Cost Effectiveness of Blood Pressure Device Evaluated

A study conducted by the University of Rochester Medical Center (URMC) demonstrates that, for certain patient populations, an experimental device that lowers blood pressure may be a cost effective treatment. The implantable device, called Rheos, is in advanced stages of testing for individuals with drug resistant hypertension.

The study – which appears this month in the Journal of Clinical Hypertension – used data from two large population-based studies and compared the incidence of adverse health events such as stroke and heart attack for groups of individuals with and without the blood pressure lowering benefit of the device. Researchers then projected the health care costs associated with those events over a patient’s lifetime. The results show that if Rheos continues to perform at a level consistent the initial findings in ongoing clinical trials, then the device is a cost effective way to control hypertension.

“Our goal was to determine whether or not the benefit of Rheos would offset the higher upfront costs,” said Kate C. Young, Ph.D., MPH, an instructor in the departments of Surgery and Neurology at URMC and lead author of the study. “What we found is that the device’s cost effectiveness is dependent upon the degree to which it can reduce blood pressure and the starting point of the patient.”

The Rheos High Blood Pressure or Hypertension Therapy System – which is being developed by CVRx, Inc. of Minneapolis – consists of a battery-powered implantable generator, which is inserted under the skin near the collarbone, and two carotid sinus leads, which run from the generator to the left and right carotid sinus in the neck.

The device activates the carotid baroreceptors – a key regulator of the body’s cardiovascular system – which prompts signals that are interpreted by the brain as a rise in blood pressure. The brain then works to counteract this perceived rise in blood pressure by sending signals to other parts of the body that relax the blood vessels and inhibit the production of stress-related hormones. These changes enable the heart to increase blood output, while maintaining or reducing its workload, thereby reducing blood pressure when it is elevated and alleviating the symptoms of heart failure.

Rheos is currently undergoing Phase III clinical trials at sites throughout the U.S., including Rochester where URMC physicians were the first in the nation to implant the device back in 2005. The device is also being used in a newer study which is evaluating its utility in treating patients with congestive heart failure.

While the majority of individuals can effectively control their blood pressure through nutrition, exercise, and medication, there are individuals who do not adequately respond to treatment, which often consists of a regimen of multiple medications. This condition is called drug resistant hypertension and the Rheos device is currently being testing in individuals with this condition.