Trial reportJournal of hypertension2016
Spironolactone versus sympathetic renal denervation to treat true resistant hypertension: results from the DENERVHTA study - a randomized controlled trial.
Trial report in Journal of hypertension, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 7 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
35 citing papers in PubMed, 7 syntheses or guidelines pooled it, 80 citations in OpenAlex.
- Pooled it
- Renal denervation for resistant hypertension.The Cochrane database of systematic reviews · 2021Pooled it
- Effect of Renal Denervation for the Management of Heart Rate in Patients With Hypertension: A Systematic Review and Meta-Analysis.Frontiers in cardiovascular medicine · 2021Pooled it
- Clinical efficacy and safety of spironolactone in patients with resistant hypertension: A systematic review and meta-analysis.Medicine · 2020Pooled it
- Renal Denervation for Resistant Hypertension in the contemporary era: A Systematic Review and Meta-analysis.Scientific reports · 2019Pooled it
- Effectiveness of Renal Denervation in Resistant Hypertension: A Meta-Analysis of 11 Controlled Studies.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2018Pooled it
- Account for Clinical Heterogeneity in Assessment of Catheter-based Renal Denervation among Resistant Hypertension Patients: Subgroup Meta-analysis.Chinese medical journal · 2017Pooled it
- Organ damage changes in patients with resistant hypertension randomized to renal denervation or spironolactone: The DENERVHTA (Denervación en Hipertensión Arterial) study.Journal of clinical hypertension (Greenwich, Conn.) · 2018Trial
- Kidney Denervation: Latest Breakthroughs and Insights.Clinical journal of the American Society of Nephrology : CJASN · 2026Review
- Resistant hypertension: Epidemiology, mechanisms and contemporary therapeutic strategies.Heart international · 2026Review
- Clinical trials in neuromodulatory treatment of drug-resistant hypertension and the need for spinal cord stimulation trials: a PRISMA systematic review.Bioelectronic medicine · 2024Review
- Review
- Research status and frontiers of renal denervation for hypertension: a bibliometric analysis from 2004 to 2023.Journal of health, population, and nutrition · 2024Article
- Update on Renal Sympathetic Denervation for the Treatment of Hypertension.Current cardiology reports · 2022Review
- Current Status and Future Perspectives of Renal Denervation.Korean circulation journal · 2021Review
- Renal Denervation for Uncontrolled and Resistant Hypertension: Systematic Review and Network Meta-Analysis of Randomized Trials.Journal of clinical medicine · 2021Review
- Optimizing identification of resistant hypertension: Computable phenotype development and validation.Pharmacoepidemiology and drug safety · 2020Article
- Device-based therapies for arterial hypertension.Nature reviews. Cardiology · 2020Review
- Renal Denervation for Resistant Hypertension: Where Do We Stand?Current hypertension reports · 2020Review
- Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveBoth renal denervation (RDN) and spironolactone have been proposed for the treatment of resistant hypertension. However, they have not been compared in a randomized clinical trial. We aimed to compare the efficacy of spironolactone versus RDN in patients with resistant hypertension.
methodsA total of 24 patients with office SBP at least 150 mmHg and 24-h SBP at least 140 mmHg despite receiving at least three full-dose antihypertensive drugs, one a diuretic, but without aldosterone antagonists, were randomized to receive RDN or spironolactone (50 mg) as add-on therapy. Primary endpoint was change in 24-h SBP at 6 months. Comparisons between treatment groups were performed using generalized linear models adjusted by age, sex, and baseline values.
resultsSpironolactone was more effective than RDN in reducing 24-h SBP and 24-h DBP: mean baseline-adjusted differences between the two groups were -17.9 mmHg (95%CI -30.9 to -4.9); P = 0.010 and -6.6 mmHg (95%CI -12.9 to -0.3); P = 0.041, for 24-h SBP and 24-h DBP, respectively. As regards changes in office blood pressure, mean baseline-adjusted differences between the two groups were -12.1 mmHg (95%CI -29.1 to 5.1); P = 0.158 and of -5.3 mmHg (95%CI -16.3 to 5.8); P = 0.332, for office SBP and office DBP, respectively. Otherwise, the decrease of estimated glomerular filtration rate was greater in the spironolactone group; mean baseline-adjusted difference between the two groups was -10.7 ml/min per 1.73 m (95%CI -20.1 to -1.4); P = 0.027.
conclusionWe conclude that spironolactone is more effective than RDN to reduce 24-h SBP and 24-h DBP in patients with resistant hypertension. Therefore, spironolactone should be the fourth antihypertensive drug to prescribe if deemed well tolerated' in all patients with resistant hypertension before considering RDN.
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