Briasoulis Alexandros, Bakris George
5841 S. Maryland Ave MC 1027, Chicago, IL 60637, USA.
Curr Vasc Pharmacol. 2014 Jan;12(1):69-76. doi: 10.2174/15701611113119990137.
In about 48% hypertensive patients in the United States, blood pressure remains higher than accepted treatment targets despite broad availability of effective pharmaceutical agents. Of these 48%, recent estimates define about 10-11% have treatment-resistant hypertension (TR-HTN). Compensatory changes in sympathetic nervous system function are an important component of HTN. Recent technical advances targeting the sympathetic activity of the carotid sinuses (Baroreflex Activation Therapy-BAT) and the renal sympathetic nerves (Renal Denervation Therapy-RDT) have renewed interest in invasive therapy for the treatment of drug-resistant hypertension. Encouraging results from the recent Rheos Pivotal and Symplicity HTN-2 trials on the safety and efficacy of BAT and RDT respectively, indicate that invasive approaches can safely reduce blood pressure in patients with resistant hypertension. The main goal of this article is to review the results of preclinical and clinical studies on the electric stimulation of the carotid sinus and the catheter-based renal denervation.
在美国，约48%的高血压患者尽管有广泛可得的有效药物，但血压仍高于公认的治疗目标。在这48%的患者中，最近的估计表明约10 - 11%患有顽固性高血压（TR-HTN）。交感神经系统功能的代偿性变化是高血压的一个重要组成部分。最近针对颈动脉窦交感神经活动（压力反射激活疗法 - BAT）和肾交感神经（肾去神经支配疗法 - RDT）的技术进展，重新引发了人们对药物抵抗性高血压侵入性治疗的兴趣。最近分别关于BAT和RDT安全性和有效性的Rheos关键试验和Symplicity HTN - 2试验的令人鼓舞的结果表明，侵入性方法可以安全地降低顽固性高血压患者的血压。本文主要目的是综述关于颈动脉窦电刺激和基于导管的肾去神经支配的临床前和临床研究结果。
