Interventional Approaches to Reduce Sympathetic Activity in Resistant Hypertension: To Ablate or Stimulate?
Abstract
In this issue of Hypertension, Lohmeier et al compare, in adog model of obesity-hypertension, 2 interventional tech-niques currently being tested in clinical trials for the treat-ment of resistant hypertension.1 Sympathetic inhibition is the mechanism by which these interventions are proposed to control hypertension. That sympathetic activity plays a role in hypertension is not a new concept. From the mid 1930s until late 1950s, surgical sympathectomy was practically the only effective treatment for malignant hypertension, and, although plagued by significant side effects, it improved survival of an other-wise fatal disease. Ganglionic blockers and reserpine were the earliest antihypertensives developed, and central sympatho-lytics followed shortly thereafter. Drugs targeting the sympathetic nervous system, however, are no longer considered as first-line antihypertensives. Cen-
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Several open-label trials have documented the efficacy of renal denervation in subjects with resistant hypertension many of whom are obese.
“Several open-label trials have documented the efficacy of renal denervation in subjects with resistant hypertension many of whom are obese (24–28).”
From Obesity-Associated Hypertension: Recent Progress in Deciphering the Pathogenesis (2014) · cites this paper as [24]
An implantable device for bilateral electric baroreceptor stimulation that decreases sympathetic tone alleviates obesity-associated hypertension in experimental and clinical settings.
“An implantable device for bilateral electric baroreceptor stimulation that decreases sympathetic tone alleviates obesity-associated hypertension in experimental and clinical settings (22–24).”
From Obesity-Associated Hypertension: Recent Progress in Deciphering the Pathogenesis (2014) · cites this paper as [24]
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Krum, H., Schlaich, M., Whitbourn, R., Sobotka, P. A., Sadowski, J., Bartus, K., Kapelak, B., Walton, A., Sievert, H., Thambar, S., et al. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60566-3 · Cited by 2,108 · see citing works
Renal Sympathetic-Nerve Ablation for Uncontrolled Hypertension
Schlaich, M. P., Sobotka, P. A., Krum, H., Lambert, E., & Esler, M. D. (2009) · New England Journal of Medicine · doi:10.1056/nejmc0904179 · Cited by 772 · see citing works
Baroreflex Activation Therapy Lowers Blood Pressure in Patients With Resistant Hypertension
Bisognano, J. D., Bakris, G., Nadim, M. K., Sanchez, L., Kroon, A. A., Schafer, J., de Leeuw, P. W., & Sica, D. A. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2011.06.008 · Cited by 600 · see citing works
Mahfoud, F., Schlaich, M. P., Kindermann, I., Ukena, C., Cremers, B., Brandt, M. C., Hoppe, U. C., Vonend, O., Rump, L. C., Sobotka, P. A., et al. (2011) · Circulation · doi:10.1161/circulationaha.110.991869 · Cited by 572 · see citing works
Witkowski, A., Prejbisz, A., Florczak, E., Kądziela, J., Śliwiński, P., Bieleń, P., Michałowska, I., Kabat, M., Warchoł, E., Januszewicz, M., et al. (2011) · Hypertension · doi:10.1161/hypertensionaha.111.173799 · Cited by 460 · see citing works
Heusser, K., Tank, J., Engeli, S., Diedrich, A., Menne, J., Eckert, S., Peters, T., Sweep, F. C. G. J., Haller, H., Pichlmaier, A. M., et al. (2010) · Hypertension · doi:10.1161/hypertensionaha.109.140665 · Cited by 433 · see citing works
Novel Baroreflex Activation Therapy in Resistant Hypertension
Scheffers, I. J. M., Kroon, A. A., Schmidli, J., Jordan, J., Tordoir, J. H. M., Mohaupt, M. G., Luft, F. C., Haller, H. G., Menne, J., Engeli, S., et al. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.03.089 · Cited by 356 · see citing works
Renal denervation: a potential new treatment modality for polycystic ovary syndrome?
Schlaich, M. P., Straznicky, N. E., Grima, M. T., Sari, C. I., Dawood, T., Mahfoud, F., Lambert, É., Chopra, R., Socratous, F., Hennebry, S. C., et al. (2011) · Journal of Hypertension · doi:10.1097/hjh.0b013e328344db3a · Cited by 141 · see citing works
Systemic and Renal-Specific Sympathoinhibition in Obesity Hypertension
Lohmeier, T. E., Iliescu, R., Liu, B., Henegar, J. R., Maric-Bilkan, C., & Irwin, E. D. (2012) · Hypertension · doi:10.1161/hypertensionaha.111.185074 · Cited by 130 · see citing works
Prolonged Activation of the Baroreflex Abolishes Obesity-Induced Hypertension
Lohmeier, T. E., Dwyer, T. M., Irwin, E. D., Rossing, M. A., & Kieval, R. S. (2007) · Hypertension · doi:10.1161/hypertensionaha.107.087874 · Cited by 118 · see citing works
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Obesity-Associated Hypertension: Recent Progress in Deciphering the Pathogenesis
Rahmouni, K. (2014) · Hypertension · doi:10.1161/hypertensionaha.114.00920 · Cited by 150 · see citing works
- Authors
- Biaggioni, I.
- Affiliations
- Vanderbilt University (US)
- Corresponding author
- Biaggioni, Italo
- ORCID
- Biaggioni, Italo
- Venue
- Hypertension
- Published
- 2012-02
- Volume
- 59
- Issue
- 2
- Pages
- 194-195
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2101924120
- Cited by
- 8
- References
- 11
- Citations by year
- 2018: 1 · 2017: 2 · 2014: 2 · 2013: 3
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (P01HL056693)
- National Institute of Neurological Disorders and Stroke (R01NS055670)
- National Center for Research Resources (KL2RR024977, TL1RR024978, UL1RR024975)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- resistant hypertension, sympathetic activity, sympathetic nerve block, interventional therapy, blood pressure reduction
- MeSH terms
- Animals, Denervation, Hypertension, Kidney, Male, Obesity, Sympathetic Nervous System, Baroreflex
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