Unilateral Carotid Body Resection in Resistant Hypertension : A Safety and Feasibility Trial

•First prospective feasibility and safety clinical trial on unilateral CB resection for the treatment of high blood pressure.•In drug-resistant patients with hypertension, unilateral CB resection was feasible and safe.•Unilateral CB resection lowered blood pressure by 26 mm Hg in 57% of patients with drug-resistant hypertension associated with a reduction in muscle sympathetic nerve activity and its baroreceptor reflex control.•Whole drug equivalents were reduced in the responding patients.•Responding patients had characteristics distinct to those that did not respond; these should allow patient selection for future CB modulation trials.

SummaryAnimal and human data indicate pathological afferent signaling emanating from the carotid body that drives sympathetically mediated elevations in blood pressure in conditions of hypertension. This first-in-man, proof-of-principle study tested the safety and feasibility of unilateral carotid body resection in 15 patients with drug-resistant hypertension. The procedure proved to be safe and feasible. Overall, no change in blood pressure was found. However, 8 patients showed significant reductions in ambulatory blood pressure coinciding with decreases in sympathetic activity. The carotid body may be a novel target for treating an identifiable subpopulation of humans with hypertension.

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