Hot Topics in Hypertension Research

Hot Topics in Hypertension Research

(piano music) – Hi, my name is Ananth Karumanchi, I’m a nephrologist at Beth
Israel Deaconess Medical Center in Boston, I just chaired
the session on hot new topics in hypertension research and we have two exciting speakers today, Dr. Jens Jordan, from Hanover Medical
School, and Dr. Bina Joy from Toledo Medical School. – Hi, I’m Jens Jordan, clinical pharmacologist and internist, I’m director of the clinical
pharmacology department at Hanover Medical School in Germany. – I’m Bina Joe, I’m
the professor and chair of physiology and pharmacology in the University of
Toledo College of Medicine, I also direct the Center for Hypertension and Personalized Medicine there. – So Dr. Jordan, let’s start with you, what does the hypertension
research community need to know about non-pharmacological new devices that are
being currently tested for the treatment of hypertension. – I think the most
important news at this point is for the clinical use of these devices, that we don’t really have the data to prove that it is clinically useful, we need more studies showing the efficacy of these treatments. On the other end, we have
very good proof of concept, that some of them might work, and most of these devices target a part of the sympathetic nervous system to lower blood pressure, and we also have to identify patients who
are on more or less likely to respond to one particular
as best treatment. – I found your talk on the data on carotid stimulation quite interesting. Can you tell us a few
words about this type of device and how this
may be the next line of treatment for resistant hypertension? – So the idea of this treatment is that it electrically activates the carotid baroreceptors, basically
it fools the brain, so the brain will think the blood pressure is even higher than it is, and lower, it disengages the activity of the sympathetic nervous system, thereby lowering blood pressure, and in some patients, we
have the proof of concept that it can lower blood pressure, but it doesn’t lower blood
pressure in all patients, so it’s not really ready for a widespread clinical use yet. – An interesting thought
that occurred in my head while you were speaking, was, is there a tolerance for these type of procedures? Like many blood pressure medications, you might see an initial effect
that disappears with time, and what do we know about tolerance with carotid sinus stimulation? – We don’t really know much, we don’t have good individual long-term data, and we have seen some
patients who suddenly lost the blood pressure lowering effects, so this might be technical issues rather than tolerance, but you’re right, we need more data on this. – Moving on to Bina, can you tell us a bit about what the research community in hypertension need to
know about microbiome? – At this point in time,
research in hypertension, specifically, related to the microbiome, is pretty scanty. So the research community needs to know that there is definite evidence for the involvement of microbiota in altering physiology and
altering blood pressure to go to hypertension. With that data, the amount of research that needs to be done
for mechanistic studies, exploring possibly gut-brain interactions, gut-liver interactions, other microbiota, not just the gut but other organs on which microbiota do exist, there’s barely anything
known at this point in time. It’s an area of research
that could be very exciting and remain a hot topic for a long time. – To follow up on the question, what about metabolic syndrome? There’s quite a bit of data emerging that microbiome may play a role, certainly in the pathogenesis of obesity, and some of the metabolic features of the syndrome, now is
there beneficial effect, could there be beneficial
effect on hypertension secondary to changing the microbiome, or do you think is a specific phenomenon related to weight loss or other issues that occur during this treatment? – That’s a good question, the difference between how microbiota influence obesity could involve metabolic syndrome as well, but we are studying models
that do not show obesity, and yet there is an association, that proves to me that there are factors beyond the metabolic
syndrome aspect of it, that represent direct interactions. I would also like to announce that the NIH has taken note, and they had a working group recently in which they have some
recommendations on hypotheses that need to be tested
both on basic science and in the clinical arena, and those recommendations are online, and that should trigger the community to catch up on doing more
exciting research in this area. – A final question to you,
what are your thoughts about research, for
researchers, how do we adjust for microbiome in our data? Is that, should this be, do
you think that everyone should be doing this regularly
in our mouse models, what is the current standard? – That is a very, very important question, as an editor of a journal,
we have had these meetings about reproducibility in research, and one of the areas that
comes up front and center is microbiota, the origin of the strain, where it is housed, how it’s transported, what they are fed, what
temperature they’re housed in, etc. Very critical points to be
included in publications that way we can track why a result does work that way or not. These are very important considerations. – Well, thank you very much,
thank you, both of you. (piano music)

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