Key result
Renal denervation reduces office systolic BP by ~16 mmHg versus sham control.
Why the study?
Renal denervation has re-emerged as a device-based therapy for hypertension, but the durability of its blood pressure-lowering effect versus sham over long follow-up remains debated.
Does renal denervation reduce office and 24-hour ambulatory blood pressure at the longest available follow-up compared to sham control in patients with hypertension?
Meta-Analysis
Sham-controlled (included trials)
Randomized (included trials)
Does renal denervation reduce office and 24-hour ambulatory blood pressure at the longest available follow-up compared to sham control in patients with hypertension?
Across 18 sham-controlled trials, renal denervation provided durable and clinically meaningful reductions in both office and 24-hour ambulatory blood pressure at the longest available follow-up.
Answers are grounded in this paper and cite their sources.
Supports renal denervation for resistant hypertension; reinforces randomized trial evidence with pooled BP reductions.
Background Renal denervation has re-emerged as a device-based therapy for hypertension, yet durability of effect versus sham over long follow-up remains debated. We synthesized sham-controlled evidence using each trial’s longest available follow-up. Methods We systematically searched PubMed, Scopus, Web of Science, and Google Scholar from inception to 1 June 2025. Eligible studies were randomized, sham-controlled trials reporting change from baseline in office blood pressure and/or 24-hour ambulatory blood pressure. The primary outcomes were mean differences in office systolic and diastolic blood pressure and 24-hour ambulatory systolic and diastolic blood pressure at the longest follow-up. Random-effects inverse-variance meta-analyses were performed. Heterogeneity was quantified with I² and τ². Results Across 18 sham-controlled trials, using each study’s longest follow-up, renal denervation consistently lowered blood pressure versus sham. On average, office systolic pressure fell by 15.54 mmHg 95%CI (−18.56 to −12.52) and office diastolic by 8.19 mmHg 95 percent confidence interval (−9.89 to −6.50). The 24-hour ambulatory readings showed smaller but still meaningful drops: systolic −9.21 mmHg 95%CI (−11.19 to −7.23) and diastolic −5.39 mmHg 95% CI (−6.50 to −4.28). While the amount of benefit varied between studies I² about ninety seven percent across outcomes, the direction of effect was uniformly in favor of renal denervation at short and longer follow-up windows, indicating a durable reduction in both office and ambulatory blood pressure. Conclusions Using the longest available follow-up from sham-controlled randomized trials, renal denervation is associated with durable reductions in both office and 24-hour ambulatory blood pressure. Despite substantial heterogeneity, the pooled effects suggest a clinically meaningful benefit that persists beyond the short term. Future work should standardize outcome reporting, explore sources of heterogeneity, and determine which patient subgroups derive the greatest long-term benefit.Renal Denervation1Renal Denervation 2
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Lashkari et al. (2026) conducted a meta-analysis in Hypertension. Renal denervation vs. Sham procedure was evaluated on Mean differences in office systolic and diastolic blood pressure and 24-hour ambulatory systolic and diastolic blood pressure at the longest follow-up (primary metric reported: office systolic blood pressure) (MD -15.54 mmHg, 95% CI -18.56 to -12.52). Renal denervation reduced office systolic BP by 15.54 mmHg (95% CI -18.56 to -12.52) and 24-hour ambulatory systolic BP by 9.21 mmHg (95% CI -11.19 to -7.23) versus sham at longest follow-up.
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