Key result
Baroreflex activation therapy fails to significantly reduce systolic ambulatory or office blood pressure.
Why the study?
Baroreflex activation therapy is a treatment option for resistant hypertension, but real-world data on blood pressure response and procedural safety of the second-generation Barostim Neo system remain limited.
Does baroreflex activation therapy using the Barostim Neo system reduce systolic office and 24 h ambulatory blood pressure in patients with resistant hypertension?
Observational (n=37)
No
Does baroreflex activation therapy using the Barostim Neo system reduce systolic office and 24 h ambulatory blood pressure in patients with resistant hypertension?
In a real-world cohort with resistant hypertension, baroreflex activation therapy did not significantly reduce blood pressure overall, though a subset of responders achieved substantial reductions with a 13.5% periprocedural complication rate.
Answers are grounded in this paper and cite their sources.
Cautious use of baroreflex activation therapy is warranted in resistant hypertension; leaves open identification of reliable response predictors.
Baroreflex activation therapy (BAT) has emerged as a treatment option for patients with resistant hypertension; however, real-world data on blood pressure response and procedural safety of the second-generation Barostim Neo system remain limited. In this single-center retrospective study, 37 patients with resistant hypertension who underwent BAT implantation between 2013 and 2024 were analyzed. Changes in systolic office blood pressure (OBP) and 24 h ambulatory blood pressure (ABP) were assessed. Patients were classified as responders if any reduction in systolic blood pressure from baseline was observed. Periprocedural safety and procedural characteristics were also evaluated. In the overall cohort, no statistically significant reduction in systolic blood pressure was observed (ABP: 159 ± 27 to 157 ± 24 mmHg; OBP: 172 ± 19 to 165 ± 29 mmHg; both p > 0.05). However, a substantial proportion of patients showed a clinically meaningful response. Among responders, systolic ABP decreased significantly from 170 ± 24 to 141 ± 15 mmHg and systolic OBP from 178 ± 16 to 146 ± 17 mmHg (both p < 0.0001). A combined improvement in ABP and OBP was observed in 48% of patients with complete data. The mean implantation time was 74 min, and periprocedural complications occurred in 13.5% of cases. Generator replacement procedures were shorter and associated with a low rate of transient complications. In this real-world cohort, BAT using the Barostim Neo system appears to be a safe therapeutic option, although not all patients benefit. Among responders, BAT is associated with substantial and clinically relevant blood pressure reduction. Further prospective studies are needed to improve patient selection and evaluate long-term outcomes.
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Al‐asbahi et al. (2026) conducted an observational in Resistant hypertension (n=37). Baroreflex activation therapy (Barostim Neo system) vs. Baseline blood pressure was evaluated on Changes in systolic office blood pressure (OBP) and 24 h ambulatory blood pressure (ABP) (p=>0.05). Baroreflex activation therapy did not significantly reduce overall systolic ABP (159 to 157 mmHg) or OBP (172 to 165 mmHg; both p>0.05), though 48% of patients had combined BP improvement.
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