The two novel approaches recently introduced for the treatment of resistant hypertension, i.e. carotid baroreceptor
stimulation and renal denervation, share a number of similarities but are also characterized by important differences.
The similarities include the evidence that both interventions have as common pathophysiological background the state of
sympathetic overdrive characterizing essential hypertension. In addition both procedures 1) are invasive, 2) exert in the
short-term period clearcut blood pressure lowering effects and 3) still face a number of open questions, particularly related
to the long-term blood pressure lowering effects, impact on end-organ damage and on cardiovascular events. The differences
include the fact that two procedures act on distinct targets that trigger sympathetic activation and consequently
blood pressure increase. In addition, only in the case of carotid baroreceptor stimulation the blood pressure effects can be
easily assessed immediately following the implantation. Finally, the economic costs, metabolic effects and impact on
vagal modulation of heart rate are different between the two interventions. This paper will provide a comparison of the
background, effects and outcome of renal denervation and carotid baroreceptor stimulation, stressing whenever possible
the clinical implications of the main features of the two interventions.
Keywords: Resistant hypertension, renal denervation, carotid baroreceptor stimulation, symapthetic activity, end organ damage.
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