Pacing the Path to Healthy Blood Pressure

MedEvidence Articles

This podcast delves into the prevalent issue of high blood pressure, a condition impacting nearly half of all Americans and contributing to severe health complications like heart attacks and strokes. Despite numerous available medications, many patients struggle with treatment effectiveness and adherence. The episode explores an innovative approach targeting the heart's role in blood pressure regulation through the Frank-Starling law, which explains how the heart's stretch before each beat affects blood pressure. Highlighting cutting-edge research on pacemakers, it discusses how these devices might be reprogrammed to not only manage arrhythmias but also effectively reduce blood pressure by optimizing heart chamber emptying. This promising technique could revolutionize treatment, making it possible to control blood pressure directly at its cardiac source, potentially offering new hope to those with hypertension.
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References:

Centers for Disease Control and Prevention. (2023). Facts about hypertension. U.S. Department of Health & Human Services. https://www.cdc.gov/bloodpressure/facts.htm

Mond, H. G., & Proclemer, A. (2011). The 11th world survey of cardiac pacing and implantable cardioverter-defibrillators: calendar year 2009--a World Society of Arrhythmia's project. Pacing and clinical electrophysiology : PACE, 34(8), 1013–1027. https://doi.org/10.1111/j.1540-8159.2011.03150.x

Kalarus, Z., Merkely, B., Neužil, P., Grabowski, M., Mitkowski, P., Marinskis, G., ... & Kuck, K. H. (2021). Pacemaker‐Based Cardiac Neuromodulation Therapy in Patients With Hypertension: A Pilot Study. Journal of the American Heart Association, 10(16), e020492. https://www.ahajournals.org/doi/full/10.1161/JAHA.120.020492

Mitchell, L.B. (2023). Cardiac pacemakers. Merck Manual, Professional Version. https://www.merckmanuals.com/professional/cardiovascular-disorders/overview-of-arrhythmias-and-conduction-disorders/cardiac-pacemakers

Neuzil, P., Merkely, B., Erglis, A., Marinskis, G., de Groot, J. R., Schmidinger, H., ... & Kuck, K. H. (2017). Pacemaker‐mediated programmable hypertension control therapy. Journal of the American Heart Association, 6(12), e006974. https://www.ahajournals.org/doi/full/10.1161/JAHA.117.006974

Sequeira, V., & van der Velden, J. (2015). Historical perspective on heart function: the Frank–Starling Law. Biophysical reviews, 7, 421-447. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5418489