Key result
Carotid sinus nerve denervation reduces resting MAP by ~16 mm Hg vs sham in preclinical hypertension.
Why the study?
The carotid body is a potential treatment target for hypertension, but the mechanisms driving increased carotid body tonicity in hypertension remain incompletely understood.
Does carotid sinus nerve denervation reduce blood pressure in an ovine model of renovascular hypertension?
Does carotid sinus nerve denervation reduce blood pressure in an ovine model of renovascular hypertension?
Absolute Event Rate: 17% vs 1%
p-value: p=<0.0001
In an ovine model of renovascular hypertension, carotid sinus nerve denervation significantly reduces blood pressure, highlighting the carotid body's role in amplifying hypertension.
Supports carotid sinus denervation as experimental BP target; leaves open translation to human renovascular hypertension.
The carotid body is implicated as an important mediator and potential treatment target for hypertension. The mechanisms driving increased carotid body tonicity in hypertension are incompletely understood. Using a large preclinical animal model, which is crucial for translation, we hypothesized that carotid sinus nerve denervation would chronically decrease blood pressure in a renovascular ovine model of hypertension in which hypertonicity of the carotid body is associated with reduced common carotid artery blood flow. Adult ewes underwent either unilateral renal artery clipping or sham surgery. Two weeks later, flow probes were placed around the contralateral renal and common carotid arteries. Hypertension was accompanied by a significant reduction in common carotid blood flow but no change in renal blood flow. Carotid sinus nerve denervation significantly reduced blood pressure compared with sham. In both hypertensive and normotensive animals, carotid body stimulation using potassium cyanide caused dose-dependent increases in mean arterial pressure and common carotid conductance but a reduction in renal vascular conductance. These responses were not different between the animal groups. Taken together, our findings indicate that (1) the carotid body is activated in renovascular hypertension, and this is associated with reduced blood flow (decreased vascular conductance) in the common carotid artery and (2) the carotid body can differentially regulate blood flow to the common carotid and renal arteries. We suggest that in the ovine renovascular model, carotid body hypertonicity may be a product of reduced common carotid artery blood flow and plays an amplifying role with the kidney in the development of hypertension.
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Chang et al. (2020) studied Renovascular hypertension (n=31). Carotid sinus nerve denervation vs. Sham surgery was evaluated on Decrease in resting mean arterial pressure (MAP) (p=<0.0001). Carotid sinus nerve denervation significantly reduced resting mean arterial pressure by 17±1 mm Hg compared to a 1±1 mm Hg reduction with sham surgery in an ovine model of renovascular hypertension.
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