Long-term effects of baroreflex activation therapy: 2-year follow-up data of the BAT Neo system
Objective Baroreflex activation therapy (BAT) reduces office blood pressure (BP) in patients with resistant hypertension (HTN). Whereas sustained effects from the BAT Rheos device have already been reported, no long-term data on 24-h ambulatory BP (ABP) are currently available for the unilateral BAT...
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| Veröffentlicht in: | Clinical research in cardiology 2020-04, Vol.109 (4), p.513-522 |
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| creator | Wallbach, Manuel Born, Ellen Kämpfer, Deborah Lüders, Stephan Müller, Gerhard A. Wachter, Rolf Koziolek, Michael J. |
| description | Objective
Baroreflex activation therapy (BAT) reduces office blood pressure (BP) in patients with resistant hypertension (HTN). Whereas sustained effects from the BAT Rheos device have already been reported, no long-term data on 24-h ambulatory BP (ABP) are currently available for the unilateral BAT Neo device.
Methods
Patients treated with the BAT neo device for resistant hypertension were prospectively included into this observational study. Office and ABP measurements were performed before BAT implantation as well as 6, 12 and 24 months after initiation of BAT.
Results
A total of 60 patients with resistant HTN (office BP 172 ± 25/90 ± 17 mmHg, 24-h ABP 150 ± 16/80 ± 12 mmHg, median of antihypertensive drugs 7 (IQR 6–8)) were included. After 24 months, there was a significant reduction of − 25 ± 33/− 9 ± 18 mmHg (
n
= 50, both
p
|
| doi_str_mv | 10.1007/s00392-019-01536-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2269394027</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2269394027</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-461310aa2f136ef25dc0ce60ae68fb233e910e1e985d7f926f433c7de77f3cad3</originalsourceid><addsrcrecordid>eNp9kE1v1DAQhq0KRD_gD_SALHHpxXTsSZyEW6n6gbSCSzlbXmfcbpXEi-0A--_rZdsi9dCDNZbmeV9bD2PHEj5LgOY0AWCnBMiunBq1qPfYgWy1FKA79eb53lb77DCle4BaAlbv2D5KbNumkgfMLMJ0KzLFkZP35HLiwfOljSGSH-gvty6vftu8ChPPdxTtevOFK7EhG7kPwxD-iHnNe5vtNlcI_vXshn-nwNMmZRrfs7feDok-PM4j9vPy4ub8Wix-XH07P1sIh02dRaUlSrBWeYmavKp7B440WNKtXypE6iSQpK6t-8Z3SvsK0TU9NY1HZ3s8Yie73nUMv2ZK2Yyr5GgY7ERhTkYp3WFXgWoK-ukFeh_mOJXfbam2xUoqKJTaUS6GlIoMs46r0caNkWC2-s1Ovyn6zT_9pi6hj4_V83Kk_jny5LsAuANSWU23FP-__UrtA5uHjvc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2268834120</pqid></control><display><type>article</type><title>Long-term effects of baroreflex activation therapy: 2-year follow-up data of the BAT Neo system</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Wallbach, Manuel ; Born, Ellen ; Kämpfer, Deborah ; Lüders, Stephan ; Müller, Gerhard A. ; Wachter, Rolf ; Koziolek, Michael J.</creator><creatorcontrib>Wallbach, Manuel ; Born, Ellen ; Kämpfer, Deborah ; Lüders, Stephan ; Müller, Gerhard A. ; Wachter, Rolf ; Koziolek, Michael J.</creatorcontrib><description>Objective
Baroreflex activation therapy (BAT) reduces office blood pressure (BP) in patients with resistant hypertension (HTN). Whereas sustained effects from the BAT Rheos device have already been reported, no long-term data on 24-h ambulatory BP (ABP) are currently available for the unilateral BAT Neo device.
Methods
Patients treated with the BAT neo device for resistant hypertension were prospectively included into this observational study. Office and ABP measurements were performed before BAT implantation as well as 6, 12 and 24 months after initiation of BAT.
Results
A total of 60 patients with resistant HTN (office BP 172 ± 25/90 ± 17 mmHg, 24-h ABP 150 ± 16/80 ± 12 mmHg, median of antihypertensive drugs 7 (IQR 6–8)) were included. After 24 months, there was a significant reduction of − 25 ± 33/− 9 ± 18 mmHg (
n
= 50, both
p
< 0.01) in office BP and − 8 ± 23/− 5 ± 13 mmHg (
n
= 46, both
p
= 0.02) in 24-h ABP, while the number of antihypertensive medications was reduced to a median of 5 (4–6) drugs (
p
< 0.01). Patients with isolated systolic HTN (ISH) experienced a BP-lowering effect in office BP, but not in ABPM at month 24. Using unadjusted BP values, BAT seems to be more effective in combined hypertension (CH) than in ISH. After adjustment for baseline BP values, there was no significant difference in BP reduction between ISH and CH patients. Ambulatory SBP at baseline was the only independent correlate of BP response at month 24.
Conclusion
BAT reduced office BP and improved relevant parameters of ABP, which is associated with a high cardiovascular risk, in patients with resistant HTN, whereas, after adjustment for baseline BP, BP reduction was not different in patients with CH compared with patients with ISH. However, randomized controlled trials are needed to confirm the effects of BAT on 24-h ABP.</description><identifier>ISSN: 1861-0684</identifier><identifier>EISSN: 1861-0692</identifier><identifier>DOI: 10.1007/s00392-019-01536-5</identifier><identifier>PMID: 31388741</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Activation ; Aged ; Antihypertensive Agents - therapeutic use ; Antihypertensives ; Baroreceptors ; Baroreflex ; Blood pressure ; Blood Pressure - drug effects ; Cardiology ; Cardiovascular diseases ; Clinical trials ; Drug Resistance ; Drugs ; Electric Stimulation Therapy - adverse effects ; Electric Stimulation Therapy - instrumentation ; Female ; Health risks ; Humans ; Hypertension ; Hypertension - diagnosis ; Hypertension - physiopathology ; Hypertension - therapy ; Implantable Neurostimulators ; Implantation ; Long-term effects ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Paper ; Pressure measurement ; Prospective Studies ; Reduction ; Reflexes ; Therapy ; Time Factors ; Treatment Outcome</subject><ispartof>Clinical research in cardiology, 2020-04, Vol.109 (4), p.513-522</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019</rights><rights>Clinical Research in Cardiology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-461310aa2f136ef25dc0ce60ae68fb233e910e1e985d7f926f433c7de77f3cad3</citedby><cites>FETCH-LOGICAL-c375t-461310aa2f136ef25dc0ce60ae68fb233e910e1e985d7f926f433c7de77f3cad3</cites><orcidid>0000-0002-1162-4682</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00392-019-01536-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00392-019-01536-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31388741$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wallbach, Manuel</creatorcontrib><creatorcontrib>Born, Ellen</creatorcontrib><creatorcontrib>Kämpfer, Deborah</creatorcontrib><creatorcontrib>Lüders, Stephan</creatorcontrib><creatorcontrib>Müller, Gerhard A.</creatorcontrib><creatorcontrib>Wachter, Rolf</creatorcontrib><creatorcontrib>Koziolek, Michael J.</creatorcontrib><title>Long-term effects of baroreflex activation therapy: 2-year follow-up data of the BAT Neo system</title><title>Clinical research in cardiology</title><addtitle>Clin Res Cardiol</addtitle><addtitle>Clin Res Cardiol</addtitle><description>Objective
Baroreflex activation therapy (BAT) reduces office blood pressure (BP) in patients with resistant hypertension (HTN). Whereas sustained effects from the BAT Rheos device have already been reported, no long-term data on 24-h ambulatory BP (ABP) are currently available for the unilateral BAT Neo device.
Methods
Patients treated with the BAT neo device for resistant hypertension were prospectively included into this observational study. Office and ABP measurements were performed before BAT implantation as well as 6, 12 and 24 months after initiation of BAT.
Results
A total of 60 patients with resistant HTN (office BP 172 ± 25/90 ± 17 mmHg, 24-h ABP 150 ± 16/80 ± 12 mmHg, median of antihypertensive drugs 7 (IQR 6–8)) were included. After 24 months, there was a significant reduction of − 25 ± 33/− 9 ± 18 mmHg (
n
= 50, both
p
< 0.01) in office BP and − 8 ± 23/− 5 ± 13 mmHg (
n
= 46, both
p
= 0.02) in 24-h ABP, while the number of antihypertensive medications was reduced to a median of 5 (4–6) drugs (
p
< 0.01). Patients with isolated systolic HTN (ISH) experienced a BP-lowering effect in office BP, but not in ABPM at month 24. Using unadjusted BP values, BAT seems to be more effective in combined hypertension (CH) than in ISH. After adjustment for baseline BP values, there was no significant difference in BP reduction between ISH and CH patients. Ambulatory SBP at baseline was the only independent correlate of BP response at month 24.
Conclusion
BAT reduced office BP and improved relevant parameters of ABP, which is associated with a high cardiovascular risk, in patients with resistant HTN, whereas, after adjustment for baseline BP, BP reduction was not different in patients with CH compared with patients with ISH. However, randomized controlled trials are needed to confirm the effects of BAT on 24-h ABP.</description><subject>Activation</subject><subject>Aged</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Antihypertensives</subject><subject>Baroreceptors</subject><subject>Baroreflex</subject><subject>Blood pressure</subject><subject>Blood Pressure - drug effects</subject><subject>Cardiology</subject><subject>Cardiovascular diseases</subject><subject>Clinical trials</subject><subject>Drug Resistance</subject><subject>Drugs</subject><subject>Electric Stimulation Therapy - adverse effects</subject><subject>Electric Stimulation Therapy - instrumentation</subject><subject>Female</subject><subject>Health risks</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - physiopathology</subject><subject>Hypertension - therapy</subject><subject>Implantable Neurostimulators</subject><subject>Implantation</subject><subject>Long-term effects</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Paper</subject><subject>Pressure measurement</subject><subject>Prospective Studies</subject><subject>Reduction</subject><subject>Reflexes</subject><subject>Therapy</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1861-0684</issn><issn>1861-0692</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kE1v1DAQhq0KRD_gD_SALHHpxXTsSZyEW6n6gbSCSzlbXmfcbpXEi-0A--_rZdsi9dCDNZbmeV9bD2PHEj5LgOY0AWCnBMiunBq1qPfYgWy1FKA79eb53lb77DCle4BaAlbv2D5KbNumkgfMLMJ0KzLFkZP35HLiwfOljSGSH-gvty6vftu8ChPPdxTtevOFK7EhG7kPwxD-iHnNe5vtNlcI_vXshn-nwNMmZRrfs7feDok-PM4j9vPy4ub8Wix-XH07P1sIh02dRaUlSrBWeYmavKp7B440WNKtXypE6iSQpK6t-8Z3SvsK0TU9NY1HZ3s8Yie73nUMv2ZK2Yyr5GgY7ERhTkYp3WFXgWoK-ukFeh_mOJXfbam2xUoqKJTaUS6GlIoMs46r0caNkWC2-s1Ovyn6zT_9pi6hj4_V83Kk_jny5LsAuANSWU23FP-__UrtA5uHjvc</recordid><startdate>20200401</startdate><enddate>20200401</enddate><creator>Wallbach, Manuel</creator><creator>Born, Ellen</creator><creator>Kämpfer, Deborah</creator><creator>Lüders, Stephan</creator><creator>Müller, Gerhard A.</creator><creator>Wachter, Rolf</creator><creator>Koziolek, Michael J.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1162-4682</orcidid></search><sort><creationdate>20200401</creationdate><title>Long-term effects of baroreflex activation therapy: 2-year follow-up data of the BAT Neo system</title><author>Wallbach, Manuel ; Born, Ellen ; Kämpfer, Deborah ; Lüders, Stephan ; Müller, Gerhard A. ; Wachter, Rolf ; Koziolek, Michael J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-461310aa2f136ef25dc0ce60ae68fb233e910e1e985d7f926f433c7de77f3cad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Activation</topic><topic>Aged</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Antihypertensives</topic><topic>Baroreceptors</topic><topic>Baroreflex</topic><topic>Blood pressure</topic><topic>Blood Pressure - drug effects</topic><topic>Cardiology</topic><topic>Cardiovascular diseases</topic><topic>Clinical trials</topic><topic>Drug Resistance</topic><topic>Drugs</topic><topic>Electric Stimulation Therapy - adverse effects</topic><topic>Electric Stimulation Therapy - instrumentation</topic><topic>Female</topic><topic>Health risks</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - physiopathology</topic><topic>Hypertension - therapy</topic><topic>Implantable Neurostimulators</topic><topic>Implantation</topic><topic>Long-term effects</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Paper</topic><topic>Pressure measurement</topic><topic>Prospective Studies</topic><topic>Reduction</topic><topic>Reflexes</topic><topic>Therapy</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wallbach, Manuel</creatorcontrib><creatorcontrib>Born, Ellen</creatorcontrib><creatorcontrib>Kämpfer, Deborah</creatorcontrib><creatorcontrib>Lüders, Stephan</creatorcontrib><creatorcontrib>Müller, Gerhard A.</creatorcontrib><creatorcontrib>Wachter, Rolf</creatorcontrib><creatorcontrib>Koziolek, Michael J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical research in cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wallbach, Manuel</au><au>Born, Ellen</au><au>Kämpfer, Deborah</au><au>Lüders, Stephan</au><au>Müller, Gerhard A.</au><au>Wachter, Rolf</au><au>Koziolek, Michael J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term effects of baroreflex activation therapy: 2-year follow-up data of the BAT Neo system</atitle><jtitle>Clinical research in cardiology</jtitle><stitle>Clin Res Cardiol</stitle><addtitle>Clin Res Cardiol</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>109</volume><issue>4</issue><spage>513</spage><epage>522</epage><pages>513-522</pages><issn>1861-0684</issn><eissn>1861-0692</eissn><abstract>Objective
Baroreflex activation therapy (BAT) reduces office blood pressure (BP) in patients with resistant hypertension (HTN). Whereas sustained effects from the BAT Rheos device have already been reported, no long-term data on 24-h ambulatory BP (ABP) are currently available for the unilateral BAT Neo device.
Methods
Patients treated with the BAT neo device for resistant hypertension were prospectively included into this observational study. Office and ABP measurements were performed before BAT implantation as well as 6, 12 and 24 months after initiation of BAT.
Results
A total of 60 patients with resistant HTN (office BP 172 ± 25/90 ± 17 mmHg, 24-h ABP 150 ± 16/80 ± 12 mmHg, median of antihypertensive drugs 7 (IQR 6–8)) were included. After 24 months, there was a significant reduction of − 25 ± 33/− 9 ± 18 mmHg (
n
= 50, both
p
< 0.01) in office BP and − 8 ± 23/− 5 ± 13 mmHg (
n
= 46, both
p
= 0.02) in 24-h ABP, while the number of antihypertensive medications was reduced to a median of 5 (4–6) drugs (
p
< 0.01). Patients with isolated systolic HTN (ISH) experienced a BP-lowering effect in office BP, but not in ABPM at month 24. Using unadjusted BP values, BAT seems to be more effective in combined hypertension (CH) than in ISH. After adjustment for baseline BP values, there was no significant difference in BP reduction between ISH and CH patients. Ambulatory SBP at baseline was the only independent correlate of BP response at month 24.
Conclusion
BAT reduced office BP and improved relevant parameters of ABP, which is associated with a high cardiovascular risk, in patients with resistant HTN, whereas, after adjustment for baseline BP, BP reduction was not different in patients with CH compared with patients with ISH. However, randomized controlled trials are needed to confirm the effects of BAT on 24-h ABP.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31388741</pmid><doi>10.1007/s00392-019-01536-5</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-1162-4682</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1861-0684 |
| ispartof | Clinical research in cardiology, 2020-04, Vol.109 (4), p.513-522 |
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| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Activation Aged Antihypertensive Agents - therapeutic use Antihypertensives Baroreceptors Baroreflex Blood pressure Blood Pressure - drug effects Cardiology Cardiovascular diseases Clinical trials Drug Resistance Drugs Electric Stimulation Therapy - adverse effects Electric Stimulation Therapy - instrumentation Female Health risks Humans Hypertension Hypertension - diagnosis Hypertension - physiopathology Hypertension - therapy Implantable Neurostimulators Implantation Long-term effects Male Medicine Medicine & Public Health Middle Aged Original Paper Pressure measurement Prospective Studies Reduction Reflexes Therapy Time Factors Treatment Outcome |
| title | Long-term effects of baroreflex activation therapy: 2-year follow-up data of the BAT Neo system |
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