Barorezeptorakivierungstherapie bei therapierefraktärer Hypertonie: Indikation und Patientenselektion

Empfehlungen der BAT-Konsensusgruppe 2017

Baroreceptor activation therapy for therapy-resistant hypertension: indications and patient selection

Recommendations of the BAT consensus group 2017

Zusammenfassung

Zur Behandlung der therapierefraktären Hypertonie (trHTN) steht seit einigen Jahren die Möglichkeit der Barorezeptoraktivierungstherapie (BAT) zur Verfügung. Das Verfahren wird derzeit in Deutschland an einer begrenzten Anzahl von Standorten durchgeführt, auch mit dem Ziel, eine hohe Expertise durch ausreichende Erfahrung anzubieten. Durch eine wachsende Zahl von Patienten, die mit einer BAT behandelt werden, treten jedoch im ärztlichen Alltag immer wieder Probleme im Umgang mit diesen Patienten auf. Um diese Probleme zu adressieren, wurde im November 2016 eine Konsensuskonferenz mit Experten auf dem Gebiet der trHTN durchgeführt, die die aktuellen Evidenzen und Erfahrungen, aber auch Problembereiche im Umgang mit BAT-Patienten zusammenfasst.

Abstract

Baroreceptor activation therapy (BAT) has been available for several years for treatment of therapy-refractory hypertension (trHTN). This procedure is currently being carried out in a limited number of centers in Germany, also with the aim of offering a high level of expertise through sufficient experience; however, a growing number of patients who are treated with BAT experience problems that treating physicians are confronted with in routine medical practice. In order to address these problems, a consensus conference was held with experts in the field of trHTN in November 2016, which summarizes the current evidence and experience as well as the problem areas in handling BAT patients.

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Correspondence to Prof. Dr. M. Koziolek.

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Interessenkonflikt

H. Reuter, M. Halbach, M. Koziolek, M. Wallbach und J. Börgel erhielten Forschungsunterstützung von CVRx. H. Reuter, M. Koziolek und J. Müller-Ehmsen sind Mitglieder im Steuerungskomitee der BAROSTIM-NEO™-Registerstudien. H. Reuter, M. Halbach, M. Koziolek, J. Beige, N. Mader und J. Müller-Ehmsen erhielten Vortragshonorare von CVRx. D. Zenker, G. Henning, F. Mahfoud, G. Schlieper, V. Schwenger, M. Hausberg, M. Lodde, M. van der Giet, J. Passauer, S. Parmentier, S. Lüders, B.K. Krämer, S. Büttner, F. Limbourg, J. Jordan, O. Vonend und H.-G. Predel geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Additional information

Der Entschluss zum vorliegenden Konsensuspapier ergab sich auf dem 39. Wissenschaftlichen Kongress der Deutschen Hochdruckliga (DHL). Die Konsensusgruppe umfasst Mitglieder der Kommission Interventionelle Hochdrucktherapie (M. Hausberg, J. Jordan, F. Mahfoud, O. Vonend) und der Sektion Hochdruckdiagnostik (S. Lüders) der DHL sowie der AG Herz und Niere der Deutschen Gesellschaft für Kardiologie (DGK) und der Deutschen Gesellschaft für Nephrologie (DGfN) (F. Mahfoud, H. Reuter, G. Schlieper, V. Schwenger). Darüber hinaus besteht inhaltlich keine Beziehung zu Fachgesellschaften oder zur DHL. Weitere Mitglieder der Konsensusgruppe wurden aus den Kliniken und Arbeitsgruppen mit großer Erfahrung in der Therapie mit Barorezeptorstimulation und aus verschiedenen Fachbereichen großer Hypertoniezentren rekrutiert.

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Koziolek, M., Beige, J., Wallbach, M. et al. Barorezeptorakivierungstherapie bei therapierefraktärer Hypertonie: Indikation und Patientenselektion. Internist 58, 1114–1123 (2017). https://doi.org/10.1007/s00108-017-0308-y

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Schlüsselwörter

  • Baroreflex
  • Blutdrucksenkung
  • Effizienz
  • Organoprotektion
  • Sicherheit

Keywords

  • Baroreflex
  • Blood pressure decrease
  • Efficacy
  • Organoprotection
  • Safety