Effects of baroreflex activation therapy on arterial stiffness and central hemodynamics in patients with resistant hypertension

Abstract

Apart from peripheral blood pressure, baroreflex activation therapy reduces central blood pressure, augmentation index at a heart rate of 75 b.p.m. and pulse wave velocity in patients with resistant hypertension, suggesting strong potential to reduce cardiovascular risk.

Effects of Baroreflex Activation Therapy on Ambulatory Blood Pressure in Patients With Resistant Hypertension

“…For BAT, the Barostim neo (CVRx, Minneapolis, MN) was used as described previously. [15][16][17] The BAT device consists of a lead, which is sutured directly on 1-side carotid sinus and a pulse generator implanted in an infraclavicular position in a minimal invasive procedure, including intraoperative testing for optimal placement of the lead for BP response. Thereafter, BAT was initiated 4 weeks after implantation and the stimulation was individually increased by adaption of programmed parameters (pulse amplitude [1-20 mA], pulse width [15-500 ms] and frequency 10-100 pulses/s) during monthly follow-up according to patients' office BP and tolerance.…”

“…Thereafter, BAT was initiated 4 weeks after implantation and the stimulation was individually increased by adaption of programmed parameters (pulse amplitude [1-20 mA], pulse width [15-500 ms] and frequency 10-100 pulses/s) during monthly follow-up according to patients' office BP and tolerance. Follow-up data were acquired as described before [15][16][17] 6 months after starting BAT.…”

Baroreflex activation therapy in patients with end-stage renal failure

“…Although sympathetic nerve overactivity is predictive for survival and cardiovascular events in patients with ESRD [12], improvement of such endpoints by BAT remains to be shown. However, in previous trials, beneficial effects of BAT were prospectively demonstrated on glucose metabolism [35], vascular stiffness [35] and proteinuria [36]. Minor side-effects associated with slight discomfort occurred frequently in our patients.…”

Effects of 2-year vitamin B12 and folic acid supplementation in hyperhomocysteinemic elderly on arterial stiffness and cardiovascular outcomes within the B-PROOF trial

“…Third, we acknowledge that the follow-up period of 2 years is relatively short for cardiovascular outcome parameters. Our study was designed to study the effect of vitamin B12 and folic acid supplementation on PWV, and for this parameter, a 2-year intervention is considered to be sufficient, because PWV is known to respond quickly as other trials with PWV as outcome variable have shown [8,29,30]. Nevertheless, arterial stiffness is known for its limited reversibility and therefore it cannot be ruled out that differences in PWV levels may have been detected when using a longer intervention period.…”