Can baroreflex activation therapy reduce cardiovascular risk in resistant hypertension?

This study examined the effectiveness of baroreflex activation therapy (BAT) on risk factors such as blood pressure and arterial stiffness in patients with resistant hypertension. The authors concluded that BAT can significantly reduce cardiovascular risk factors in resistant hypertension.

Patients with hypertension have a higher resting blood pressure than the body needs. The blood pressure needs to be lowered to avoid cardiovascular complications such as heart attacks, strokes, and heart failure. Resistant hypertension, where blood pressure is consistently higher than 140/90 mm Hg, usually requires treatment with three or more drugs.

Intense drug treatment is not always effective or can cause unwanted side-effects, and non-drug treatments for resistant hypertension are being sought. Baroreflex activation therapy (BAT) is one such non-drug treatment. This is a procedure where a small device is implanted under the patient’s skin. This device delivers a small electrical pulse to the carotid arteries (the veins that supply blood to the brain). BAT may reduce arterial stiffness and blood pressure, which are both risk factors for cardiovascular disease. The stiffness of arteries influences how hard the heart has to work to pump blood through the body. 

25 patients with resistant hypertension received BAT. Measurements including systolic blood pressure (SBP – pressure in the heart when it is contracting), diastolic blood pressure (DBP – pressure in the heart when it is between beats), average blood pressure, and central pulse pressure (PP) augmentation (an indicator of arterial stiffness) were all taken before and after 6 months of treatment.

SBP was significantly reduced from 147.2 mm Hg to 130.2 mm Hg. DBP was significantly reduced from 84.5 mm Hg to 74.8 mm Hg. Central PP augmentation was reduced from 62.9 mm Hg to 55.2 mm Hg. Average blood pressure was significantly reduced from 109.7 mm Hg to 97.4 mm Hg.

The authors concluded that 6 months of BAT can significantly reduce blood pressure and arterial stiffness in patients with resistant hypertension. 

Two of the authors have previously received fees from the company that make the baroreflex device. 

Consult with your physician to discuss possible non-drug treatment options for resistant hypertension.