Premise,Promise, and Potential Limitations of Invasive Devices to Treat Hypertension

Invasive device-based therapies for drug-resistant hypertension are undergoing active clinical investigation. The two approaches are 1) permanent implantation of a carotid baroreceptor pacemaker and 2) radiofrequency catheter ablation of the renal nerves. Both are designed to reduce the sympathetic nervous system component of drug-resistant hypertension. Several excellent comprehensive articles have reviewed each of these devices separately. In contrast, this brief article aims to provide a conceptual framework for evaluating the premise, promise, and potential limitations of both invasive antihypertensive therapies.