Creation of an iliac arteriovenous shunt lowers blood pressure in chronic obstructive pulmonary disease patients with hypertension

Faul, John L.; Schoors, Danny; Brouwers, Sofie; Scott, Benjamin; Jerrentrup, Andreas; Galvin, Joseph; Luitjens, Sandra; Dolan, Eamon

doi:10.1016/j.jvs.2013.10.069

Cited by 52 publications

(40 citation statements)

References 14 publications

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“…Compared with baseline (145±12/86±13 mm Hg), systolic and diastolic BP were significantly reduced after 6 (130±18/71±13 mm Hg, P<0.01) and 12 months (132±18/67±13 mm Hg, P<0.01), respectively. 181 No clinical meaningful BP reduction was seen in normotensive COPD patients after creation of an AVF using the ROX coupler.…”

Section: Arteriovenous Fistulamentioning

confidence: 98%

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New Approaches in the Treatment of Hypertension

Oparil

Schmieder

2015

Circulation Research

242

137

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Hypertension is the most common modifiable risk factor for cardiovascular disease and death, and lowering blood pressure with antihypertensive drugs reduces target organ damage and prevents cardiovascular disease outcomes. Despite a plethora of available treatment options, a substantial portion of the hypertensive population has uncontrolled blood pressure. The unmet need of controlling blood pressure in this population may be addressed, in part, by developing new drugs and devices/procedures to treat hypertension and its comorbidities. In this Compendium Review, we discuss new drugs and interventional treatments that are undergoing preclinical or clinical testing for hypertension treatment. New drug classes, eg, inhibitors of vasopeptidases, aldosterone synthase and soluble epoxide hydrolase, agonists of natriuretic peptide A and vasoactive intestinal peptide receptor 2, and a novel mineralocorticoid receptor antagonist are in phase II/III of development, while inhibitors of aminopeptidase A, dopamine β-hydroxylase, and the intestinal Na + /H + exchanger 3, agonists of components of the angiotensin-converting enzyme 2/angiotensin(1–7)/Mas receptor axis and vaccines directed toward angiotensin II and its type 1 receptor are in phase I or preclinical development. The two main interventional approaches, transcatheter renal denervation and baroreflex activation therapy, are used in clinical practice for severe treatment resistant hypertension in some countries. Renal denervation is also being evaluated for treatment of various comorbidities, eg, chronic heart failure, cardiac arrhythmias and chronic renal failure. Novel interventional approaches in early development include carotid body ablation and arteriovenous fistula placement. Importantly, none of these novel drug or device treatments has been shown to prevent cardiovascular disease outcomes or death in hypertensive patients.

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Section: Arteriovenous Fistulamentioning

confidence: 98%

“…Detailed technical information about deployment of the device is given elsewhere. 181 Several mechanisms are hypothesized to cause BP reduction after creation of an AVF. 182 Reduction in total systemic vascular resistance, despite an increment in cardiac output, is considered to be the key mechanism.…”

Section: Arteriovenous Fistulamentioning

confidence: 99%

New Approaches in the Treatment of Hypertension

Oparil

Schmieder

2015

Circulation Research

242

137

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“…66 A subsequent open label study of 24 patients with COPD and mild hypertension demonstrated a significant reduction in office BP from 145/86 to 132/67 mmHg at 12 months leading to a repurposing of the device for the hypertension indication. 67 …”

Section: Central Iliac Arteriovenous Anastomosismentioning

confidence: 99%

Interventional procedures and future drug therapy for hypertension

2016

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Hypertension management poses a major challenge to clinicians globally once non-drug (lifestyle) measures have failed to control blood pressure (BP). Although drug treatment strategies to lower BP are well described, poor control rates of hypertension, even in the first world, suggest that more needs to be done to surmount the problem. A major issue is non-adherence to antihypertensive drugs, which is caused in part by drug intolerance due to side effects. More effective antihypertensive drugs are therefore required which have excellent tolerability and safety profiles in addition to being efficacious. For those patients who either do not tolerate or wish to take medication for hypertension or in whom BP control is not attained despite multiple antihypertensives, a novel class of interventional procedures to manage hypertension has emerged. While most of these target various aspects of the sympathetic nervous system regulation of BP, an additional procedure is now available, which addresses mechanical aspects of the circulation. Most of these new devices are supported by early and encouraging evidence for both safety and efficacy, although it is clear that more rigorous randomized controlled trial data will be essential before any of the technologies can be adopted as a standard of care.

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“…Begleitend zeigte sich in den retrospektiven Analysen ein Blutdruckabfall[25].DerHauptmechanismus der Blutdrucksenkung ist die Reduktion des peripheren vaskulären Widerstandes. Die Reduktion des peripheren vaskulären Widerstands und das verminderte effektive arterielle Volumen verbessern die vaskuläre Compliance, was wiederum die reflektierten Pulswellen vermindert und somit zu einer verminderten Herzarbeit führt.…”

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Interventionelle Therapie bei schwer einstellbarer Hypertonie

Ott

2015

Diabetologe

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Creation of an iliac arteriovenous shunt lowers blood pressure in chronic obstructive pulmonary disease patients with hypertension

Abstract: Percutaneous iliac arteriovenous fistula creation for COPD causes a significant and persistent lowering of blood pressure in patients with co-existing hypertension.

Cited by 52 publications

References 14 publications

New Approaches in the Treatment of Hypertension

New Approaches in the Treatment of Hypertension

Interventional procedures and future drug therapy for hypertension

Interventionelle Therapie bei schwer einstellbarer Hypertonie

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