title: Resistant hypertension: baroreflex stimulation as a new tool.
abstract: Uncontrolled hypertension remains a significant public health challenge. In recent years, a new baroreflex stimulator has been used to treat these patients. Initial observations suggest that the electrical field stimulation of carotid baroreceptors acutely attenuates sympathetic activation of the vasculature, heart and kidney while augmenting cardiac vagal regulation. During the long-term treatment an average blood pressure (BP) drop of 30-40/15-25 mmHg was observed with a responder rate (>10 mmHg reduction in BP) of up to 80% after 1 year of treatment. Some of this effect can be explained by a 'placebo' effect as suggested by the double-blind Pivotal Trial. The complication rate with the first generation device was 20-30%. With a second generation device, these problems have been reduced to <10%. Even though additional data from controlled clinical trials will be required before more widespread use can be recommended, this treatment option is now approved in Europe for the treatment of severe resistant hypertension and is performed in selected centres with experienced vascular surgeons and hypertension specialists.
authors.affiliation: Department of Nephrology and Hypertension, Medical School Hannover, Hannover, Germany. menne.jan@mh-hannover.de
authors.forename: Jan
authors.initials: J
authors.lastname: Menne
authors.forename: Jens
authors.initials: J
authors.lastname: Jordan
authors.forename: Silvia
authors.initials: S
authors.lastname: Linnenweber-Held
authors.forename: Hermann
authors.initials: H
authors.lastname: Haller
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D017704:Baroreflex / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D002339:Carotid Arteries / Q000502:physiology; D004351:Drug Resistance; D004599:Electric Stimulation Therapy / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000628:therapy*; D011311:Pressoreceptors / Q000502:physiology; D013564:Sympathetic Nervous System / Q000502:physiology; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents