New device aims to aid patients with very high blood pressure

(Republished with permission from the St. Louis Post-Dispatch. This article originally ran in the Science & Medicine section on Tuesday, July 12, 2005)

By Deborah L. Shelton
Of the Post-Dispatch

Bruce Sollors takes the maximum doses of four medications to control his dangerously high blood pressure. But they haven’t helped.

At times his blood pressure has soared as high as 217/119. Normal blood pressure is about 120/80.

Monday, a device implanted in his chest was activated to see if it can do what the drugs can’t. If the experimental device works, it could be a lifesaver for Sollors and several million others in the United States who have elevated blood pressure that can’t be treated by usual means.

Sollors, 63, of St. Charles is the first person in Missouri – and the fifth American – to get the device, which consists of a pulse generator about the size and weight of a small cell phone. It was implanted in his chest under the skin near the collarbone on June 10.

A thin wire with electrodes on the ends wraps around the carotid artery on each side of the neck. The carotid arteries are two primary blood pressure control points.

The device is being studied in a clinical trial in the United States and Europe. So far, 19 people worldwide have had the device implanted. The device was developed by CVRx Inc., in Maple Grove, Minn.

Sollors’ blood pressure was 190/110 Monday just before the two-hour procedure to activate and program the device. By the time he left, his systolic pressure had fallen more than 30 points.

Blood pressure readings consist of a top number, the systolic pressure, which is the pressure in arteries when the heart is forcing blood through them. The bottom number, the diastolic pressure, is the pressure in arteries when the heart relaxes.

The device will be adjusted once a month for the next year with the goal of slowly lowering his blood pressure.

The device works by electrically activating the baroreflex, the system in the body that regulates blood pressure. When the baroreflex is activated, signals are sent to the central nervous system and interpreted as a rise in blood pressure. The brain works to counteract this perceived rise by dilating blood vessels to allow blood to flow more freely, reducing the heart rate and triggering the kidneys to release fluid, said Gary Jarvis, CVRx senior manager of clinical research. Jarvis turned on Sollor’s implant by computer Monday at Barnes-Jewish Dialysis Center.

Sollors, a retired aircraft mechanic, has seen his blood pressure rise to 200 or higher four times in the last six weeks. He takes 12 pills a day to try to lower it.

He’s been undergoing treatment for his high blood pressure for more than 30 years.

About 50 million Americans have blood pressure elevated enough to require medication. Of those, about 3 percent to 4 percent can’t control it by medication or other means such as dieting, exercising or losing weight.

“This device offers new hope for that segment of the population,” said Dr. Marcos Rothstein, associate professor of medicine at Washington University School of Medicine and director of dialysis services at Barnes-Jewish Dialysis Center.

Elevated blood pressure can lead to a stroke, heart attack or kidney failure.

Every 20-point rise in blood pressure increases the chance of stroke or heart attack by at least 50 percent, Rothstein said.

Over time, uncontrolled high blood pressure is like connecting a garden hose to a water main, he said. Eventually the excess pressure will cause the garden hose to strain and burst. That’s what happens to the blood vessels.

The clinical trial is not for people with mild or moderate high blood pressure. Only people with extremely high blood pressure that has not been controlled by usual means are eligible.

The goal of the trial is to manage blood pressure while the patient continues to take medication. “After that, the goal is to see if we can control the medications,” Rothstein said.

Jarvis said for most people, it will be a combination of the drugs and the device.

“This development is nothing short of revolutionary,” Rothstein said. “It takes advantage of your own physiology, your body’s own natural defense mechanism.”

Reporter Deborah L. Shelton
Phone: 314-340-8203

Copyright 2005 St. Louis Post-Dispatch, Inc.