Why the study?
The comparative effect of different treatments on resistant hypertension was not comprehensively established.
Do different pharmacological, device-based, and lifestyle interventions reduce blood pressure in patients with resistant hypertension?
Population
Thirty-three eligible studies of patients with resistant hypertension
Comparison
Second-generation RDN, MRA, ERA, ASI, SGLT2i, BAT, central AV anastomosis, lifestyle, and control
Design
Systematic review and random-effects network meta-analysis
Key result
Mineralocorticoid receptor antagonists significantly lowered office systolic blood pressure compared to control (MD -9.11; 95% CI -10.44 to -7.79) in patients with resistant hypertension.
Authors
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Network meta-analysis ranks RH regimens by BP effect; leaves open optimal selection pending direct trials.
Meta-Analysis
Do different pharmacological, device-based, and lifestyle interventions reduce blood pressure in patients with resistant hypertension?
Mean Difference: -9.11 (95% CI -10.44–-7.79)
In a network meta-analysis, MRA emerged as the most effective priority treatment for resistant hypertension, with aldosterone synthase inhibitors and renal denervation as optimal alternatives.
Xiao et al. (2026) conducted a meta-analysis in resistant hypertension (RH). Mineralocorticoid receptor antagonist (MRA) vs. Control group was evaluated on change of office systolic blood pressure (SBP) (MD -9.11, 95% CI -10.44 to -7.79). Mineralocorticoid receptor antagonists significantly lowered office systolic blood pressure compared to control (MD -9.11; 95% CI -10.44 to -7.79) in patients with resistant hypertension.