Method of treating drug resistant hypertension and heart failure with preserved ejection fraction by combined drug treatment with baropacing and beta blockers
A method of treating a patient with drug resistant hypertension (“DRH”) and/or heart failure with preserved ejection fraction (“HFpEF ”) including the steps of: treating the patient with angiotensin converting enzyme inhibitor (“ACEI”) and/or an angiotensin receptor blocking [ARB] drug and cardiac pacing the patient as controlled by an algorithm. Performance may be improved by simultaneously withholding administration of any beta-1 selective beta adrenergic blockers. The method may also include the steps of administering to a patient a therapeutic amount of a beta blocker having intrinsic sympathomimetic activity (“ISA”) and pacing the heart of a patient using the algorithm.
1 . A method of treatment, the method comprising:
administering one or more of an angiotensin converting enzyme inhibitor (ACEI) treatment and an angiotensin receptor blocking (ARB) treatment to a patient;
administering a beta blocker intrinsic sympathomimetic activity (ISA) treatment to the patient;
receiving a first blood pressure value at a first time subsequent to providing the at least one or more of the ACEI treatment and the ARB treatment and subsequent to providing the ISA treatment;
determining that the first blood pressure value deviates from a target blood pressure value by at least a threshold amount;
determining a first pacing rate of a pacing device based on the first blood pressure value and an artificial intelligence (AI) trend analysis;
outputting the first pacing rate to the pacing device; and
administering, by the pacing device, a first pacing therapy to the patient based on the first pacing rate.
2 . The method of claim 1 , wherein determining the first pacing rate of the pacing device is performed in real-time upon receiving the first blood pressure value or determining that the first blood pressure deviates from the target blood pressure value by at least the threshold amount.
3 . The method of claim 1 , wherein the first pacing rate is approximately 10% greater than a baseline atrial pacing rate.
4 . The method of claim 1 , further comprising:
receiving a second blood pressure value at a second time subsequent to the first time;
determining that the second blood pressure value deviates from the target blood pressure value by at least the threshold amount;
determining a second pacing rate of the pacing device; and
outputting the second pacing rate to the pacing device.
5 . The method of claim 4 , further comprising:
administering, by the pacing device, a second pacing therapy to the patient based on the second pacing rate.
6 . The method of claim 1 , wherein the first blood pressure value is a systolic blood pressure (SBP) value.
7 . The method of claim 1 , further comprising:
receiving a second blood pressure value at a second time subsequent to the first time;
determining that the second blood pressure value is one of: within the threshold amount of the target blood pressure value, lower than the first blood pressure value by a threshold pressure value; and
maintaining the first pacing rate of the pacing device.
8 . A system for providing treatment comprising:
a first module configured to administer one or more of an angiotensin converting enzyme inhibitor (ACEI) treatment and an angiotensin receptor blocking (ARB) treatment to a patient;
a second module configured to provide administer a beta blocker intrinsic sympathomimetic activity (ISA) treatment to the patient;
a pacing device configured to output electric pacing signals based on pacing rates; and
at least one processor operatively coupled to a memory storing computer-readable instructions that, when executed by the at least one processor, cause the at least one processor to:
receive a first blood pressure value at a first time subsequent to providing the one or more of the ACEI treatment and the ARB treatment and subsequent to providing the ISA treatment;
determine that the first blood pressure value from a target blood pressure value by at least a threshold amount;
based on the first blood pressure value and an artificial intelligence (AI) trend analysis executed by an AI module, and
output the first pacing rate to the pacing device; and
the pacing device configured to administer a first pacing therapy to the patient based on the first pacing rate.
9 . The system of claim 8 , wherein the computer-readable instructions, when executed by the at least one processor, further cause the at least one processor to determine the first pacing rate of the pacing device in real-time upon receiving the first blood pressure value or determining that the first blood pressure value deviates from the target blood pressure value by at least the threshold amount.
10 . The system of claim 8 , wherein the first pacing rate is approximately 10% greater than a baseline atrial pacing rate.
11 . The system of claim 8 , wherein the computer-readable instructions, when executed by the processor, further cause the at least one processor to:
receive a second blood pressure value at a second time subsequent to the first time;
determine that the second blood pressure value deviates from the target blood pressure value by at least the threshold amount; and
determine a second pacing rate of the pacing device; and
output the second pacing rate to the pacing device.
12 . The system of claim 11 , wherein the computer-readable instructions, when executed by the processor, further cause the at least one processor to:
administer a second pacing therapy to the patient based on the second pacing rate.
13 . The system of claim 8 , wherein the first blood pressure value is a systolic blood pressure (SBP) value.
14 . The system of claim 8 , wherein the computer-readable instructions, when executed by the processor, further cause the at least one processor to:
receive a second blood pressure value at a second time subsequent to the first time;
determine that the second blood pressure value is one of: within the threshold amount of the target blood pressure value and lower than the first blood pressure value by a threshold pressure value; and
maintain the first pacing rate of the pacing device.
15 . A system comprising:
a pacing device configured to output electric pacing signals based on pacing rates; and
at least one processor operatively coupled to a memory storing computer-readable instructions that, when executed by the at least one processor, cause the at least one processor to:
receive a first blood pressure value from a patient at a first time subsequent to administration of one or more of an angiotensin converting enzyme inhibitor (ACEI) treatment and an angiotensin receptor blocking (ARB) treatment to the patient and subsequent to administration of a beta blocker intrinsic sympathomimetic activity (ISA) treatment to the patient;
determine that the first blood pressure value deviates from a target blood pressure value by at least a threshold amount;
determine a first pacing rate of a pacing device based on the first blood pressure value and an artificial intelligence (AI) trend analysis executed by an AI module, and
output the first pacing rate to the pacing device; and
the pacing device configured to administer a first pacing therapy to the patient based on the first pacing rate.
16 . The system of claim 15 , wherein the computer-readable instructions, when executed by the processor, further cause the at least one processor to:
receive a second blood pressure value at a second time subsequent to the first time;
determine that the second blood pressure value deviates from the target blood pressure value by at least the threshold amount;
determine a second pacing rate of the pacing device; and
output the second pacing rate to the pacing device.
17 . The system of claim 16 , wherein the computer-readable instructions, when executed by the processor, further cause the at least one processor to:
administer a second pacing therapy to the patient based on the second pacing rate.
18 . The system of claim 15 , wherein the computer-readable instructions, when executed by the processor, further cause the at least one processor to:
receive a second blood pressure value at a second time subsequent to the first time;
determine that the second blood pressure value is one of: within the threshold amount of the target blood pressure value and lower than the first blood pressure value by a threshold pressure value; and
maintain the first pacing rate of the pacing device.
19 . The system of claim 15 , wherein the computer-readable instructions, when executed by the at least one processor, further cause the at least one processor to determine the first pacing rate of the pacing device in real-time upon receiving the first blood pressure value or determining that the first blood pressure value deviates from the target blood pressure value by at least the threshold amount.
20 . The system of claim 15 , wherein the first pacing rate is approximately 10% greater than a baseline atrial pacing rate.