Projects per year
Perform a proof of concept study to test the safety and feasibility of unilateral carotid body resection in patients with drug resistant hypertension, and assess what proportion of the patients showed a blood pressure reduction over 12 months.BackgroundEvidence indicates that the carotid bodies may contribute to the development of hypertension. Therefore it is a putative target for treating hypertension.
Fifteen participants with office blood pressure (BP) 179+7/106+4 mmHg on 5.7+0.3 antihypertensive drugs were studied at baseline and 1, 3, 6 and 12 months after removing either the right (n=11) or left (n=4) carotid body. Hypoxic ventilatory response (HVR), adverse events, polysomnography, blood pressure (office: OBP; ambulatory: ABP) and muscle sympathetic nerve activity (MSNA) were measured.
Glomus cells were found in resected tissue from 14/15 patients confirming feasibility. Two serious adverse events developed: one related and the other unlikely related to the procedure. In all cases, the HVR was maintained. Overall, no change in OBP, ABP, MSNA or BRS was found (n=15). However, 8/14 patients responded with a reduction in ABP >10mmHg at 3 and 6 months (P<0.01) and MSNA (P<0.05). Respiratory frequency and HVR measured pre-operatively were higher in responders (P<0.05) compared to non-responders, consistent with increased carotid body drive.
Unilateral carotid body resection was feasible and safe. In 57% of patients ABP was lowered for at least 6 months associated with reduced MSNA and improved BRS. We conclude, some drug resistant hypertensive patients have increased carotid body drive.
- Bristol Heart Institute
- Peripheral chemoreceptor
- sympathetic nervous system
- afferent drive
- baroreceptor reflex
1/03/15 → 5/01/16
Abdala Sheikh, A. P. & Paton, J. F. R.
1/01/12 → 31/01/14