Key result
Renal denervation reduces 24-hour ambulatory systolic BP by ~16 mmHg over nearly 9 years.
Why the study?
Although renal denervation (RDN) is approved and guideline-recommended for resistant or uncontrolled hypertension, current evidence on the long-term durability and safety of the procedure beyond 3 years of follow-up required systematic evaluation.
Does renal denervation provide long-term reductions in 24-hour ambulatory blood pressure and maintain renal safety in patients with hypertension?
Meta-Analysis (n=384)
Yes
Does renal denervation provide long-term reductions in 24-hour ambulatory blood pressure and maintain renal safety in patients with hypertension?
This meta-analysis demonstrates that renal denervation provides durable 24-hour blood pressure reductions up to 10 years post-procedure without clinically meaningful deterioration in renal function beyond expected age-related decline.
Supports durable BP reduction with renal denervation beyond 3 years; extends short-term data to mean 8.7-year follow-up in resistant hypertension.
Background/Introduction Renal denervation (RDN) has been approved in Europe and the US and is recommended by the ESH, ACC/AHA and ESC hypertension guidelines as a therapeutic option for patients with resistant or uncontrolled hypertension. Purpose The aim of this study was to perform a systematic review and meta-analysis of current evidence to evaluate the long-term durability and safety of the procedure. Methods A systematic literature search was conducted to identify relevant studies reporting long-term outcomes of RDN beyond 3 years of follow-up. Data of interest (baseline characteristics, BP data, eGFR) were extracted and tabulated in order to be used in the context of a meta-analysis. Results Eight studies fulfilled the inclusion criteria and were included in the systematic review and meta-analysis. Most studies were conducted in Europe, one in Brazil, one in China and one in Australia. Follow-up duration ranged from 5 to 10 years. Meta-analysis of 8 studies (N=384, weighted mean age 61 years, 25% females) indicated a pooled follow-up minus baseline systolic and diastolic 24h ABP mean difference of -15.7 mmHg (-18.4, -13.0) and -9.2 mmHg (-10.5, -7.9), respectively, over a period of 8.7 years. Meta-analysis of 5 studies (N=187, weighted mean age 64 years, 34% females) indicated a pooled follow-up minus baseline eGFR mean difference of -8.9 ml/min/1.73 m2 (-11.1, -6.7) over a period of 8.5 years. Conclusion(s) The RDN procedure has a favorable efficacy and safety profile, with minimal peri-procedural and long-term vascular complications and no clinically meaningful effects on renal function. The lasting benefits of the intervention enhance its appeal as a supplementary approach for the management of hypertension.
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Kyriakoulis et al. (2026) conducted a meta-analysis in Resistant or uncontrolled hypertension (n=384). Renal denervation (RDN) vs. Baseline (pre-procedure) was evaluated on Follow-up minus baseline 24h ambulatory systolic blood pressure (MD -15.7 mmHg, 95% CI -18.4 to -13.0). Renal denervation reduced 24h ambulatory systolic BP by 15.7 mmHg (95% CI -18.4 to -13.0) and diastolic BP by 9.2 mmHg over 8.7 years.
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