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Current Cardiology Reports
Erschienen in: Current Cardiology Reports 5/2013

01.05.2013 | Interventional Cardiology (S Rao, Section Editor)

Interventional Treatment of Hypertension: A New Paradigm

verfasst von: W. Schuyler Jones, Sreekanth Vemulapalli, Manesh R. Patel

Erschienen in: Current Cardiology Reports | Ausgabe 5/2013

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Abstract

Hypertension is thought to contribute to more than 7 million deaths worldwide each year and contributes to the development of atherosclerotic lesions that lead to myocardial infarction and stroke. While lifestyle modifications (diet, exercise, weight loss) and pharmacotherapy have been proven to be effective in the treatment of hypertension, as many as half of patients have uncontrolled BP and remain at risk for elevated cardiovascular morbidity and mortality. The main physiologic targets for interventional treatment include alteration of blood flow to the kidney, activation of the carotid baroreflex system, and modification of the renal sympathetic nervous system. The results of prior studies and new studies of interventional treatments of resistant hypertension are covered in this review.
Literatur
1.
Aronow WS, Fleg JL, Pepine CJ, Artinian NT, Bakris G, Brown AS, et al. ACCF/AHA 2011 expert consensus document on hypertension in the elderly: a report of the American College of Cardiology Foundation Task Force on clinical expert consensus documents. Circulation. 2011;123:2434–506.PubMedCrossRef
2.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–52.PubMedCrossRef
3.
Rosendorff C, Black HR, Cannon CP, Gersh BJ, Gore J, Izzo JL, et al. Treatment of hypertension in the prevention and management of ischemic heart disease: a scientific statement from the American Heart Association council for high blood pressure research and the councils on clinical cardiology and epidemiology and prevention. Circulation. 2007;115:2761–88.PubMedCrossRef
4.
Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000. J Am Med Assoc. 2003;290:199–206.CrossRef
5.
6.
Calhoun DA, Jones D, Textor S, Goff DC, Murphy TP, Toto RD, et al. Resistant hypertension: diagnosis, evaluation, and treatment: a scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Circulation. 2008;117:e510–26.PubMedCrossRef
7.
Sarafidis PA, Bakris GL. Resistant hypertension. An overview of evaluation and treatment. J Am Coll Cardiol. 2008;52:1749–57.PubMedCrossRef
8.
Moser M, Setaro JF. Resistant or difficult-to-control hypertension. N Engl J Med. 2006;355:385–92.PubMedCrossRef
9.
• Daugherty SL, Powers JD, Magid DJ, Tavel HM, Masoudi FA, Margolis KL, et al. Incidence and prognosis of resistant hypertension in hypertensive patients. Circulation. 2012;125:1635–42. This community cohort study is a nice descriptive analysis of resistant hypertension and outcomes in these patients.PubMedCrossRef
10.
Parati G, Esler M. The human sympathetic nervous system: its relevance in hypertension and heart failure. Eur Heart J. 2012;33:1058–66.PubMedCrossRef
11.
Olin JY, Melia M, Young JR, Graor RA, Risius B. Prevalence of atherosclerotic renal artery stenosis in patients with atherosclerosis elsewhere. Am J Med. 1990;88:46N–51N.PubMedCrossRef
12.
Rimmer JM, Gennari FJ. Atherosclerotic renovascular disease and progressive renal failure. Ann Intern Med. 1993;118:712–9.PubMedCrossRef
13.
The ASTRAL Investigators. Revascularization versus medical therapy for renal-artery stenosis. N Engl J Med. 2009;361:1953–62.CrossRef
14.
White CJ. Kiss my astral: one seriously flawed study of renal stenting after another. Catheter Cardiovasc Interv. 2010;75:305–7.PubMedCrossRef
15.
White CJ. Management of renal artery stenosis: the case for intervention, defending current guidelines, and screening (Drive By) renal angiography at the time of catheterization. Prog Card Dis. 2009;52:229–37.CrossRef
16.
• Kumbhani DJ, Bavry AA, Harvey JE, de Souza R, Scarpioni R, Bhatt DL, et al. Clinical outcomes after percutaneous revascularization versus medical management in patients with significant renal artery stenosis: a meta-analysis of randomized controlled trials. Am Heart J. 2011;161:622–30. This is the most updated meta-analysis on treatment of hypertension with renal artery revascularization.PubMedCrossRef
17.
• Jaff MR, Bates M, Sullivan T, Popma J, Gao X, Zaugg M, et al. Significant reduction in systolic blood pressure following renal artery stenting in patients with uncontrolled hypertension: results from the HERCULES trial. Catheter Cardiovasc Interv. 2012;80:343–50. A single-arm study of renal artery stenting in selected population of uncontrolled hypertensive patients.PubMedCrossRef
18.
Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, et al. ACC/AHA 2005 Guidelines for the Management of Patients with Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic): a Collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease). J Am Coll Cardiol. 2006;47:e1–e192.CrossRef
19.
Schwartz SI, Griffith LSC, Neistadt A, Hagfors N. Chronic carotid sinus nerve stimulation in the treatment of essential hypertension. Am J Surg. 1967;114:5–15.PubMedCrossRef
20.
Wustmann K, Kucera JP, Scheffers I, Mohaupt M, Kroon AA, de Leeux PW, et al. Effects of chronic baroreceptor stimulation on the autonomic cardiovascular regulation in patients with drug-resistant arterial hypertension. Hypertension. 2009;54:530–6.PubMedCrossRef
21.
Heusser K, Tank J, Engeli S, Diedrich A, Menne J, Eckert S, et al. Carotid baroreceptor stimulation, sympathetic activity, baroreflex function, and blood pressure in hypertensive patients. Hypertension. 2010;55:619–26.PubMedCrossRef
22.
Illig KA, Levy M, Sanchez L, Trachiotis GD, Shanley C, Irwin E, et al. An Implantable carotid sinus stimulator for drug-resistant hypertension: surgical technique and short-term outcome from the multicenter phase II rheos feasibility trial. J Vasc Surg. 2006;44:1213–8.PubMedCrossRef
23.
Scheffers IJM, Kroon AA, Schmidli J, Jordan J, Tordoir JJ, Mohaupt MG, et al. Novel baroreflex activation therapy in resistant hypertension: results of a European multi-center feasibility study. J Am Coll Cardiol. 2010;56:1254–8.PubMedCrossRef
24.
•• Bisognano JD, Bakris G, Nadim MK, Sanchez L, Kroon AA, Schafer J, et al. Baroreflex activation therapy lowers blood pressure in patients with resistant hypertension. J Am Coll Cardiol. 2011;58:765–73. The largest study of baroreflex activation therapy published to date.PubMedCrossRef
25.
Bakris GL, Nadim MK, Haller H, Lovett EG, Schafer JE, Bisognano JD, et al. Baroreflex activation therapy provides durable benefit in patients with resistant hypertension: results of long-term follow-up in the rheos pivotal trial. J Am Soc Hypertens. 2012;6:152–8.PubMedCrossRef
26.
Freyberg RH, Peet MM. The effect on the kidney of bilateral splanchnicectomy in patients with hypertension. J Clin Invest. 1937;16:49–65.PubMedCrossRef
27.
Isberg EM, Peet MM. The influence of supradiaphragmatic splanchnicectomy on the heart in hypertension. Am Heart J. 1948;35:567–83.PubMedCrossRef
28.
29.
Smithwick RH, Bush RD, Kinsey D, Whitelaw GP. Hypertension and associated cardiovascular disease; comparison of male and female mortality rates and their influence on selection of therapy. J Am Med Assoc. 1956;160:1023–6.PubMedCrossRef
30.
Krum H, Schlaich M, Whitbourn R, et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicenter safety and proof-of-principle cohort study. Lancet. 2009;373:1275–81.PubMedCrossRef
31.
• Symplicity HTN-1 Investigators. Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months. Hypertension. 2011;57:911–7. The first study to show that renal sympathetic denervation is associated with long-term blood pressure reduction.
32.
•• Symplicity HTN-2 Investigators. Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomized controlled trial. Lancet. 2010;376:1903–9. This study reported the safety and effectiveness of renal sympathetic denervation when compared with control in resistant hypertension.
33.
Ukena C, Mahfoud F, Kindermann I, Barth C, Lenski M, Kindermann M, et al. Cardiorespiratory response to exercise after renal sympathetic denervation in patients with resistant hypertension. J Am Coll Cardiol. 2011;58:1176–82.PubMedCrossRef
34.
Geisler BP, Egan BM, Cohen JT, Garner AM, Akehurst RL, Esler MD, et al. Cost-effectiveness and clinical effectiveness of catheter-based renal denervation for resistant hypertension. J Am Coll Cardiol. 2012;60:1271–7.PubMedCrossRef
35.
Kandzari DE, Bhatt DL, Sobotka PA, O’Neill WW, Esler M, Flack JM, et al. Catheter-based renal denervation for resistant hypertension: rationale and design of the SYMPLICITY HTN-3 Trial. Clin Cardiol. 2012;35:528–35.PubMedCrossRef
36.
Brandt MC, Reda S, Mahfoud F, Lenski M, Böhm M, Hoppe UC. Effects of renal sympathetic denervation on arterial stiffness and central hemodynamics in patients with resistant hypertension. J Am Coll Cardiol. 2012;60:1956–65.PubMedCrossRef
37.
Brandt MC, Mahfoud F, Reda S, Schirmer SH, Erdmann E, Bohm M, et al. Renal sympathetic denervation reduces left ventricular hypertrophy and improves cardiac function in patients with resistant hypertension. J Am Coll Cardiol. 2012;59:901–9.PubMedCrossRef
38.
Ukena C, Mahfoud F, Spies A, Kindermann I, Linz D, Cremers B, et al. Effects of Renal Sympathetic Denervation on Heart Rate and Atrioventricular Conduction in Patients with Resistant Hypertension. Int J Cardiol 2012 [epub ahead of print].
39.
Mahfoud F, Schlaich M, Kindermann I, Ukena C, Cremers B, Brandt MC, et al. Effect of sympathetic denervation on glucose metabolism in patients with resistant hypertension. Circulation. 2011;123:1940–6.PubMedCrossRef
40.
Prochnau D, Lucas N, Kuehnert H, Figulla HR, Surber R. Catheter-based renal denervation for drug-resistant hypertension by using a standard electrophysiology catheter. Eurointervention. 2012;7:1077–80.PubMedCrossRef
41.
Mabin T, Sapoval M, Cabane V, Stemmett J, Iyer M. First experience with endovascular ultrasound renal denervation for the treatment of resistant hypertension. Eurointervention. 2012;8:57–61.PubMedCrossRef
42.
Ormiston J, Watson T, van Pelt N, Stewart R, Haworth P, Stewart JT, et al. First report of the 6-month first in human results of the OneShot renal denervation system: the RHAS Study [Abstract TCT-212]. Presented at Transcatheter Cardiovascular Therapeutics Conference. Miami, Florida, USA; October 22–26, 2012.
43.
Worthley S, Tsioufis C, Worthley M, Sinhal A, Chew D, Meredith I, et al. Safety and efficacy of a novel multi-electrode renal denervation catheter in resistant hypertension: 3 month data from the EnligHTN I Trial. [Abstract TCT-213]. Presented at Transcatheter Cardiovascular Therapeutics Conference. Miami, Florida, USA; October 22–26, 2012.
44.
Doumas M, Faselis C, Papdemetriou V. Renal sympathetic denervation and systemic hypertension. Am J Cardiol. 2010;105:570–6.PubMedCrossRef
Metadaten
Titel
Interventional Treatment of Hypertension: A New Paradigm
verfasst von
W. Schuyler Jones
Sreekanth Vemulapalli
Manesh R. Patel
Publikationsdatum
01.05.2013
Verlag
Current Science Inc.
Erschienen in
Current Cardiology Reports / Ausgabe 5/2013
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-013-0356-4

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