Insights into pathophysiology of carotid baroreceptor stimulation as a method for treatment of resistant hypertension

Resistant hypertension is the term used for patients who are tolerant to a maximum of three doses of antihypertensive drugs, where one of them is a diuretic. Resistant hypertension also applies to patients who are unable to reach the target blood pressure. Patients with resistant hypertension are at a higher risk of cardiovascular morbidity and mortality than those whose hypertension is controlled well. Evidence suggests that baroreceptors play an important role in a long-term blood pressure regulation. Previous studies in animals and humans have demonstrated safe and effective blood pressure decrease with chronic electrical stimulation of the carotid sinus. Electrical baroreflex stimulation appears safe and effective and may be a useful adjunct to medical treatment in patients with resistant hypertension. This review discusses the evolution and patophysiological basis of carotid baroreceptor stimulation as well as the current data available from ongoing trials.