Hypertension treatment device and method for mitigating rapid changes in blood pressure
An implantable baroreflex activation device administers a special electrotherapy program that causes the device to apply electrotherapy to limit a rate of change of blood pressure increase associated with a blood pressure surge event such as a morning blood pressure surge (MBPS).
1. An implantable baroreflex activation system for controlling an expected blood pressure surge event, the system comprising:
at least one electrode;
an electrotherapy circuit electrically coupled with the at least one electrode;
a clock; and
a processor electrically coupled with the electrotherapy circuit and the clock, the processor including operating logic that controls administration of electrotherapy to stimulate baroreceptors of a patient via the electrotherapy circuit and based at least in part on information received from the clock, the processor configured to:
administer a nominal electrotherapy program during an absence of the expected blood pressure surge event; and
administer a special electrotherapy program during a predetermined time window, the predetermined time window extending from prior to the expected blood pressure surge event until after conclusion of the expected blood pressure surge event, the special electrotherapy program configured to affect the intrinsic circadian rhythm of the patient by reducing the rate of increase of blood pressure in the patient during the expected blood pressure surge event.
2. The implantable baroreflex activation system of claim 1 , further comprising: a physiologic sensor interfaced with the processor; wherein the special electrotherapy program is scheduled in part based on measurements made by the physiologic sensor.
3. The implantable baroreflex activation system of claim 1 , further comprising: a physiologic sensor interfaced with the processor; wherein the operating logic includes analysis of stored historical measurements made by the physiologic sensor, wherein the analysis is utilized to predict a future blood pressure surge event.
4. The implantable baroreflex activation system of claim 1 , wherein the special electrotherapy program is configured to reduce the rate of increase of blood pressure in a patient during the expected blood pressure surge event by increasing the level of electrotherapy as compared to a level provided during nominal electrotherapy.
5. The implantable baroreflex activation system of claim 1 , wherein the special electrotherapy program is configured to reduce the rate of increase of blood pressure in a patient during the expected blood pressure surge event by reducing the level of electrotherapy prior to the expected blood pressure surge event, then subsequent to the start of the expected blood pressure surge event return the level of electrotherapy to a level provided during nominal electrotherapy.
6. The implantable baroreflex activation system of claim 1 , wherein the special electrotherapy program is configured to reduce the rate of increase of blood pressure in a patient during the expected blood pressure surge event by reducing the level of electrotherapy prior to the expected blood pressure surge event, then subsequent to the start of the expected blood pressure surge event increase the level of electrotherapy greater than a level provided during nominal electrotherapy, and by the conclusion of the expected blood pressure surge event return the level of electrotherapy to a level provided during nominal electrotherapy.
7. The implantable baroreflex activation system of claim 1 , further comprising: a physiologic sensor interfaced with the processor; wherein the predetermined time window is determined at least in part by data collected via the physiologic sensor.
8. A method, comprising:
providing an implantable baroreflex activation system to a user, the implantable baroreflex activation system including:
an electrode;
an electrotherapy circuit electrically coupled with the electrode;
a clock; and
a processor electrically coupled with the electrotherapy circuit and the clock, the processor including operating logic that controls administration of electrotherapy to stimulate baroreceptors of a patient via the electrotherapy circuit and based at least in part on information received from the clock,
providing instructions recorded on a tangible medium to the user that cause the processor to:
administer a nominal electrotherapy program during an absence of an expected blood pressure surge event; and
administer a special electrotherapy program during a predetermined time window, the predetermined time window extending from prior to the expected blood pressure surge event until after conclusion of the expected blood pressure surge event, the special electrotherapy program configured to affect the intrinsic circadian rhythm of the patient by reducing the rate of increase of blood pressure in the patient during the expected blood pressure surge event.
9. The method of claim 8 , wherein providing an implantable baroreflex activation system to a user includes causing the implantable baroreflex activation system to be manufactured and made available to the user.