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Current Hypertension Reports
Published in: Current Hypertension Reports 8/2016

01-08-2016 | Device-Based Approaches for Hypertension (M Schlaich, Section Editor)

Device-Based Therapy for Drug-Resistant Hypertension: An Update

Authors: Ping Li, Mark Nader, Kousalya Arunagiri, Vasilios Papademetriou

Published in: Current Hypertension Reports | Issue 8/2016

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Abstract

Drug-resistant hypertension (RH) remains a significant and common cardiovascular risk despite the availability of multiple potent antihypertensive medications. Uncontrolled resistant hypertension contributes substantially to excessive cardiovascular and renal morbidity and mortality. Clinical and experimental evidence suggest that sympathetic nervous system over-activity is the main culprit for the development and maintenance of drug-resistant hypertension. Both medical and interventional strategies, targeting the sympathetic over-activation, have been designed in patients with hypertension over the past few decades. Minimally invasive, catheter-based, renal sympathetic denervation (RDN) and carotid baroreceptor activation therapy (BAT) have been extensively evaluated in patients with RH in clinical trials. Current trial outcomes, though at times impressive, have been mostly uncontrolled trials in need of validation. Device-based therapy for drug-resistant hypertension has the potential to provide alternative treatment options to certain groups of patients who are refractory or intolerant to current antihypertensive medications. However, more research is needed to prove its efficacy in both animal models and in humans. In this article, we will review the evidence from recent renal denervation, carotid baroreceptor stimulation therapy, and newly emerged central arteriovenous anastomosis trials to pinpoint the weak links, and speculate on potential alternative approaches.
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Metadata
Title
Device-Based Therapy for Drug-Resistant Hypertension: An Update
Authors
Ping Li
Mark Nader
Kousalya Arunagiri
Vasilios Papademetriou
Publication date
01-08-2016
Publisher
Springer US
Published in
Current Hypertension Reports / Issue 8/2016
Print ISSN: 1522-6417
Electronic ISSN: 1534-3111
DOI
https://doi.org/10.1007/s11906-016-0671-4

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