Date of Graduation

Summer 8-11-2012

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Annjanette Sommers MS, PA-C

Abstract

Background: Resistant hypertension is of growing concern due not only to its increasing prevalence, but also to the associated co-morbidities and their long-term consequences. This systematic review was performed to evaluate the efficacy of the Rheos System, a baroreflex activation device for use in patients diagnosed with resistant hypertension.

Method: Exhaustive search of available medical literature was conducted using Medline, CINAHL, Web of Science and Google Scholar. Exclusion criteria was applied and resulted in a total of three studies. Search terms used: baroreflex activation therapy, resistant hypertension, Rheos, carotid sinus, baroreceptor

Results: Three studies were evaluated on the Rheos system, two prospective cohort and one randomized control trial within the United States and Europe. Patients were prognostically similar between studies, based on age and number of hypertensive medications. Surgical implantation at the carotid sinus was evaluated for safety and efficacy both for the device itself as well as BAT use. Decreases in SBP and DBP were seen at an acute response as well as maintained during follow-up visits.

Conclusion: Baroreflex activation therapy is a new and exciting technology for potential treatment of resistant hypertension. However, there is still a great deal of research and evaluation that must take place before the Rheos system can be used as routine therapy. It should be used in patients who have exhausted pharmaceutical agents as well as thorough lifestyle modifications to manage their hypertension.

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