title: Blood pressure after blinded, randomized withdrawal, and resumption of baroreceptor-activating therapy.
abstract: Baroreceptor-activating therapy (BAT) has been shown to control resistant hypertension in one sham-controlled and further observational studies. Incremental but significant reincrease of blood pressure (BP) have been described after open-label temporary withdrawal of such therapy.
  
  
  
  Our study in 16 randomized patients investigated the course of automated office, ambulatory, and home BP in a randomized, controlled cross-over design.
  
  
  
  After 4 weeks of blinded and randomized withdrawal in hypertension-controlled long-term carriers of BAT (2.67 ± 1.3 years, 145/104 mmHg), the primary end point of 35 mmHg difference, similar to initial BP drop after BAT initiation, was not reached in any patient. Ambulatory BP rose significantly during BAT off by 10/8 ± 4/3 mmHg (3.13/2.10, P = 0.007/0.002) and automated office BP by 10/4 ± 2/1 (4.17/0.58, P = 0.005/0.03) at 4 weeks after BAT on while mean home BP did not change significantly by 2/2 ± 3/2 mmHg (-5.9/-3.5, P = 0.6/0.5).
  
  
  
  Our data in a limited study population show, that BP rise after temporary BAT withdrawal is significant but does not reach a magnitude comparable with the initial drop after de novo implantation. Such results points to preserved hypertension control after electrical BAT withdrawal and deserves further pathophysiological and clinical clarification.
authors.affiliation: aDepartment of Nephrology, KfH Renal Unit, Hospital St. Georg, Leipzig and Martin-Luther-University Halle/Wittenberg, Halle bDepartment of Vascular Surgery, Hospital St. Georg, Leipzig cDepartment of Nephrology and Rheumatology, University of Göttingen, Göttingen, Germany *Joachim Beige and Theresa Jentzsch contributed equally to this article.
authors.forename: Joachim
authors.initials: J
authors.lastname: Beige
authors.forename: Theresa
authors.initials: T
authors.lastname: Jentzsch
authors.forename: Ralph
authors.initials: R
authors.lastname: Wendt
authors.forename: Gert
authors.initials: G
authors.lastname: Hennig
authors.forename: Michael
authors.initials: M
authors.lastname: Koziolek
authors.forename: Manuel
authors.initials: M
authors.lastname: Wallbach
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D003131:Combined Modality Therapy; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011311:Pressoreceptors / Q000503:physiopathology*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents