Thorac Cardiovasc Surg 2018; 66(S 01): S1-S110
DOI: 10.1055/s-0038-1627907
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Sunday, February 18, 2018
DGTHG: Aspects of Thoracic Surgery
Georg Thieme Verlag KG Stuttgart · New York

Baroreflex Activation Therapy in Resistant Arterial Hypertension: Results from Updated Prospective Ambulatory Blood Pressure Follow-up Registry

M. Knaut
1   Dresden Heart Center, Dresden University of Technology, Herzchirurgie, Dresden, Germany
,
T. Schmidt
2   Kardioanästhesie, Dresden Heart Center, Dresden University of Technology, Dresden, Germany
,
K. Matschke
1   Dresden Heart Center, Dresden University of Technology, Herzchirurgie, Dresden, Germany
,
S. Grimm
3   Kardiologie, Dresden Heart Center, Dresden University of Technology, Dresden, Germany
,
K. Hemker
1   Dresden Heart Center, Dresden University of Technology, Herzchirurgie, Dresden, Germany
,
T. Madej
1   Dresden Heart Center, Dresden University of Technology, Herzchirurgie, Dresden, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
22 January 2018 (online)

 
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    Objectives: Baroreflex activation therapy (BAT) has shown relevant benefit in patients with drug-resistant arterial hypertension. All data regarding efficacy of actual generation of barostimulation devices (Barostim neo were generated from office blood pressure (BP) measurements. Given the superiority of ambulatory blood pressure (ABP) over office BP measurement, we conducted this prospective registry to evaluate the long-term effect of BAT on 24-hour ABP.

    Methods: Patients with resistant arterial hypertension were first screened for secondary hypertension and these were not eligible for BAT. All other patients who were treated with BAT at our institution from November 2013 until May 2017 were included into this study. Patients with heart failure as a main indication for BAT were not included (n = 10). 24-hour ABP was performed at baseline and in 3-month-intervals during entire follow-up. Clinically significant response was defined as achievement of goal systolic Bp < 140 mm Hg or systolic BP drop of > 20 mm Hg. Study data were prospectively collected and statistically analyzed.

    Results: A total of 44 patients (68% males, mean age 61 years) underwent BAT for resistant hypertension. After 12 months, mean 24-hour systolic ABP dropped from 179 ± 21 mm Hg to 151 ± 20 mm Hg and mean diastolic ABP dropped from 100 ± 20 mm Hg to 89 ± 12 mm Hg (p < 0.01). The effect on ABP after 24 months was a mean reduction of systolic BP of 38mmHg and diastolic BP of 16 mm Hg compared with baseline BP (p < 0.01). The number of prescribed antihypertonics could be reduced from 6.2 ± 1.5 to 5.3 ± 1.8 (p = 0.04). Overall, there were 41 responders (93%) with a mean systolic BP drop of −44 mm Hg after 24 months and 3 non-responders (7%) with BP similar to baseline. Causes of insufficient clinical response in these patients were low drug intake compliance and lower baseline systolic BP (p = 0.04).

    Conclusion: BAT significantly decreases both systolic and diastolic 24-hour ABP in patients with drug-resistant arterial hypertension in mid-term follow-up.


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    No conflict of interest has been declared by the author(s).

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