Chronic lowering of blood pressure by carotid baroreflex activation: mechanisms and potential for hypertension therapy.
Chronic lowering of blood pressure by carotid baroreflex activation: mechanisms and potential for hypertension therapy.
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DOI：
10.1161/hypertensionaha.108.119859
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发表时间：
2011-05
期刊：
影响因子：
--
通讯作者：
Iliescu R
中科院分区：
文献类型：
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作者：
Lohmeier TE;Iliescu R
近期的技术进步使人们对基于器械的疗法治疗耐药性高血压重新产生了兴趣。本文综述了近期有关颈动脉窦电刺激治疗耐药性高血压疗效的临床试验结果。然而，本文的主要目的是总结临床前研究，这些研究为颈动脉压力反射激活的慢性降压作用机制提供了见解。所确定的一些机制是可预测的，并通过实验得到了证实。其他机制则令人惊讶且存在争议，解决这些问题需要进一步研究。尽管可行性研究前景良好，但关于这种基于器械的疗法对治疗耐药性高血压的价值，还需等待当前多中心试验的结果才能得出确切结论。
Recent technical advances have renewed interest in device-based therapy for the treatment of drug-resistant hypertension. Findings from recent clinical trials regarding the efficacy of electrical stimulation of the carotid sinus for the treatment of resistant hypertension are reviewed here. The main goal of this article, however, is to summarize the preclinical studies that have provided insight into the mechanisms that account for the chronic blood pressure lowering effects of carotid baroreflex activation. Some of the mechanisms identified were predictable and confirmed by experimentation. Others have been surprising and controversial and resolution will require further investigation. Although feasibility studies have been promising, firm conclusions regarding the value of this device-based therapy for the treatment of resistant hypertension awaits the results of current multicenter trials.