title: Long-term effects of baroreflex activation therapy on glucose metabolism.
abstract: OBJECTIVE
  Sympathetic overactivity is one critical factor associated with the development of arterial hypertension, impaired insulin secretion and resistance. Some antihypertensives exert beneficial effects on glucose metabolism, whereas others lead to an impairment of metabolic state with consecutive weight gain. In resistant hypertension, baroreflex activation therapy (BAT) reduces arterial blood pressure (BP) by inhibition of the sympathetic nervous system. The objective of this study was to evaluate whether BAT influences metabolic state in patients with resistant hypertension.
  
  
  METHODS
  Thirty patients with resistant hypertension (10 with known diabetes mellitus) were prospectively included into this study. Blood pressure, BMI, weight, fasting glucose, insulin, C-peptide, hemoglobin A1c, HOMA-IR, HOMA-β, ISQuickI, and glucose levels during oral glucose tolerance test were measured at baseline and 6 months after BAT activation.
  
  
  RESULTS
  Fasting glucose was significantly reduced after 6 months of BAT, whereas mean 2-h glucose levels during oral glucose tolerance test, fasting insulin levels, C-peptide levels, hemoglobin A1c, HOMA-IR, HOMA-β, ISQuickI, weight, and BMI remained unchanged.
  
  
  CONCLUSIONS
  Despite improvement in fasting glucose, BAT exerts neither sustained additional beneficial effects nor an impairment of metabolic state. Thus, chronic BAT might be an effective interventional method to reduce BP without metabolic disadvantages.
authors.affiliation: Department of Nephrology and Rheumatology, Georg-August-University Göttingen, Robert - Koch - Str. 40, 37075, Göttingen, Germany. manuel.wallbach@med.uni-goettingen.de.
authors.forename: Manuel
authors.initials: M
authors.lastname: Wallbach
authors.affiliation: Department of Nephrology and Rheumatology, Georg-August-University Göttingen, Robert - Koch - Str. 40, 37075, Göttingen, Germany.
authors.forename: Luca-Yves
authors.initials: LY
authors.lastname: Lehnig
authors.affiliation: Department of Medical Statistics, Georg-August-University Göttingen, Göttingen, Germany.
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Helms
authors.affiliation: Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Schroer
authors.affiliation: Department of Nephrology and Rheumatology, Georg-August-University Göttingen, Robert - Koch - Str. 40, 37075, Göttingen, Germany.
authors.forename: Gerhard A
authors.initials: GA
authors.lastname: Müller
authors.affiliation: Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Wachter
authors.affiliation: Department of Nephrology and Rheumatology, Georg-August-University Göttingen, Robert - Koch - Str. 40, 37075, Göttingen, Germany.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Koziolek
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects; D017704:Baroreflex / Q000502:physiology*; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D001794:Blood Pressure / Q000502:physiology; D002096:C-Peptide / Q000097:blood; D048909:Diabetes Complications / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013564:Sympathetic Nervous System / Q000503:physiopathology
chemical_list: D000959:Antihypertensive Agents; D001786:Blood Glucose; D002096:C-Peptide; D006442:Glycated Hemoglobin; D007328:Insulin
keywords: Fasting glycemia; Glucose metabolism; Insulin resistance; Resistant hypertension; Sympathetic nervous system