Moderato System in Patients With Hypertension

Inclusion Criteria: * Requirement of dual chamber pacemaker or upgrade from a single chamber to a dual chamber pacemaker. * Stable (at least 6 weeks) hypertension treatment with at least 1 anti-hypertensive drug, which is anticipated to be maintained without changes. Stable is defined as being in the same drug regimen, and the dose of each drug(s) no more than 50% reduced or 100% increased over the past 6 weeks. * Average 24-hour ambulatory systolic blood pressure ≥ 130 mmHg (with directly observed medical therapy, DOT) and office blood pressure ≥140 mmHg. * Subject is able to comply with study visits for at least 13 months (e.g., is capable and willing to travel to/from the center for all scheduled study visits). Exclusion Criteria: * Known secondary cause of HTN. * Average ambulatory or office systolic BP \> 195 mmHg. * Permanent atrial fibrillation. * History of significant paroxysmal atrial fibrillation/flutter burden (defined as \>25% of beats). * Cardiac ejection fraction \<50%. * Symptoms of heart failure, NYHA Class II or greater. * Hypertrophic cardiomyopathy, restrictive cardiomyopathy or inter-ventricular septal thickness ≥ 15 mm. * Subject is on dialysis. * Subject has an estimated Glomerular Filtration Rate \< 30 ml/min/1.73 m² * Prior neurological events (stroke or TIA) within the past year or events at a prior time that has resulted in residual neurologic deficit. * Carotid artery disease. * Known autonomic dysfunction. * History of clinically significant un…