Background: Baroreceptor activation therapy (BAT) is proposed for patients with treatment-resistant hypertension (TRH), aiming at reducing blood pressure by electrically stimulating the carotid baroreflex.

Method: A systematic search in four databases yielded 416 records. Seven publications were included for the analysis and synthesis of the evidence: one RCT on the first generation device, one crossover trial and five observational before-after case series.

Results: No comparative evidence was available for the second generation device. One case series (n=44) showed a reduction of the 24-hours blood pressure by 8mmHg with a follow-up of six months. The RCT on the first generation device did not show significant differences in the blood pressure reduction between the sham and the intervention group. No evidence on mortality, morbidity or quality of life as compared to standard treatment was available. The quality of evidence was very low.

Conclusion and recommendation: Given the current paucity of evidence, BAT can currently not be recommended for inclusion in the Austrian benefit catalogue.