Carotid Baroreceptor Stimulation and Arteriovenous Shunts for Resistant Hypertension

Pharmacologic therapy for hypertension is effective for the majority of patients with hypertension, but there is a subset of the population with treatment-resistant hypertension who cannot achieve their blood pressure goal despite taking multiple medications. Since these patients are at increased risk of cardiovascular disease and end-organ damage, additional therapies must be considered. This review discusses several novel interventional therapies— including baroreflex activation therapy, baroreceptor stenting, and creation of an arteriovenous shunt—that may provide alternative options for blood pressure control in those with treatment-resistant hypertension. All of these therapies remain investigational, and each has its own strengths and weaknesses that will be critical to assess as they come to market.