort, supporting its role in resistant hypertension management amid local constraints. These findings urge guideline updates for device therapies in Central Asia.
Gulkhayo et al. (Thu,) conducted a rct in uncontrolled hypertension (n=120). Renal denervation (RDN) vs. Pharmacological optimization (PO) was evaluated on 12-month change in 24-hour ambulatory SBP (Difference -13.2 mmHg, 95% CI -18.1 to -8.3, p=<0.001). Renal denervation yielded a significantly greater 12-month reduction in 24-hour ambulatory SBP compared to pharmacological optimization (-30.5 vs -16.6 mmHg; difference -13.2 mmHg, P<0.001).