FIGURE 2.

Sequential pairwise meta-analysis for mean change in 24-h ambulatory systolic blood pressure for sham-RCTs comparing renal denervation to sham intervention. Sequential pairwise meta-analysis for mean change in 24-h ambulatory systolic blood pressure is shown in the Figure for sham-RCTs comparing renal denervation to sham intervention. As heterogeneity was low, fixed effect meta-analysis was performed. The sham-RCTs were included in the sequential meta-analysis following the chronological order of publication and drawn boundaries were calculated using an adaptation of the continuous alpha-spending function. The sequential approach illustrates the trend of the accumulated evidence over time as the evidence becomes available in favor of renal denervation up to 6 months of follow-up. Crossing a boundary is indicative of strong evidence against the null hypothesis of equal mean differences between the interventions. As shown, the boundaries are already crossed following the addition of the 4th sham-RCT, with a summary mean difference favoring renal denervation of −2.76 (95% CI −4.93 to −0.59). Any additional sham-RCT available after that time-point, did not change the conclusive finding. CI, confidence interval; RCT, randomized controlled trial.