Real-world efficacy and safety of baroreceptor activation therapy in a series of patients with refractory arterial hypertension.

The number of patients suffering from refractory hypertension and advanced-stage chronic heart failure (CHF) is progressively increasing. In recent years, device-mediated therapies have been developed as an alternative or adjunct to conventional medical treatment. Our primary objective is to describe the clinical experience in a series of patients with refractory hypertension following the implantation of baroreceptor activation therapy (BAT). We analyzed five patients with refractory hypertension, one of whom also had CHF, treated in a specialized cardiovascular risk clinic. After the implantation of the Barostim device with an average activation of 3.64mA (ranging from 2.80 to 5.4), there was a mean reduction of 30±7.68mmHg (p=0.001) and 13.40±9.07mmHg (p=0.03) in systolic and diastolic blood pressure, respectively, as measured by ambulatory blood pressure monitoring (ABPM), along with a heart rate reduction of 25±9.13bpm (p=0.004). A reduction in the number of antihypertensive medications required for blood pressure control was observed, with an average of 5.2 medications, as well as an improvement in functional class. No adverse events were recorded in our patient series. Currently, BAT is considered a compassionate-use alternative for blood pressure control in patients with refractory hypertension and failure of pharmacological treatment and other invasive techniques, such as renal denervation.