scholarly journals Carotid Baroreceptor Stimulation: A Potential Solution for Resistant Hypertension

2013 ◽  
Vol 2 (3) ◽  
pp. 118-122 ◽  
Author(s):  
Jun Zhang ◽  
Shuyu Zhou ◽  
Gelin Xu
Keyword(s):  
Resistant Hypertension ◽  
Potential Solution ◽  
Carotid Baroreceptor ◽  
Baroreceptor Stimulation ◽  
Carotid Baroreceptor Stimulation

scholarly journals Carotid Baroreceptor Stimulation for the Treatment of Resistant Hypertension

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Vasilios Papademetriou ◽  
Michael Doumas ◽  
Charles Faselis ◽  
Constantinos Tsioufis ◽  
Stella Douma ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Resistant Hypertension ◽  
Blood Pressure Reduction ◽  
Current Data ◽  
Pressure Reduction ◽  
Beneficial Effects ◽  
Carotid Baroreceptor ◽  
Complex Anatomy ◽  
Baroreceptor Stimulation ◽  
Carotid Baroreceptor Stimulation

Interventional activation of the carotid baroreflex has been an appealing idea for the management of resistant hypertension for several decades, yet its clinical application remained elusive and a goal for the future. It is only recently that the profound understanding of the complex anatomy and pathophysiology of the circuit, combined with the accumulation of relevant experimental and clinical data both in animals and in humans, has allowed the development of a more effective and well-promising approach. Indeed, current data support a sustained over a transient reduction of blood pressure through the resetting of baroreceptors, and technical deficits have been minimized with a subsequent recession of adverse events. In addition, clinical outcomes from the application of a new implantable device (Rheos) that induces carotid baroreceptor stimulation point towards a safe and effective blood pressure reduction, but longer experience is needed before its integration in the everyday clinical practice. While accumulating evidence indicates that carotid baroreceptor stimulation exerts its benefits beyond blood pressure reduction, further research is necessary to assess the spectrum of beneficial effects and evaluate potential hazards, before the extraction of secure conclusions.

The Pathophysiological Basis of Carotid Baroreceptor Stimulation for the Treatment of Resistant Hypertension

2014 ◽  
Vol 12 (1) ◽  
pp. 16-22 ◽  
Author(s):  
Dragan Lovic ◽  
Athanasios Manolis ◽  
Branko Lovic ◽  
Vesna Stojanov ◽  
Milan Lovic ◽  
...  
Keyword(s):  
Resistant Hypertension ◽  
Carotid Baroreceptor ◽  
Baroreceptor Stimulation ◽  
Carotid Baroreceptor Stimulation

VP101 Medical Devices For Treatment-resistant Hypertension: Health Technology Assessment Report

2017 ◽  
Vol 33 (S1) ◽  
pp. 195-196
Author(s):  
Tom Jefferson ◽  
Iosief Abraha ◽  
Anna Maria Vincenza Amicosante ◽  
Mirella Corio ◽  
Antonio Migliore ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Resistant Hypertension ◽  
Renal Denervation ◽  
Health Technology ◽  
Economic Evaluations ◽  
Treatment Resistant ◽  
Carotid Baroreceptor ◽  
Baroreceptor Stimulation ◽  
Carotid Baroreceptor Stimulation

INTRODUCTION:While optimal medical therapy (OMT) represents the current standard of care for treatment-resistant hypertension, non-pharmaceutical therapeutic approaches, such as renal denervation and carotid baroreceptor stimulation therapy, have been proposed. The present Health Technology Assessment (HTA) project was aimed at assessing benefits and risk of those approaches versus OMT.METHODS:A systematic review of evidence on effectiveness and safety was performed together with a review of economic studies. A contextual analysis of market availability and use of the technology in Italy was also performed.RESULTS:In Italy, ninety-nine renal denervation procedures were performed in 2014. Ten studies from six trials were included in the review and meta-analysis. No evidence of dominance or increased harms of renal denervation compared to OMT were found. Four economic evaluations were included and reported dominance of renal denervation. These were based on short-term clinical data and three evaluations used the same Markov model assuming dominance of renal denervation. Estimated average prospective cost of the procedure was EUR6,129.90 (range EUR3,821.15 – EUR9,714.23). We updated the results of an earlier assessment published by an Italian Regional agency on carotid baroreceptor stimulation therapy (1). None of the three studies identified as ongoing in 2015 were completed or had published preliminary results and the technology was not assessed further within the present HTA project.CONCLUSIONS:Even if follow-up was limited to 6 months, randomised evidence showed no benefits of the procedure. Economic evaluations were unreliable, based on unrealistic assumptions of effectiveness and contrived therapy regimes. Further investment in renal denervation should await the results of well-designed and adequately followed-up trials assessing the impact of renal denervation on major cardiovascular events compared to OMT. Future economic evaluations should be based on realistic assumptions of cost and effectiveness.

scholarly journals Benefits from Treatment and Control of Patients with Resistant Hypertension

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Michael Doumas ◽  
Vasilios Papademetriou ◽  
Stella Douma ◽  
Charles Faselis ◽  
Konstantinos Tsioufis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Resistant Hypertension ◽  
Critical Evaluation ◽  
Renal Sympathetic Denervation ◽  
Therapeutic Modalities ◽  
Carotid Baroreceptor ◽  
Baroreceptor Stimulation ◽  
And Control ◽  
Renal Sympathetic ◽  
Carotid Baroreceptor Stimulation

Resistant hypertension is commonly found in everyday clinical practice. However, the risks of resistant hypertension, as well as the benefits of treatment and control of blood pressure in patients with resistant hypertension remain vaguely clarified. Data from small clinical studies and observational cohorts suggest that patients with resistant hypertension are at increased cardiovascular risk, while control of blood pressure offers substantial benefits. It has to be noted however that data from appropriate large randomized studies are missing, and resistant hypertension remains remarkably understudied. Resistant hypertension has attracted significant scientific interest lately, as new therapeutic modalities become available. The interventional management of resistant hypertension either by carotid baroreceptor stimulation or renal sympathetic denervation is currently under investigation with promising preliminary results. This review presents available evidence regarding the benefits of treatment and control of blood pressure in patients with resistant hypertension and offers a critical evaluation of existing data in this field.

scholarly journals Electrical Carotid Baroreceptor Stimulation in Resistant Hypertension

Hypertension ◽  
2010 ◽  
Vol 55 (3) ◽  
pp. 607-609 ◽  
Author(s):  
Giuseppe Mancia ◽  
Gianfranco Parati ◽  
Alberto Zanchetti
Keyword(s):  
Resistant Hypertension ◽  
Carotid Baroreceptor ◽  
Baroreceptor Stimulation ◽  
Carotid Baroreceptor Stimulation
Sign in / Sign up

Export Citation Format

Share Document