The private company CVRx has developed an interesting method under investigation for blood pressure control in highly refractory hypertensive patients. The approach consists of a surgical implant of electrodes at the carotid sinus; stimulation at the sinus results in a baroreceptor reflex which is predicted to decrease blood pressure. While not yet commercially available, a feasibility trial in which 10 patients with refractory hypertension were implanted with such a device showed an average reduction in systolic blood pressure of 41 mmHg with no significant hypotension or major safety issues. The suggestion of surgery to correct high blood pressure is certain to be controversial, but in the future this might be a viable option in selected patients in whom medications are unable to control blood pressure.
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