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Hypertension after solid-organ transplantation: special considerations for management
Jason Feliberti1, Amit Alam2, Christopher Maulion3
1Heart and Vascular Institute, Tampa General Hospital, Tampa, Florida.
Current Opinion in Cardiology
|May 22, 2025
Summary
Hypertension is common after heart transplants. This review covers medical management, including calcium channel blockers and newer therapies like glucagon-like peptide-1 receptor (GLP-1R) agonists, baroreflex therapy, and renal denervation.
Area of Science:
- Cardiology
- Nephrology
- Transplantation Medicine
Background:
- Hypertension is a frequent comorbidity post-solid organ transplantation.
- Management strategies require careful consideration throughout the perioperative and postoperative phases.
Purpose of the Study:
- To review mechanisms of hypertension post-heart transplant.
- To discuss current medical management practices.
- To explore emerging therapies like GLP-1R agonists, baroreflex therapy, and renal denervation.
Main Methods:
- Review of current medical literature and clinical practices.
- Analysis of perioperative and postoperative management considerations.
- Evaluation of emerging therapeutic interventions.
Main Results:
- Common antihypertensives include calcium channel blockers, ACE inhibitors, and ARBs.
- GLP-1R agonists show promise in cardiovascular outcomes.
- Baroreflex activation therapy and renal denervation are under investigation for post-transplant use, with limited data.
Conclusions:
- Optimal medical management of post-heart transplant hypertension requires further study.
- Emerging therapies like GLP-1R agonists, baroreflex activation therapy, and renal denervation warrant further investigation.
- Special considerations exist for managing these therapies perioperatively and postoperatively.
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