Evidence map›Paper›PMID 25709581›Full record

ReviewFrontiers in physiology2015

Renal sympathetic denervation after Symplicity HTN-3 and therapeutic drug monitoring in severe hypertension.

Fadl Elmula M Fadl Elmula, Anne C Larstorp, Sverre E Kjeldsen, Alexandre Persu, Yu Jin, Jan A Staessen

Open access · goldAbstract readReview
In one paragraph

Review in Frontiers in physiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.1field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 15 citations in OpenAlex.

  1. Review
  2. Can we predict the blood pressure response to renal denervation?Autonomic neuroscience : basic & clinical · 2017
    Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 3 countries.

Fadl Elmula M Fadl ElmulaDepartments of Cardiology and Internal Medicine, Oslo University Hospital Ullevaal, Norway ; Faculty of Medicine, University of Oslo Oslo, Norway.
Anne C LarstorpDepartments of Cardiology and Internal Medicine, Oslo University Hospital Ullevaal, Norway ; Faculty of Medicine, University of Oslo Oslo, Norway.
Sverre E KjeldsenDepartments of Cardiology and Internal Medicine, Oslo University Hospital Ullevaal, Norway ; Faculty of Medicine, University of Oslo Oslo, Norway.
Alexandre PersuPole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain Brussels, Belgium ; Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain Brussels, Belgium.
Yu JinStudies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven Leuven, Belgium.
Jan A StaessenStudies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven Leuven, Belgium ; VitaK Development and Research, Maastricht University Maastricht, Netherlands.
University of Oslo · NOKU Leuven · BECliniques Universitaires Saint-Luc · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Renal sympathetic denervation (RDN) has been and is still proposed as a new treatment modality in patients with apparently treatment resistant hypertension (TRH), a condition defined as persistent blood pressure elevation despite prescription of at least 3 antihypertensive drugs including a diuretic. However, the large fall in blood pressure after RDN reported in the first randomized study, Symplicity HTN-2 and multiple observational studies has not been confirmed in five subsequent prospective randomized studies and may be largely explained by non-specific effects such as improvement of drug adherence in initially poorly adherent patients (the Hawthorne effect), placebo effect and regression to the mean. The overall blood-pressure lowering effect of RDN seems rather limited and the characteristics of true responders are largely unknown. Accordingly, RDN is not ready for clinical practice. In most patients with apparently TRH, drug monitoring and improvement of drug adherence may prove more effective and cost-beneficial to achieve blood pressure control. In the meantime, research should aim at identifying characteristics of those patients with truly TRH who may respond to RDN.

Indexed as

antihypertensive drugsdrug monitoringhypertensionrenal denervationtreatment resistance

Identifiers

PMID25709581
PMCPMC4321349
OpenAlexW2073342624

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.