Why the study?
Hypertension remains a major cause of cardiovascular complications and premature death despite pharmacotherapy, prompting nonpharmacological device-based attempts to reduce sympathetic activity in therapy-resistant hypertension.
Do device-based treatments (renal denervation, baroreceptor activation, pacemaker neuromodulation) reduce blood pressure in patients with therapy-resistant arterial hypertension?
Do device-based treatments (renal denervation, baroreceptor activation, pacemaker neuromodulation) reduce blood pressure in patients with therapy-resistant arterial hypertension?
Device-based therapies offer a promising nonpharmacological approach for reducing blood pressure in patients with therapy-resistant hypertension, though routine clinical use awaits further large-scale randomized trial data.
May support device therapies in resistant hypertension; leaves open long-term safety and optimal candidates pending large RCTs.
Hypertension is still the cause of many cardiovascular complications and the premature death of a large number of patients despite the use of increasingly effective pharmacological drugs. Most patients with therapy-resistant hypertension show excessive activity of the sympathetic system. In the last two decades, there have been successful attempts at nonpharmacological reduction of this activity. The earliest method for this purpose is the denervation of the renal arteries by using devices specially designed for this purpose. Other methods of lowering blood pressure are the electrical activation of baroreceptors, which increases the tone of the parasympathetic system, and special pacemaker software to lower blood pressure. The paper discusses the studies assessing the effectiveness and safety of these methods, and on the basis of the current research results, predictions are made concerning which patients with arterial hypertension would be the most appropriate for these treatment methods.
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Głuszek et al. (2023) studied this question.
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