ReviewEvaluating the carotid bodies and renal nerves as therapeutic targets for hypertension

- With 50% of hypertensive patients failing to achieve target blood pressure there is a pressing need for novel therapeutic strategies.
- Despite early promise, the efficacy of renal denervation has recently come under question, and the search for new treatment targets continues.
- Here, we review the evidence implicating the carotid bodies in generating sympathetic overactivity and hypertension.
- We evaluate whether the renal nerves play a role in the blood pressure reduction after carotid body ablation.
- Finally, we assess the potential of carotid body therapy for future clinical application.

Despite the plethora of current treatment options, hypertension remains a difficult condition to adequately control, and there is a pressing need for novel therapeutic strategies. The carotid body has recently become the focus of considerable interest as a potential novel treatment target in essential hypertension. Herein, we appraise the current literature suggesting that the carotid body plays an important causative role to generate sympathetic overactivity and drive increases in arterial pressure, in animal models of hypertension. We also review evidence from human studies showing cardiovascular benefits to the transient inactivation, or surgical removal of carotid bodies, and evaluate the potential benefits of pre-screening to identify patients likely to respond to carotid body-targeted therapy. Finally, given that a high proportion of patients who have undergone renal nerve ablation procedures remain hypertensive, we examine whether the renal nerves are necessary for the drop in blood pressure seen with carotid body removal.