TSA hdac inhibitor with of patients who were implanted with the BAT device but did not receive stimulation during this period. A mean systolic blood pressure reduction of mmHg in patients who received BAT and mmHg in patients who did not receive BAT was seen in the same time period. The mean blood pressure decrease and proportion of patients who met the mmHg blood pressure goal had some what increased months after BAT thera to mHg and respectively. Although these data were NATURE REVIEWS | CARDIOLOGY BP Figure | Schematic representation of baroreflex activation therapy. The BAT device consists of an implantable pulse generat bilateral carotid sinus leads delivering stimulation to the area of greatest respon and an external programmable device for noninvasive control of the pulse generator.
Stimulation of the carotid sinus by this device supplies false information indicating Seliciclib 186692-46-6 hypertension to the blood pressure control centers of the central nervous syst leading to reflexive blood pressure lowering. Abbreviation: B baroreflex activation therapy; signals resulting in decreased blood pressure; false signal indicating increased blood pressureermission obtained from Nature Publishing Group Mear B. M. Nat. Rev. Cardiol. encouragi and predefined effica BAT safe and device safety end points were m the study did not meet the predefined procedural safety criteria of no implanta tion procedure related adverse effects in of patien as only of patients did not experience buy BMS-754807 adverse effects such as transient or permanent nerve inju general surgicalplicatio and surgical wound infection.
Several technical improvements a therefo likely to be required”most importantly device size reducti and the development of a unilateral device withparable efficacy to the bilateral version used in these studies. To address these concer a small second generation unilateral BAT device was introduced in . This device has been reported to offer improved procedural safety andparable blood pressure reducing efficacy to the bilateral BAT device. ADVANCE ONLINE PUBLICATION | Macmillan Publishers Limited. All rights reserved Stigmasterol inhibitor REVIEWS Conclusions Although development of new medications and treat ment strategies for hypertension is still requir the investigation of novel therapeuticpounds for this indication seems to be losing momentum. Neverthele clinicians can remain optimistic that new antihypertensive drugs with novel mechanisms of action will be approved in the next years.
The aldosterone synthase inhibitors currently in drug development pipelines seem to show particular promi although problems of specificity and funding need to be address and the development of novel molecules with dual activity is likely to continue. Howev approvals for antihypertensive therapies in the near future will probably be dominated by new fixed dosebinatio includ ing a broader and more variable range of triple therapies. Device based approaches to antihypertensive treatment have also advanced considerably a as the technologies progre they might represent a strategy to ovee the problem of treatment ascorbic acid resistant hypertension. Review criteria Drugs approved in were identified using the CenterWatch and FDA databas and those in clinical development were identified using the PhRMA database.