Key result
Baroreflex amplification and carotid body modulation show promise as novel therapies for resistant hypertension, but require confirmation from ongoing randomized, sham-controlled trials.
Why the study?
Patients with true resistant hypertension have high sympathetic activity and may benefit from baroreflex amplification or carotid body modulation, warranting an up-to-date overview of available evidence.
Does baroreflex amplification or carotid body modulation improve blood pressure control in patients with resistant hypertension?
Does baroreflex amplification or carotid body modulation improve blood pressure control in patients with resistant hypertension?
Baroreflex amplification and transvenous carotid body ablation show promise for improving blood pressure in resistant hypertension, but large randomized sham-controlled trials are needed before clinical implementation.
May expand options for resistant hypertension; extends sympathetic modulation evidence with recent trial data.
PURPOSE OF REVIEW: Patients with true resistant hypertension (RH) are characterized by having high sympathetic activity and therefore potentially benefit from treatments such as baroreflex amplification (baroreflex activation therapy (BAT) or endovascular baroreflex amplification therapy (EVBA)) or carotid body (CB) modulation. This review aims at providing an up-to-date overview of the available evidence regarding these two therapies. RECENT FINDINGS: In recent years, increasing evidence has confirmed the potential of baroreflex amplification, either electrically (Barostim neo) or mechanically (MobiusHD), to improve blood pressure control on short- and long-term with only few side effects, in patients with RH. Two studies regarding unilateral CB resection did not show a significant change in blood pressure. Only limited studies regarding CB modulation showed promising results for transvenous CB ablation, but not for unilateral CB resection. Despite promising results from mostly uncontrolled studies, more evidence regarding the safety and efficacy from ongoing large randomized sham-controlled trials is needed before baroreflex amplification and CB modulation can be implemented in routine clinical practice.
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Groenland et al. (2020) conducted a review in Resistant hypertension. Baroreflex amplification and carotid body modulation was evaluated. Baroreflex amplification and carotid body modulation show promise as novel therapies for resistant hypertension, but require confirmation from ongoing randomized, sham-controlled trials.
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