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A11216 Baroreflex activation therapy in combination with slow breathing and external stimulation of carotid sinus in the treatment of hypertension

Objectives: Baroreflex recently emerged as a therapeutic target of hypertension. In the present study, we used the multisensory stimulation system, which slowed the breathing and stimulates the carotid sinus, to evaluate the effect of baroreflex activation therapy in hypertension. Methods: The study was a single-center, randomized, cross-over trail and 14 untreated subjects with mild hypertension or prehypertension were recruited. The study procedure lasted for 8 weeks. Participants were randomly assigned into 2 groups, and they were treated with either the multisensory stimulation system that slowed breathe (<10 breaths/min) and stimulated carotid sinus or a sham device in different order. The treatment and control periods lasted 2 weeks, and were separated by a 2-week wash-out period. In each period, subjects were treated for 20 minutes per day. Ambulatory, home and clinic blood pressure were measured during the whole procedure. Results: After 8-week of treatment, 24-h, daytime, nighttime ambulatory blood pressure decreased from 129.9/84.8, 134.1/88.2, 121.5/78.0 at baseline by 4.1/4.2, 3.2/3.6 and 5.9/5.6 mmHg in stimulation period and decreased by 3.8/4.3, 2.9/3.9, 1.6/2.5 mmHg in control period, respectively. AASI, however, did not change in both periods. Clinic blood pressure and pulse rates showed small nonsignificant reductions between 2 periods (P ≥ 0.10). When further analyzed home blood pressure in stimulation period, mean BP decreased by 1.5/2.0 mmHg from baseline and kept falling after the treatment. Conclusion: The baroreflex activation therapy combined with slow breathing and external stimulation of carotid sinus reduced ambulatory BP, especially the nighttime BP, while it had no effect on arterial stiffness. The device could serve as a complementary therapy in hypertension.