Patients with blood pressure find hope in the Rheos High Blood Pressure Treatment System

TAMPA

Exercise didn't help. Nor did changing her diet and losing weight. She has never smoked, so she couldn't blame tobacco.

As for medication, "you name it, I tried it," says Rosa Jones, 58, who has battled high blood pressure for more than 20 years.

It's not unusual for Jones' blood pressure to hit 220 over 110, a reading some doctors would call a medical emergency. A healthy blood pressure is less than 120/80.

For Jones, a clerk in the nursing department at Tampa General Hospital, two uncontrollable risk factors make her fight especially hard: being African-American and having a family history of high blood pressure.

"As I got older, it kept getting worse,'' Jones said. "It came to the point where I was on seven different blood pressure medications at one time. Right now I'm on six."

She has already had one stroke. Fearing another, she allowed doctors to implant an experimental device in her chest that she hopes will save her life.

Many don't get checked

High blood pressure, or hypertension, is often called the silent killer because it usually has no symptoms. Unless checked routinely, it can be dangerously high for years without any sign.

About 72 million Americans have high blood pressure; one-third of them don't even know it. Another 50 million Americans have prehypertension, borderline high blood pressure that can often be lowered with lifestyle changes.

Think of the stress that too much air pressure puts on the walls of an overfilled tire. That's what hypertension is, except the tire is your arteries feeding major organs and the air is blood flow.

The heart, brain, kidneys and artery walls can only take so much pressure before becoming injured, leading to a heart attack, congestive heart failure or a stroke. Over time, high blood pressure can also cause kidney failure, vision loss, angina or chest pain, erectile dysfunction and memory loss.

A treatment from within

Although most people with hypertension respond well to lifestyle changes and medication, about 25 percent don't. Like Jones, their blood pressure remains dangerously high despite aggressive treatment.

Jones has struggled to shed pounds, and had weight-loss surgery. Yet even when her weight goes down, her pressure does not. So she enrolled in a clinical trial testing a device that lowers blood pressure mechanically, by stimulating the body's own blood pressure regulation system. The Rheos High Blood Pressure Treatment System is being tested in 300 patients at 50 medical centers in the United States, including the Florida Cardiovascular Institute Heart Center in Tampa.

"The patients we are recruiting have uncontrolled high blood pressure and are on (at least) three blood pressure medications, one that is a diuretic or contains a diuretic," says Dr. Fadi Matar, principal investigator for the FCI Heart Center study.

The main part of the Rheos system, a battery-powered pulse generator about the size of a pacemaker for the heart, is implanted under the skin, just below the collarbone. Two wires extend from the generator and are wrapped around the carotid arteries, one on each side of the neck. The generator delivers mild electrical pulses to the walls of the carotid arteries, stimulating the body's own blood pressure regulation system.

This baroreflex system senses the body's needs and tells the brain to, for example, increase blood pressure for intense exercise or lower it for rest or sleep. The brain sends signals to all body systems, including the heart, brain, blood vessels and kidneys, so they work together to regulate blood pressure.

Blood pressure medications generally target one body system at a time, which is why many patients are on multiple medications. The Rheos implant can work on several organs at once simultaneously.

An external wandlike device controls the Rheos. "In early testing, pressures dropped from 200/100 to 120/80. Turn the device off and it shoots back up. It's like a blood pressure switch," Matar said.

Because the implant is part of a clinical trial, patients who have it don't know if their device is switched on or off.

Jones received her implant in June at Tampa General Hospital. Some days her pressure is very high, but on a recent afternoon her home blood pressure monitor showed 119/60. After six months of participation, all study patients will have the device turned on.

"I'm hoping and praying,'' Jones said, that the device works so well that she can get down to just one or two medications.

"That would be a blessing in itself."

Irene Maher can be reached at imaher@sptimes.com or (813) 226-3416.

Blood pressure,

by the numbers

Systolic, the top number, represents pressure in the arteries when the heart muscle contracts.

Normal: Less than 120 for Americans over age 20

Prehypertension: 121-139. Can usually be treated with lifestyle changes.

Stage 1 hypertension: 140-159. Usually requires lifestyle changes and medication

Stage 2 hypertension: Over 160. Requires immediate medical attention.

Diastolic, the bottom number, measures pressure in the arteries when the heart muscle is resting between beats.

Normal: Less than 80

Prehypertension: 80-89

Stage 1 hypertension: 90-99

Stage 2 hypertension: 100 or higher

To reduce your risk of

high blood pressure:

Reduce dietary sodium

Maintain a healthy weight

Get regular physical activity

Avoid tobacco

Limit alcohol

Reduce stress

Source: American Heart Association

(www.heart.org)

For more information on the Rheos clinical trial, including a new study now enrolling patients that will test the implant in patients with congestive heart failure, go to www.

bloodpressuretrial.com.

For information on the Tampa study contact study coordinator Leona Stewart at (813) 353-8535.

Patients with blood pressure find hope in the Rheos High Blood Pressure Treatment System 10/21/09 [Last modified: Wednesday, October 21, 2009 6:37pm]

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