New strategy for cardio-cerebrovascular diseases: baroreflex activation therapy

ZHANG Lili; LIU Aijun; CHEN Lei; SONG Hongtao

doi:10.3969/j.issn.1006-0111.2017.04.002

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Article Navigation > Journal of Pharmaceutical Practice and Service > 2017 > 35(4): 294-297,345

ZHANG Lili, LIU Aijun, CHEN Lei, SONG Hongtao. New strategy for cardio-cerebrovascular diseases: baroreflex activation therapy[J]. Journal of Pharmaceutical Practice and Service, 2017, 35(4): 294-297,345. doi: 10.3969/j.issn.1006-0111.2017.04.002

Citation:

ZHANG Lili, LIU Aijun, CHEN Lei, SONG Hongtao. New strategy for cardio-cerebrovascular diseases: baroreflex activation therapy[J]. Journal of Pharmaceutical Practice and Service, 2017, 35(4): 294-297,345. doi: 10.3969/j.issn.1006-0111.2017.04.002

New strategy for cardio-cerebrovascular diseases: baroreflex activation therapy

doi: 10.3969/j.issn.1006-0111.2017.04.002

1.
Department of Pharmacy, Fuzhou General Hospital, Fuzhou 350025, China
2.
Department of Pharmacology, School of Pharmacy, Second Military Medical University, Shanghai 200433, China

Received Date: 2016-12-26
Rev Recd Date: 2017-03-20

Abstract

The incident number and death toll of cardio-cerebrovascular diseases increase continuously in China. The impairment of arterial baroreflex (ABR) is closely related to the genesis and development of cardio-cerebrovascular diseases (such as hypertension and chronic heart failure). Barostim neo^TM(by American CRVx. Inc) can reduce blood pressure and heart rate by electrically stimulating carotid sinus baroreceptors and activating baroreflex. Therefore, it can be used to treat resistant hypertension, heart failure and end-stage renal disease, etc. The mechanism of baroreflex activation therapy (BAT) includes inhibiting sympathetic nervous system and rennin-angiotensin system, and increasing the activity of vagus nerve. Thus it improves baroreflex sensitivity and heart rate variability, and restores the structure and function of key organs.
- baroreflex activation therapy,
- cardio-cerebrovascular diseases,
- mechanism

References

[1]	GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015[J]. Lancet, 2016, 388(10053):1459-1544.
[2]	Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report[J]. JAMA, 2003, 289(19):2560-2572.
[3]	Dauphinot V, Kossovsky MP, Gueyffier F, et al. Impaired baroreflex sensitivity and the risks of new-onset ambulatory hypertension, in an elderly population-based study[J]. Int J Cardiol, 2013, 168(4):4010-4014.
[4]	Grassi G, Seravalle G, Brambilla G, et al. Marked sympathetic activation and baroreflex dysfunction in true resistant hypertension[J]. Int J Cardiol, 2014, 177(3):1020-1025.
[5]	Pinna GD, Maestri R, Capomolla S, et al. Applicability and clinical relevance of the transfer function method in the assessment of baroreflex sensitivity in heart failure patients[J]. J Am Coll Cardiol, 2005, 46(7):1314-1321.
[6]	苏定冯.动脉压力感受性反射与心血管疾病[M].//苏定冯,缪朝玉,主编.心血管药理学.2版,北京:科学出版社,2010:101-109.
[7]	Heusser K, Tank J, Engeli S, et al. Carotid baroreceptor stimulation, sympathetic activity, baroreflex function, and blood pressure in hypertensive patients[J]. Hypertension, 2010, 55(3):619-626.
[8]	Shen MJ, Zipes DP. Interventional and device-based autonomic modulation in heart failure[J]. Heart Fail Clin, 2015, 11(2):337-348.
[9]	Acelajado MC, Calhoun DA. Resistant hypertension, secondary hypertension, and hypertensive crises: diagnostic evaluation and treatment[J]. Cardiol Clin, 2010, 28(4):639-654.
[10]	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]. J Am Soc Hypertens, 2012, 6(4):270-276.
[11]	Mozaffarian D, Benjamin EJ, Go AS,et al. Heart disease and stroke statistics-2016 update: A report from the American Heart Association[J]. Circulation, 2016, 133(4):e38-360.
[12]	Forfar JC. Neuroendocrine activation in congestive heart failure[J]. Am J Cardiol, 1991, 67(12):3C-5C.
[13]	Keivanidou A, Fotiou D, Arnaoutoglou C, et al. Evaluation of autonomic imbalance in patients with heart failure: a preliminary study of pupillomotor function[J]. Cardiol J, 2010, 17(1):65-72.
[14]	Abraham WT, Zile MR, Weaver FA, et al. Baroreflex activation therapy for the treatment of heart failure with a reduced ejection fraction[J]. JACC Heart Fail, 2015, 3(6):487-496.
[15]	Richards AM, Troughton R, Lainchbury J, et al. Guiding and monitoring of heart failure therapy with NT-ProBNP: concepts and clinical studies[J]. J Card Fail, 2005, 11(5 Suppl):S34-37.
[16]	Collins AJ, Foley RN, Gilbertson DT, et al. The state of chronic kidney disease, ESRD, and morbidity and mortality in the first year of dialysis[J]. Clin J Am Soc Nephrol, 2009, 4 (Suppl 1):S5-11.
[17]	Converse RL, Jr., Jacobsen TN, Toto RD, et al. Sympathetic overactivity in patients with chronic renal failure[J]. N Engl J Med, 1992, 327(27):1912-1918.
[18]	Zoccali C, Mallamaci F, Parlongo S, et al. Plasma norepinephrine predicts survival and incident cardiovascular events in patients with end-stage renal disease[J]. Circulation, 2002, 105(11):1354-1359.
[19]	Beige J, Koziolek MJ, Hennig G, et al. Baroreflex activation therapy in patients with end-stage renal failure: proof of concept[J]. J Hypertens, 2015, 33(11):2344-2349.
[20]	Wheeler DC, Becker GJ. Summary of KDIGO guideline. What do we really know about management of blood pressure in patients with chronic kidney disease?[J]. Kidney Int, 2013, 83(3):377-383.
[21]	Pollare T, Lithell H, Selinus I, et al. Sensitivity to insulin during treatment with atenolol and metoprolol: a randomised, double blind study of effects on carbohydrate and lipoprotein metabolism in hypertensive patients[J]. BMJ, 1989, 298(6681):1152-1157.
[22]	Pollare T, Lithell H, Berne C. A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension[J]. N Engl J Med, 1989, 321(13):868-873.
[23]	Chazova I, Almazov VA, Shlyakhto E. Moxonidine improves glycaemic control in mildly hypertensive, overweight patients: a comparison with metformin[J]. Diabetes Obes Metab, 2006, 8(4):456-465.
[24]	Wallbach M, Lehnig LY, Helms HJ, et al. Long-term effects of baroreflex activation therapy on glucose metabolism[J]. Acta Diabetol, 2015, 52(5):829-835.
[25]	Palatini P. Sympathetic overactivity in hypertension: a risk factor for cardiovascular disease[J]. Curr Hypertens Rep, 2001, 3 (Supp11):S3-S9.
[26]	Lohmeier TE, Iliescu R, Dwyer TM, et al. Sustained suppression of sympathetic activity and arterial pressure during chronic activation of the carotid baroreflex[J]. Am J Physiol Heart Circ Physiol, 2010, 299(2):H402-H409.
[27]	Lohmeier TE, Iliescu R. Lowering of blood pressure by chronic suppression of central sympathetic outflow: insight from prolonged baroreflex activation[J]. J Appl Physiol, 2012, 113(10):1652-1658.
[28]	Alnima T, de Leeuw PW, Tan FE, et al, Rheos Pivotal Trial I. Renal responses to long-term carotid baroreflex activation therapy in patients with drug-resistant hypertension[J]. Hypertension, 2013, 61(6):1334-1339.
[29]	Lohmeier TE, Iliescu R, Liu B, et al. Systemic and renal-specific sympathoinhibition in obesity hypertension[J]. Hypertension, 2012, 59(2):331-338.
[30]	Bakris GL, Nadim MK, Haller H, et al. Baroreflex activation therapy provides durable benefit in patients with resistant hypertension: results of long-term follow-up in the Rheos Pivotal Trial[J]. J Am Soc Hypertens, 2012, 6(2):152-158.
[31]	Bisognano JD, Kaufman CL, Bach DS, et al. Improved cardiac structure and function with chronic treatment using an implantable device in resistant hypertension: results from European and United States trials of the Rheos system[J]. J Am Coll Cardiol, 2011, 57(17):1787-1788.
[32]	La Rovere MT, Christensen JH. The autonomic nervous system and cardiovascular disease: role of n-3 PUFAs[J]. Vascul Pharmacol, 2015, 71:1-10.
[33]	Gronda E, Seravalle G, Trevano FQ, et al. Long-term chronic baroreflex activation: persistent efficacy in patients with heart failure and reduced ejection fraction[J]. J Hypertens, 2015, 33(8):1704-1708.
[34]	Scheffers IJ, Kroon AA, de Leeuw PW. Carotid baroreflex activation: past, present, and future[J]. Curr Hypertens Rep, 2010, 12(2):61-66.

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通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

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New strategy for cardio-cerebrovascular diseases: baroreflex activation therapy

1. Department of Pharmacy, Fuzhou General Hospital, Fuzhou 350025, China

2. Department of Pharmacology, School of Pharmacy, Second Military Medical University, Shanghai 200433, China

Received Date: 2016-12-26

Rev Recd Date: 2017-03-20

Key words:

Abstract: The incident number and death toll of cardio-cerebrovascular diseases increase continuously in China. The impairment of arterial baroreflex (ABR) is closely related to the genesis and development of cardio-cerebrovascular diseases (such as hypertension and chronic heart failure). Barostim neo^TM(by American CRVx. Inc) can reduce blood pressure and heart rate by electrically stimulating carotid sinus baroreceptors and activating baroreflex. Therefore, it can be used to treat resistant hypertension, heart failure and end-stage renal disease, etc. The mechanism of baroreflex activation therapy (BAT) includes inhibiting sympathetic nervous system and rennin-angiotensin system, and increasing the activity of vagus nerve. Thus it improves baroreflex sensitivity and heart rate variability, and restores the structure and function of key organs.

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Reference (34)

[1]	GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015[J]. Lancet, 2016, 388(10053):1459-1544.
[2]	Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report[J]. JAMA, 2003, 289(19):2560-2572.
[3]	Dauphinot V, Kossovsky MP, Gueyffier F, et al. Impaired baroreflex sensitivity and the risks of new-onset ambulatory hypertension, in an elderly population-based study[J]. Int J Cardiol, 2013, 168(4):4010-4014.
[4]	Grassi G, Seravalle G, Brambilla G, et al. Marked sympathetic activation and baroreflex dysfunction in true resistant hypertension[J]. Int J Cardiol, 2014, 177(3):1020-1025.
[5]	Pinna GD, Maestri R, Capomolla S, et al. Applicability and clinical relevance of the transfer function method in the assessment of baroreflex sensitivity in heart failure patients[J]. J Am Coll Cardiol, 2005, 46(7):1314-1321.
[6]	苏定冯.动脉压力感受性反射与心血管疾病[M].//苏定冯,缪朝玉,主编.心血管药理学.2版,北京:科学出版社,2010:101-109.
[7]	Heusser K, Tank J, Engeli S, et al. Carotid baroreceptor stimulation, sympathetic activity, baroreflex function, and blood pressure in hypertensive patients[J]. Hypertension, 2010, 55(3):619-626.
[8]	Shen MJ, Zipes DP. Interventional and device-based autonomic modulation in heart failure[J]. Heart Fail Clin, 2015, 11(2):337-348.
[9]	Acelajado MC, Calhoun DA. Resistant hypertension, secondary hypertension, and hypertensive crises: diagnostic evaluation and treatment[J]. Cardiol Clin, 2010, 28(4):639-654.
[10]	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]. J Am Soc Hypertens, 2012, 6(4):270-276.
[11]	Mozaffarian D, Benjamin EJ, Go AS,et al. Heart disease and stroke statistics-2016 update: A report from the American Heart Association[J]. Circulation, 2016, 133(4):e38-360.
[12]	Forfar JC. Neuroendocrine activation in congestive heart failure[J]. Am J Cardiol, 1991, 67(12):3C-5C.
[13]	Keivanidou A, Fotiou D, Arnaoutoglou C, et al. Evaluation of autonomic imbalance in patients with heart failure: a preliminary study of pupillomotor function[J]. Cardiol J, 2010, 17(1):65-72.
[14]	Abraham WT, Zile MR, Weaver FA, et al. Baroreflex activation therapy for the treatment of heart failure with a reduced ejection fraction[J]. JACC Heart Fail, 2015, 3(6):487-496.
[15]	Richards AM, Troughton R, Lainchbury J, et al. Guiding and monitoring of heart failure therapy with NT-ProBNP: concepts and clinical studies[J]. J Card Fail, 2005, 11(5 Suppl):S34-37.
[16]	Collins AJ, Foley RN, Gilbertson DT, et al. The state of chronic kidney disease, ESRD, and morbidity and mortality in the first year of dialysis[J]. Clin J Am Soc Nephrol, 2009, 4 (Suppl 1):S5-11.
[17]	Converse RL, Jr., Jacobsen TN, Toto RD, et al. Sympathetic overactivity in patients with chronic renal failure[J]. N Engl J Med, 1992, 327(27):1912-1918.
[18]	Zoccali C, Mallamaci F, Parlongo S, et al. Plasma norepinephrine predicts survival and incident cardiovascular events in patients with end-stage renal disease[J]. Circulation, 2002, 105(11):1354-1359.
[19]	Beige J, Koziolek MJ, Hennig G, et al. Baroreflex activation therapy in patients with end-stage renal failure: proof of concept[J]. J Hypertens, 2015, 33(11):2344-2349.
[20]	Wheeler DC, Becker GJ. Summary of KDIGO guideline. What do we really know about management of blood pressure in patients with chronic kidney disease?[J]. Kidney Int, 2013, 83(3):377-383.
[21]	Pollare T, Lithell H, Selinus I, et al. Sensitivity to insulin during treatment with atenolol and metoprolol: a randomised, double blind study of effects on carbohydrate and lipoprotein metabolism in hypertensive patients[J]. BMJ, 1989, 298(6681):1152-1157.
[22]	Pollare T, Lithell H, Berne C. A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension[J]. N Engl J Med, 1989, 321(13):868-873.
[23]	Chazova I, Almazov VA, Shlyakhto E. Moxonidine improves glycaemic control in mildly hypertensive, overweight patients: a comparison with metformin[J]. Diabetes Obes Metab, 2006, 8(4):456-465.
[24]	Wallbach M, Lehnig LY, Helms HJ, et al. Long-term effects of baroreflex activation therapy on glucose metabolism[J]. Acta Diabetol, 2015, 52(5):829-835.
[25]	Palatini P. Sympathetic overactivity in hypertension: a risk factor for cardiovascular disease[J]. Curr Hypertens Rep, 2001, 3 (Supp11):S3-S9.
[26]	Lohmeier TE, Iliescu R, Dwyer TM, et al. Sustained suppression of sympathetic activity and arterial pressure during chronic activation of the carotid baroreflex[J]. Am J Physiol Heart Circ Physiol, 2010, 299(2):H402-H409.
[27]	Lohmeier TE, Iliescu R. Lowering of blood pressure by chronic suppression of central sympathetic outflow: insight from prolonged baroreflex activation[J]. J Appl Physiol, 2012, 113(10):1652-1658.
[28]	Alnima T, de Leeuw PW, Tan FE, et al, Rheos Pivotal Trial I. Renal responses to long-term carotid baroreflex activation therapy in patients with drug-resistant hypertension[J]. Hypertension, 2013, 61(6):1334-1339.
[29]	Lohmeier TE, Iliescu R, Liu B, et al. Systemic and renal-specific sympathoinhibition in obesity hypertension[J]. Hypertension, 2012, 59(2):331-338.
[30]	Bakris GL, Nadim MK, Haller H, et al. Baroreflex activation therapy provides durable benefit in patients with resistant hypertension: results of long-term follow-up in the Rheos Pivotal Trial[J]. J Am Soc Hypertens, 2012, 6(2):152-158.
[31]	Bisognano JD, Kaufman CL, Bach DS, et al. Improved cardiac structure and function with chronic treatment using an implantable device in resistant hypertension: results from European and United States trials of the Rheos system[J]. J Am Coll Cardiol, 2011, 57(17):1787-1788.
[32]	La Rovere MT, Christensen JH. The autonomic nervous system and cardiovascular disease: role of n-3 PUFAs[J]. Vascul Pharmacol, 2015, 71:1-10.
[33]	Gronda E, Seravalle G, Trevano FQ, et al. Long-term chronic baroreflex activation: persistent efficacy in patients with heart failure and reduced ejection fraction[J]. J Hypertens, 2015, 33(8):1704-1708.
[34]	Scheffers IJ, Kroon AA, de Leeuw PW. Carotid baroreflex activation: past, present, and future[J]. Curr Hypertens Rep, 2010, 12(2):61-66.

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New strategy for cardio-cerebrovascular diseases: baroreflex activation therapy

doi: 10.3969/j.issn.1006-0111.2017.04.002

Abstract

References

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通讯作者: 陈斌, bchen63@163.com

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