What does this research mean for the field?

First-generation baroreflex activation devices significantly reduce 24h blood pressure in patients with refractory hypertension, while second-generation devices primarily lower heart rate without a significant effect on blood pressure. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

February 11, 2026Open Access

Long-Term Efficacy and Safety of First- and Second-Generation Baroreflex Activation Devices in Refractory Hypertension: A Single Center Retrospective Analysis

Key Result

First-generation Rheos® device lowered 24h blood pressure more, while second-generation Neo™ mainly reduced heart rate in resistant hypertension patients.

Key Points

This analysis evaluates the long-term safety and efficacy of first- and second-generation baroreflex activation devices in patients with refractory hypertension.
Conducted a single-center retrospective analysis
Assessed patients with resistant hypertension
Compared outcomes of first-generation Rheos® and second-generation Neo™ systems
Baroreflex activation was safe for patients
First-generation Rheos® system showed greater blood pressure reductions
Second-generation Neo™ system primarily reduced heart rate without significantly affecting blood pressure

Structured PICO

Does baroreflex activation therapy reduce 24h blood pressure and heart rate in patients with resistant hypertension, and how do first- and second-generation devices compare?

Population

Patients with refractory/resistant hypertension

Intervention

Baroreflex activation therapy (first-generation Rheos system and second-generation Neo system)

Comparator

Comparison between first-generation and second-generation devices

Outcome

24h blood pressure, heart rate, and safetysurrogate

First-generation baroreflex activation devices provided better blood pressure reduction than second-generation devices in resistant hypertension, highlighting the impact of electrode design and implantation strategy.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Baroreflex activation was safe and associated with reductions in 24h blood pressure and heart rate in patients with resistant hypertension. The first-generation Rheos® system demonstrated more pronounced blood pressure-lowering effects, whereas the second-generation Neo™ system was associated primarily with heart rate reduction without a significant effect on blood pressure. Although Rheos® is no longer commercially available, these findings highlight the importance of electrode design, implantation strategy, and patient selection in optimizing the efficacy of contemporary BAT.