Baroreflex Activation: from Mechanisms to Therapy for Cardiovascular Disease
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Recent technical advances have led to the development of a medical device that can reliably activate the carotid baroreflex with an acceptable degree of safety. Because activation of the sympathetic nervous system plays an important role in the pathogenesis of hypertension and heart failure, the unique ability of this device to chronically suppress central sympathetic outflow in a controlled manner suggests potential value in the treatment of these conditions. This notion is supported by both clinical and experimental animal studies, and the major aim of this article is to elucidate the physiological mechanisms that account for the favorable effects of baroreflex activation therapy in patients with resistant hypertension and heart failure. Illumination of the neurohormonal, renal, and cardiac actions of baroreflex activation is likely to provide the means for better identification of those patients that are most likely to respond favorably to this device-based therapy.
KeywordsResistant hypertension Blood pressure Sympathetic nervous system Renin-angiotensin system Renal nerves Glomerular filtration rate Baroreflex Baroreflex sensitivity Heart rate Heart rate variability Cardiac autonomics Device-based therapy
The authors’ studies cited in this report were funded by National Heart, Lung, and Blood Institute Grant HL-51971.
Compliance with Ethics Guidelines
Conflict of Interest Radu Iliescu and Ionut Tudorancea declare that they have no conflict of interest.
Thomas E. Lohmeier has received consulting fees from CVRx, Inc., and research support from National Institutes of Health.
Human and Animal Rights and Informed Consent This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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