Department of Internal Medicine III, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Department of Cardiac Surgery, University of Cologne, Cologne, Germany.
Clin Auton Res. 2020 Dec;30(6):541-548. doi: 10.1007/s10286-020-00670-9. Epub 2020 Feb 12.
Baroreflex activation therapy (BAT) has been shown to lower blood pressure in patients with resistant hypertension. The purpose of this study was to analyze whether this translates into a reduction of more relevant clinical endpoints.
Patients with resistant hypertension were treated with the second-generation BAT system. Records on hospitalization (dates of admission and discharge, main diagnosis) were obtained from medical insurance companies.
Records on hospitalization were available for a period of 1 year before BAT in two patients and 2 years in 22 patients. The total number of hospitalizations per patient was 3.3 ± 3.5/year before BAT and 2.2 ± 2.7/year after BAT (p = 0.03). Hospitalizations related to hypertension were significantly decreased from 1.5 ± 1.6/year before BAT to 0.5 ± 0.9/year after BAT (p < 0.01). The cumulative duration of hypertension-related hospital stays was significantly reduced from 8.0 ± 8.7 days/year before BAT to 1.8 ± 4.8 days/year after BAT (p < 0.01). Office cuff blood pressure was 183 ± 27 mmHg over 102 ± 17 mmHg under 6.6 ± 2.0 antihypertensive drugs before BAT and 157 ± 32 mmHg over 91 ± 20 mmHg (both p < 0.01) under 5.9 ± 1.9 antihypertensive drugs (p = 0.09 for number of drugs) at latest follow-up. Daytime ambulatory blood pressure was 164 ± 21 mmHg over 91 ± 14 mmHg before BAT and 153 ± 21 mmHg (p = 0.03) over 89 ± 15 mmHg (p = 0.56) at latest follow-up. Heart rate was 75 ± 16 bpm before BAT and 72 ± 12 bpm at latest follow-up (p = 0.35).
Rate and duration of hypertension-related hospitalizations in patients with severe resistant hypertension were lowered after BAT. Whether the response is mediated through improvements in blood pressure control requires further studies.
压力感受性反射激活治疗（BAT）已被证明可降低抗药性高血压患者的血压。本研究的目的是分析这是否转化为更相关临床终点的降低。
接受第二代 BAT 系统治疗的抗药性高血压患者。从医疗保险公司获得住院记录（入院和出院日期、主要诊断）。
在 BAT 之前，两名患者有一年的住院记录，22 名患者有两年的住院记录。每名患者的住院总数为 BAT 前 3.3±3.5/年和 BAT 后 2.2±2.7/年（p=0.03）。BAT 前与高血压相关的住院治疗从 1.5±1.6/年显著减少到 BAT 后 0.5±0.9/年（p<0.01）。与高血压相关的住院时间累积时间从 BAT 前 8.0±8.7 天/年显著减少到 BAT 后 1.8±4.8 天/年（p<0.01）。在 BAT 前，诊室血压为 183±27mmHg，降压药为 102±17mmHg，6.6±2.0 种，而在 BAT 后，诊室血压为 157±32mmHg，降压药为 91±20mmHg（均 p<0.01），5.9±1.9 种（降压药数量 p=0.09）。在 BAT 前，日间动态血压为 164±21mmHg，降压药为 91±14mmHg，而在 BAT 后，日间动态血压为 153±21mmHg（p=0.03），降压药为 89±15mmHg（p=0.56）。在 BAT 前，心率为 75±16bpm，在最新随访时为 72±12bpm（p=0.35）。
严重抗药性高血压患者的高血压相关住院率和住院时间在 BAT 后降低。这种反应是否通过改善血压控制来介导，还需要进一步的研究。
