Baroreceptor Activation for Hypertension and Heart Failure

Abstract The rising incidence of hypertension and the increasing prevalence of treatment-resistant hypertension carry significant societal impact from a public health perspective. Nonpharmacologic adjuncts to the treatment of hypertension are a welcome addition to the management of hypertension and likely necessary for some patients. With the longitudinal success of the Rheos Pivotal Trial in sustained reduction in blood pressure and the early encouragement of a possibly safer procedural approach in the Barostim neo Trial, there is encouraging evidence that baroreceptor activation therapy may become a viable adjunct in the treatment of resistant hypertension and perhaps change the landscape of how we approach hypertension. Heart failure (HF), the leading cause of hospitalization among adults >65 years of age in the United States, is intertwined with the very same physiological system baroreflex activation therapy (BAT) targets. The Barostim neo and its application in HF may hold the most immediate promise for mainstream use of BAT. The positive effects on functional status and improvement in quality of life for patients with New York Heart Association (NYHA) Class III HF already on guideline-directed medical therapy may make BAT a desirable treatment option for many patients living with a debilitating disease.