Baroreflex activation for the treatment of hypertension: principles and practice

This article reviews the history and current status of an innovative nonpharmacological approach for the treatment of resistant hypertension - chronic electrical activation of the afferent limb of the carotid baroreflex. Recent studies in both normotensive and hypertensive canine models have unambiguously demonstrated sustained and clinically relevant reductions in arterial pressure and sympathetic activity in the course of prolonged baroreflex activation. Clinical trials designed to evaluate the efficacy and safety of this therapy in patients with resistant hypertension are now underway in both Europe and the USA.