The Pathophysiological Basis of Carotid Baroreceptor Stimulation for the Treatment of Resistant Hypertension
Dragan Lovic, Athanasios J. Manolis, Branko Lovic, Vesna Stojanov, Milan Lovic, Andreas Pittaras and Branko Jakovljevic
Affiliation: Clinic for internal disease InterMedica, Hypertension Centre, Jovana Ristica str. 20-2; 18000 Nis, Mediana, Serbia.
Keywords: Resistant hypertension, baroreceptors, carotid baroreceptor stimulation.
The prevalence of resistant hypertension and existing limitations in antihypertensive drug therapy renders the
interventional management of hypertension an attractive alternative. Carotid baroreceptors have been traditionally thought
to be implicated only in short-term blood pressure regulation; however recent evidence suggests that the baroreceptors
might play an important role even in the long-term blood pressure regulation. Electrical baroreflex stimulation appears
safe and effective and might represent a useful adjunct to medical therapy in patients with resistant hypertension. This
review endeavors to summarize the complex pathophysiology of blood pressure regulation, to describe the baroreflex
circuit, its anatomy and physiology, to present previous data refuting a role for the baroreceptors in the long-term control
of blood pressure and recent animal and human data suggesting an effective role of carotid baroreceptor activation in
long-lasting blood pressure reduction. In this paper we attempt to critically evaluate existing information in this area and
provide the scientific basis for carotid baroreceptor stimulation in the management of resistant hypertension.
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