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Device-based Therapy for Hypertension

Fu L Ng1,2, Manish Saxena1,2, Felix Mahfoud3

  • 1Barts BP Centre of Excellence, Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London, EC1A 7BE, UK.

Current Hypertension Reports
|July 3, 2016
PubMed

Insights

Resistant hypertension management is evolving with novel device-based therapies. This review explores seven innovative devices, their evidence, and selection criteria for uncontrolled blood pressure.

Area of Science:

  • Cardiovascular Medicine
  • Medical Devices
  • Hypertension Research

Background:

  • Hypertension remains a leading cause of global mortality and morbidity.
  • Many patients have uncontrolled blood pressure despite available pharmacological treatments, often due to resistant hypertension, intolerance, or non-adherence.
  • Device-based therapies offer novel non-pharmacological approaches for resistant hypertension.

Purpose of the Study:

  • To review emerging device-based therapies for resistant hypertension.
  • To compare seven novel devices, including their mechanisms, evidence base, and ongoing trials.
  • To discuss factors influencing the selection of appropriate devices for diverse hypertension phenotypes.

Main Methods:

  • Review of current literature on device-based therapies for hypertension.
  • Analysis of seven specific novel devices: renal nerve denervation, baroreflex activation therapy, carotid body ablation, central iliac arteriovenous anastomosis, deep brain stimulation, median nerve stimulation, and vagal nerve stimulation.
  • Evaluation of the varying degrees of evidence and upcoming clinical trials for each device.

Main Results:

  • Seven distinct device-based therapies are presented, each with unique mechanisms of action.
  • The evidence supporting these devices varies, with ongoing trials to further establish efficacy and safety.
  • Factors for selecting devices based on hypertension phenotypes are considered.

Conclusions:

  • Device-based therapies represent a significant advancement in managing resistant hypertension.
  • Further research and clinical trials are crucial to define the role of these devices.
  • Personalized device selection may optimize treatment outcomes for patients with uncontrolled blood pressure.

Keywords:
Arteriovenous anastomosisBaroreflex activationCarotid sinus stimulationCouplerHypertensionInterventional devicesRenal denervation

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