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Elevated BP is associated with increased risks of stroke, coronary artery disease, heart failure, and chronic kidney disease. Resistant hypertension is defined as office BP \u2265140\/90 mmHg despite treatment with 3 classes of antihypertensive agents (including a diuretic) at maximally tolerated doses, or the need for 4 or more agents regardless of BP level. Device-based antihypertensive therapies primarily target autonomic nervous system through techniques, such as renal denervation, carotid baroreceptor activation, and carotid body ablation. This review outlines the pathophysiological basis of selected interventions, critically evaluates existing clinical evidence, and highlights future directions for their development and integration into clinical practice.<\/jats:p>","DOI":"10.1093\/ajh\/hpaf235","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T12:53:30Z","timestamp":1764680010000},"page":"844-859","source":"Crossref","is-referenced-by-count":1,"title":["Innovative Device-Based Treatments for Hypertension"],"prefix":"10.1093","volume":"39","author":[{"given":"Min","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University , Suzhou, Jiangsu,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0365-2103","authenticated-orcid":false,"given":"Peng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu,","place":["China"]},{"name":"Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University , Nanjing, Jiangsu,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhui","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University , Suzhou, Jiangsu,","place":["China"]},{"name":"Department of Cardiology, Jiangsu Province Hospital , Nanjing, Jiangsu,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"2026061604110280500_hpaf235-B1","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1001\/jama.2016.19043","article-title":"Global burden of hypertension and systolic blood pressure of at least 110 to 115 mm Hg, 1990-2015","volume":"317","author":"Forouzanfar","year":"2017","journal-title":"Jama"},{"key":"2026061604110280500_hpaf235-B2","first-page":"100082","article-title":"Transparency in the reporting of artificial intelligence\u2014the TITAN guideline","volume":"10","author":"Agha","year":"2025","journal-title":"Pjs"},{"key":"2026061604110280500_hpaf235-B3","doi-asserted-by":"crossref","first-page":"R42","DOI":"10.4244\/EIJV9SRA8","article-title":"Pathophysiology I: the kidney and the sympathetic nervous system","volume":"9","author":"de Jager","year":"2013","journal-title":"EuroIntervention"},{"key":"2026061604110280500_hpaf235-B4","first-page":"316","article-title":"Resistant hypertension in the elderly","volume":"108","author":"Cicconetti","year":"2017","journal-title":"Recenti Prog Med"},{"key":"2026061604110280500_hpaf235-B5","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1038\/nrcardio.2015.96","article-title":"Carotid baroreflex activation therapy for resistant hypertension","volume":"12","author":"Victor","year":"2015","journal-title":"Nat Rev Cardiol"},{"key":"2026061604110280500_hpaf235-B6","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1038\/ki.2008.30","article-title":"Paroxysmal hypertension due to baroreflex failure","volume":"74","author":"Zar","year":"2008","journal-title":"Kidney Int"},{"key":"2026061604110280500_hpaf235-B7","doi-asserted-by":"crossref","first-page":"R79","DOI":"10.1152\/ajpregu.00351.2014","article-title":"Role of renal sensory nerves in physiological and pathophysiological conditions","volume":"308","author":"Kopp","year":"2015","journal-title":"Am J Physiol Regul Integr Comp Physiol"},{"key":"2026061604110280500_hpaf235-B8","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1016\/S0140-6736(09)60566-3","article-title":"Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study","volume":"373","author":"Krum","year":"2009","journal-title":"Lancet"},{"key":"2026061604110280500_hpaf235-B9","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1161\/HYPERTENSIONAHA.110.163014","article-title":"Krum H, Barman N, Schlaich M, et al. 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