Carotid Baroreceptor Stimulation: A Promising Approach for the Management of Resistant Hypertension and Heart Failure
Many difficult-to-treat clinical entities in the cardiovascular field are characterized by pronounced sympathetic
overactivity, including resistant hypertension and heart failure, underlining the need to explore therapeutic options beyond
pharmacotherapy. Autonomic modulation via carotid baroreceptor activation has already been evaluated in clinical trials
for resistant hypertension, and relevant outcomes with regard to safety and efficacy of the technique are critically presented.
The pathophysiological background of heart failure renders carotid baroreceptor stimulation a potential treatment
candidate for the disease. Available data from animal models with heart failure point towards significant cardioprotective
benefits of this innovative technique. Accordingly, the effects of baroreceptor activation treatment (BAT) on cardiac parameters
of hypertensive patients are well-promising, setting the basis for upcoming clinical trials with baroreflex activation
on patients with heart failure. However, as the potential therapeutic of BAT unfolds and new perspectives are highlighted,
several concerns are raised that should be meticulously addressed before the wide application of this invasive
procedure is set in the limelight.
Keywords: Carotid baroreceptor stimulation, baroreflex, hypertension, heart failure, resistant hypertension, heart failure with
preserved ejection fraction, sympathetic nervous system.
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