Objective To summary the effects and prospects of percutaneous radiofrequency catheter-based renal sympathetic denervation for resistant hypertension. Methods Literatures which about the relationship between renal sympathetic nerves and hypertension， and the technical prospect and inadequacy of percutaneous radiofrequency catheter-based renal sympathetic denervation for resistant hypertension， were analyzed and reviewed. Results Hypertension， which as a seriously public health problem， was the focus of clinical treatment currently. Renal sympathetic nerve was certified playing an important role in regulation of blood pressure， and percutaneous radiofrequency catheter-based renal sympathetic denervation had potential superiority in the treatment of resistant hypertension. Conclusion Percutaneous radiofrequency catheter-based renal sympathetic denervation is an effective method for resistant hypertension.
ObjectiveTo review the progress of percutaneous radiofrequency catheter-based renal sympathetic denervation for resistant hypertension as well as the inadequacy, and to reevaluate the clinical significance of the technology. MethodsDomestic and foreign literatures were collected to summary the progress of percutaneous radiofrequency catheter-based renal sympathetic denervation in treatment of resistant hypertension. ResultsThe percutaneous radiofrequency catheter-based renal sympathetic denervation in the treatment of resistant hypertension had obtained some positive results recently, but the long-term outcomes and safety of the technology were still subjected to further evaluation. ConclusionThe effect of percutaneous radiofrequency catheter-based renal sympathetic denervation for resistant hypertension remains to be controversial, and both the equipment and technology of radiofrequency catheter-based ablation need to be improved.
ObjectiveTo Affiliated systematically review the efficacy of continuous positive airway pressure (CPAP) for resistant hypertension (RH) patients with obstructive sleep apnea (OSA). MethodsWe electronically searched databases including PubMed, EMbase, The Cochrane Library (Issue 10, 2015), CBM, CNKI and WanFang Data from inception to March 2016, to collect randomized controlled trials (RCTs) about CPAP for RH patients with OSA. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 5 RCTs involving 395 patients were included. The results of meta-analysis showed that: After 3 months of follow-up, compared with the antihypertensive drug therapy alone, CPAP plus antihypertensive drug therapy could significantly reduce the 24 h diastolic blood pressure (DBP), day DBP, night DBP, 24 h diastolic blood pressure (SBP) and night SBP of RH patients with OSA (MD=-4.79, 95%CI -7.39 to -2.18, P=0.000 3; MD=-2.94, 95%CI -4.99 to -0.89, P=0.005; MD=-3.19, 95%CI -5.84 to -0.55, P=0.02; MD=-4.36, 95%CI -7.38 to -1.33, P=0.005; MD=-4.90, 95%CI -8.72, -1.08, P=0.01), but there was no significant difference between the two groups in day SBP. After 6 months of follow-up, compared with the antihypertensive drug therapy alone, CPAP plus antihypertensive drug therapy could significantly reduce the 24 h DBP, day DBP of RH patients with OSA (MD=-4.89, 95%CI -6.76 to -3.02, P<0.000 01; MD=-5.01, 95%CI -9.58 to -0.45, P=0.03), but there were no significant differences between the two groups in night DBP, 24 h SBP, day SBP, and night SBP. ConclusionCurrent evidence suggests that CPAP on the basis of antihypertensive drug therapy could effectively reduce the DBP and SBP of RH patients with OSA at short-term follow-up, but the long-term effect on SBP is not obvious. Due to limited quality and quantity of the included studies, the above conclusions need to be verified by more high quality studies.