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Medical research: A nerve-wrecking treatment for severe hypertension

Nature Communications

September 4, 2013

Mechanistic insight into an interventional technique that lowers blood pressure in rats is reported in Nature Communications. The work shows that carotid body denervation achieves this lowering of blood pressure by reducing activity of the sympathetic nervous system. This method could, with further testing, be used as a treatment for patients with drug-resistant hypertension.

Renal denervation - an intervention that aims to reduce nervous system activity by disabling nerves in renal arteries - is currently performed in patients with treatment-resistant hypertension but with limited success. Julian Paton and colleagues now demonstrate the translational potential of an alternative method that involves disabling specific nerves connected to the carotid body, a procedure known as carotid body denervation. The carotid body, located in the neck near the fork of the carotid artery, constantly measures oxygen levels in the blood and can modulate blood pressure by activating the sympathetic nervous system - the part of the autonomous nervous system commonly associated with the fight-or-flight response. The authors find that disabling these nerves leads to a relatively rapid and long-term reduction in the activity of the sympathetic nervous system and a decrease in blood pressure in hypertensive rats. Importantly, the procedure remained effective even if performed in addition to renal denervation.

Related clinical trials in patients with drug-resistant hypertension have been initiated to establish the effectiveness, safety and feasibility of this approach.

doi: 10.1038/ncomms3395

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