Surgical, Interventional, and Device Innovations in the Management of Hypertension

Abstract

The prevalence of hypertension around the world has increased significantly with projections for an increasing major global burden of hypertension. Medication-resistant hypertension can be perplexing and frustrating. The existence of these difficult patients results in the need for additional approaches to treatment including surgery, percutaneous interventions, and device management. The sophistication of these techniques has progressed markedly and initial procedures such as classical sympathectomy and renal artery bypass are almost never performed. Newer techniques of angioplasty with stenting, renal artery denervation, and baroreflex activation therapy via electrical stimulation of the carotid baroreceptors are now in use with increasing evidence for significant benefit.

Keywords

hypertension - renal artery denervation - renal artery stenting - resistant hypertension - sympathectomy

• References

• 1 Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365 (9455) 217-223
• 2 Centers for Disease Control and Prevention (CDC). Vital signs: prevalence, treatment, and control of hypertension—United States, 1999-2002 and 2005-2008. MMWR Morb Mortal Wkly Rep 2011; 60 (4) 103-108
• 3 McAlister FA. The Canadian Hypertension Education Program—a unique Canadian initiative. Can J Cardiol 2006; 22 (7) 559-564
• 4 Campbell N, Young ER, Drouin D , et al. A framework for discussion on how to improve prevention, management, and control of hypertension in Canada. Can J Cardiol 2012; 28 (3) 262-269
• 5 Burroughs Peña MS, Mendes Abdala CV, Silva LC, Ordúñez P. Usefulness for surveillance of hypertension prevalence studies in Latin America and the Caribbean: the past 10 years. Rev Panam Salud Publica 2012; 32 (1) 15-21
• 6 Reklaitiene R, Tamosiunas A, Virviciute D, Baceviciene M, Luksiene D. Trends in prevalence, awareness, treatment, and control of hypertension, and the risk of mortality among middle-aged Lithuanian urban population in 1983-2009. BMC Cardiovasc Disord 2012; 12: 68
• 7 Bosu WK. Epidemic of hypertension in Ghana: a systematic review. BMC Public Health 2010; 10: 418
• 8 Haghdoost AA, Sadeghirad B, Rezazadehkermani M. Epidemiology and heterogeneity of hypertension in Iran: a systematic review. Arch Iran Med 2008; 11 (4) 444-452
• 9 Schmieder RE. End organ damage in hypertension. Dtsch Arztebl Int 2010; 107 (49) 866-873
• 10 Cooper-DeHoff RM, Gong Y, Handberg EM , et al. Tight blood pressure control and cardiovascular outcomes among hypertensive patients with diabetes and coronary artery disease. JAMA 2010; 304 (1) 61-68
• 11 Chobanian AV, Bakris GL, Black HR , et al; Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42 (6) 1206-1252
• 12 Littenberg B, Garber AM, Sox Jr HC. Screening for hypertension. Ann Intern Med 1990; 112 (3) 192-202
• 13 Thompson M, Dana T, Bougatsos C, Blazina I, Norris SL. Screening for hypertension in children and adolescents to prevent cardiovascular disease. Pediatrics 2013; 131 (3) 490-525
• 14 Sacks FM, Svetkey LP, Vollmer WM , et al; DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med 2001; 344 (1) 3-10
• 15 Robbins CL, Dietz PM, Bombard J, Tregear M, Schmidt SM, Tregear SJ. Lifestyle interventions for hypertension and dyslipidemia among women of reproductive age. Prev Chronic Dis 2011; 8 (6) A123
• 16 Ranpura V, Pulipati B, Chu D, Zhu X, Wu S. Increased risk of high-grade hypertension with bevacizumab in cancer patients: a meta-analysis. Am J Hypertens 2010; 23 (5) 460-468
• 17 Wright JM, Musini VM. First-line drugs for hypertension. Cochrane Database Syst Rev 2009; (3) CD001841
• 18 Oh BH, Mitchell J, Herron JR, Chung J, Khan M, Keefe DL. Aliskiren, an oral renin inhibitor, provides dose-dependent efficacy and sustained 24-hour blood pressure control in patients with hypertension. J Am Coll Cardiol 2007; 49 (11) 1157-1163
• 19 Dudenbostel T, Calhoun DA. Resistant hypertension, obstructive sleep apnoea and aldosterone. J Hum Hypertens 2012; 26 (5) 281-287
• 20 Cannon B. The effects of progressive sympathectomy on blood pressure. Am J Physiol 1931; 97 (4) 592-596
• 21 Smithwick RH. Surgery in hypertension. Lancet 1948; 2 (6515) 65
• 22 Smithwick RH, Thompson JE. Splanchnicectomy for essential hypertension; results in 1,266 cases. J Am Med Assoc 1953; 152 (16) 1501-1504
• 23 Modrall JG, Rosero EB, Smith ST , et al. Operative mortality for renal artery bypass in the United States: results from the National Inpatient Sample. J Vasc Surg 2008; 48 (2) 317-322
• 24 Hu ZP, Wang ZW, Dai XF , et al. Outcomes of surgical versus balloon angioplasty treatment for native coarctation of the aorta: a meta-analysis. Ann Vasc Surg 2014; 28 (2) 394-403
• 25 Stewart AB, Ahmed R, Travill CM, Newman CG. Coarctation of the aorta life and health 20-44 years after surgical repair. Br Heart J 1993; 69 (1) 65-70
• 26 Walhout RJ, Lekkerkerker JC, Oron GH, Bennink GB, Meijboom EJ. Comparison of surgical repair with balloon angioplasty for native coarctation in patients from 3 months to 16 years of age. Eur J Cardiothorac Surg 2004; 25 (5) 722-727
• 27 Pádua LM, Garcia LC, Rubira CJ, de Oliveira Carvalho PE. Stent placement versus surgery for coarctation of the thoracic aorta. Cochrane Database Syst Rev 2012; 5: CD008204
• 28 Wong D, Benson LN, Van Arsdell GS, Karamlou T, McCrindle BW. Balloon angioplasty is preferred to surgery for aortic coarctation. Cardiol Young 2008; 18 (1) 79-88
• 29 Canniffe C, Ou P, Walsh K, Bonnet D, Celermajer D. Hypertension after repair of aortic coarctation—a systematic review. Int J Cardiol 2013; 167 (6) 2456-2461
• 30 Vohra HA, Adamson L, Haw MP. Does surgical correction of coarctation of the aorta in adults reduce established hypertension?. Interact Cardiovasc Thorac Surg 2009; 8 (1) 123-127
• 31 Disick GI, Munver R. Adrenal-preserving minimally invasive surgery: update on the current status of laparoscopic partial adrenalectomy. Curr Urol Rep 2008; 9 (1) 67-72
• 32 Dubel GJ, Murphy TP. The role of percutaneous revascularization for renal artery stenosis. Vasc Med 2008; 13 (2) 141-156
• 33 Abela R, Ivanova S, Lidder S, Morris R, Hamilton G. An analysis comparing open surgical and endovascular treatment of atherosclerotic renal artery stenosis. Eur J Vasc Endovasc Surg 2009; 38 (6) 666-675
• 34 Bloch MJ, Basile J. Clinical insights into the diagnosis and management of renovascular disease. An evidence-based review. Minerva Med 2004; 95 (5) 357-373
• 35 Rabbia C, Pini R. Evidence-based medicine in renal artery stenting. J Cardiovasc Surg (Torino) 2010; 51 (5) 755-763
• 36 Kumbhani DJ, Bavry AA, Harvey JE , et al. Clinical outcomes after percutaneous revascularization versus medical management in patients with significant renal artery stenosis: a meta-analysis of randomized controlled trials. Am Heart J 2011; 161 (3) 622-630 , e1
• 37 Balk E, Raman G, Chung M , et al. Effectiveness of management strategies for renal artery stenosis: a systematic review. Ann Intern Med 2006; 145 (12) 901-912
• 38 Kashyap VS, Sepulveda RN, Bena JF , et al. The management of renal artery atherosclerosis for renal salvage: does stenting help?. J Vasc Surg 2007; 45 (1) 101-108 , discussion 108–109
• 39 Cooper CJ, Murphy TP, Cutlip DE , et al; CORAL Investigators. Stenting and medical therapy for atherosclerotic renal-artery stenosis. N Engl J Med 2014; 370 (1) 13-22
• 40 DiBona GF. Sympathetic nervous system and the kidney in hypertension. Curr Opin Nephrol Hypertens 2002; 11 (2) 197-200
• 41 Krum H, Schlaich M, Whitbourn R , et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. Lancet 2009; 373 (9671) 1275-1281
• 42 Symplicity HTN-1 Investigators. Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months. Hypertension 2011; 57 (5) 911-917
• 43 Esler MD, Krum H, Sobotka PA, Schlaich MP, Schmieder RE, Böhm M ; Symplicity HTN-2 Investigators. Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet 2010; 376 (9756) 1903-1909
• 44 Esler MD, Krum H, Schlaich M, Schmieder RE, Böhm M, Sobotka PA ; Symplicity HTN-2 Investigators. Renal sympathetic denervation for treatment of drug-resistant hypertension: one-year results from the Symplicity HTN-2 randomized, controlled trial. Circulation 2012; 126 (25) 2976-2982
• 45 Kandzari DE, Bhatt DL, Sobotka PA , et al. Catheter-based renal denervation for resistant hypertension: rationale and design of the SYMPLICITY HTN-3 Trial. Clin Cardiol 2012; 35 (9) 528-535
• 46 O'Riordan M . Renal denervation fails in SYMPLICITY HTN-3. Available at: http://www.medscape.com/viewarticle/818938 , Accessed January 12, 2014
• 47 Bunte MC, Infante de Oliveira E, Shishehbor MH. Endovascular treatment of resistant and uncontrolled hypertension: therapies on the horizon. JACC Cardiovasc Interv 2013; 6 (1) 1-9
• 48 Davis MI, Filion KB, Zhang D , et al. Effectiveness of renal denervation therapy for resistant hypertension: a systematic review and meta-analysis. J Am Coll Cardiol 2013; 62 (3) 231-241
• 49 Mahfoud F, Lüscher TF, Andersson B , et al; European Society of Cardiology. Expert consensus document from the European Society of Cardiology on catheter-based renal denervation. Eur Heart J 2013; 34 (28) 2149-2157
• 50 Viskoper R, Shapira I, Priluck R , et al. Nonpharmacologic treatment of resistant hypertensives by device-guided slow breathing exercises. Am J Hypertens 2003; 16 (6) 484-487
• 51 Bisognano JD, Bakris G, Nadim MK , et al. Baroreflex activation therapy lowers blood pressure in patients with resistant hypertension: results from the double-blind, randomized, placebo-controlled Rheos pivotal trial. J Am Coll Cardiol 2011; 58 (7) 765-773
• 52 Bakris GL, Nadim MK, Haller H, Lovett EG, Schafer JE, Bisognano JD. Baroreflex activation therapy provides durable benefit in patients with resistant hypertension: results of long-term follow-up in the Rheos Pivotal Trial. J Am Soc Hypertens 2012; 6 (2) 152-158
• 53 CVRx Barostim Hypertension Pivotal Trial Available at: http://www.clinicaltrials.gov/ct2/results?term=CVRX+Barostim+Hypertension+Pivotal+Trial&Search=Search . Accessed August 21, 2013
• 54 Hoppe UC, Brandt MC, Wachter R , et al. Minimally invasive system for baroreflex activation therapy chronically lowers blood pressure with pacemaker-like safety profile: results from the Barostim neo trial. J Am Soc Hypertens 2012; 6 (4) 270-276
• 55 van Lill L, Malan L, van Rooyen J, Steyn F, Reimann M, Ziemssen T. Baroreceptor sensitivity, cardiovascular responses and ECG left ventricular hypertrophy in men: the SABPA study. Blood Press 2011; 20 (6) 355-361
• 56 Jordan J, Heusser K, Brinkmann J, Tank J. Electrical carotid sinus stimulation in treatment resistant arterial hypertension. Auton Neurosci 2012; 172 (1-2) 31-36
• 57 Reyes del Paso GA, Cea JI, González-Pinto A , et al. Short-term effects of a brief respiratory training on baroreceptor cardiac reflex function in normotensive and mild hypertensive subjects. Appl Psychophysiol Biofeedback 2006; 31 (1) 37-49
• 58 Raczak G. Atorvastatin reduces sympathetic activity and improves baroreceptor reflex sensitivity in patients with hypercholesterolemia and hypertension [in Polish]. Kardiol Pol 2009; 67 (6) 621-622
• 59 Lewandowski J, Siński M, Bidiuk J , et al. Simvastatin reduces sympathetic activity in men with hypertension and hypercholesterolemia. Hypertens Res 2010; 33 (10) 1038-1043