Baroreflex Activation Therapy for Resistant Hypertension: Results from Midterm Prospective Ambulatory Blood Pressure Registry

Abstract Arterial hypertension is associated with increased cardiovascular morbidity and mortality. Although blood pressure-lowering therapies significantly reduce the risk of major cardiovascular events, blood pressure control remains unsatisfactorily low. Several device-based antihypertensive therapies have been investigated in patients with treatment-resistant hypertension and in patients unable or unwilling to adhere to antihypertensive medication. As the field of device-based therapies is subject to constant change, this review aims at providing an up-to-date overview of different device-based approaches for the treatment of hypertension. These approaches target the sympathetic nervous system (renal denervation, baroreflex amplification therapy, baroreflex activation therapy, and carotid body ablation) or alter mechanical arterial properties by creating an iliac arteriovenous fistula. Notably, the use of all of these treatment options is not recommended for the routine treatment of hypertension by current guidelines but should be investigated in the context of controlled clinical studies.

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New Hope for Resistant Hypertention

Cardiovascular Journal ◽

10.3329/cardio.v5i1.12278 ◽

2012 ◽

Vol 5 (1) ◽

pp. 81-91

Author(s):

Z Rahman ◽

KK Karmaker ◽

M Ahmed ◽

M Aziz ◽

S Chowdhury ◽

...

Keyword(s):

Resistant Hypertension ◽

Patient Adherence ◽

Public Health Problem ◽

Drug Regimen ◽

Renal Sympathetic Denervation ◽

Major Public Health Problem ◽

Antihypertensive Medications ◽

Baroreflex Activation Therapy ◽

Activation Therapy ◽

Increasing Trends

Hypertension is a major public health problem. Despite the increasing awareness of hypertension and its implications among patients and treating physicians, the prevalence of resistant hypertension remains high.Resistant hypertension define as blood pressure that remains elevated above treatment goals despite administration of an optimal three drug regimen that include a diuretic1 The prevalence of resistant hypertension is projected to increase, owing to the aging population and increasing trends in obesity, sleep apnea, and chronic kidney disease. It is estimated that at least 10% of all patients with hypertension are resistant to existing drugs. Management of resistant hypertension must begin with a careful evaluation of the patient to confirm the diagnosis and exclude factors associated with pseudo-resistance, such as improper BP measurement technique, the white-coat effect, and poor patient adherence to life-style and/or antihypertensive medications. Despite the use of the appropriate dose and type of diuretic to overcome the management of resistant hypertension, we cant achieve our goal. But there is at least two devices namely Baroreflex Activation Therapy and Catheter-based renal sympathetic denervation make the new hope for the patient with resistant hypertension DOI: http://dx.doi.org/10.3329/cardio.v5i1.12278 Cardiovasc. j. 2012; 5(1): 81-91

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