Filippone John D, Bisognano John D
Cardiology Division, Department of Medicine, University of Rochester Medical Center, Rochester, New York 14642-8679, USA.
Curr Opin Nephrol Hypertens. 2007 Sep;16(5):403-8. doi: 10.1097/MNH.0b013e3282f01e4b.
It is not uncommon for hypertension to be resistant to the effects of medical therapy, and this poses a significant risk of adverse cardiovascular events. Electrical stimulation of the carotid sinus is a novel treatment for hypertension, and has been shown to reduce blood pressure by activating the baroreflex and reducing sympathetic tone.
Evidence suggests that the baroreceptors play a more important role in long-term blood pressure regulation than was once believed. It appears that the baroreflex attenuates chronic hypertension in large part by inhibiting renal sympathetic tone. Animal and human studies have demonstrated a safe and effective lowering of blood pressure with chronic electrical stimulation of the carotid sinus, and have generated enthusiasm for implantable carotid sinus stimulators in the treatment of hypertension.
Electrical baroreflex stimulation appears safe and effective, and may represent a useful adjunct to medical therapy in patients with resistant hypertension.
高血压对药物治疗产生抵抗的情况并不少见,这会带来严重的心血管不良事件风险。颈动脉窦电刺激是一种治疗高血压的新方法,已证明其可通过激活压力反射和降低交感神经张力来降低血压。
有证据表明,压力感受器在长期血压调节中所起的作用比以往认为的更为重要。压力反射似乎主要通过抑制肾交感神经张力来减轻慢性高血压。动物和人体研究均已证明,对颈动脉窦进行慢性电刺激可安全有效地降低血压,并激发了人们对植入式颈动脉窦刺激器治疗高血压的热情。
电压力反射刺激似乎安全有效,对于难治性高血压患者而言,可能是药物治疗的一种有用辅助手段。