Prevalence of neurovascular compression in patients with essential and secondary hypertension

Goldmann, A; Herzog, T; Schaffer, Jeffrey; Mühling, Monika; Haubitz, B.; Haller, H.; Becker, Hans; Radermacher, Jörg

doi:10.5414/cnp68357

Cited by 5 publications

(3 citation statements)

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“…[37][38][39][40][41] In addition, the prevalence of NVC of the RVLM varied from 30 to 90% in essential hypertensives and from 7 to 55% in normotensives. [4][5][6][7]9,11,12,18,[37][38][39][40][41][42][43] The reason for the variation of the estimated prevalence of NVC of the RVLM may be due to the inability of MRI for the perfect and adequate assessment of the presence of NVC of the RVLM and to a lack of standardized classification of NVC of the RVLM. Investigation to establish adequate methods to assess whether NVC of the RVLM exists or not, and whether the compression is functional or not, will be needed.…”

Section: Ne (Pg/mlmentioning

confidence: 99%

Efficacy of an L- and N-type calcium channel blocker in hypertensive patients with neurovascular compression of the rostral ventrolateral medulla

et al. 2009

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The rostral ventrolateral medulla is an important regulation center of sympathetic nerve activity. Several clinical studies have indicated a possible association between essential hypertension and neurovascular compression of the rostral ventrolateral medulla. We have found that patients with essential hypertension and neurovascular compression of the rostral ventrolateral medulla by adjacent arteries have increased sympathetic nerve activity and that microvascular decompression of the rostral ventrolateral medulla normalizes blood pressure and sympathetic nerve activity. Although sympatholytic agents are expected to lower blood pressure in these patients, this remains to be clarified. In this study, we evaluated the effect of cilnidipine, a calcium channel blocker that blocks both vascular L-type and sympathetic N-type Ca 2+ channels in hypertensive patients with neurovascular compression. Using high-resolution magnetic resonance imaging, 46 patients with untreated essential hypertension were distributed into those with and without neurovascular compression of the rostral ventrolateral medulla. All patients were prescribed 10 mg of cilnidipine for 16 weeks. Office and home blood pressure, plasma norepinephrine and left ventricular mass index were measured by echocardiography before and after cilnidipine treatment, and changes were compared between the two groups. At baseline, plasma norepinephrine was significantly higher in patients with neurovascular compression. Decreases in office and home blood pressure, plasma norepinephrine and left ventricular mass index were significantly greater in patients with neurovascular compression. These results suggest that cilnidipine lowers blood pressure by inhibiting enhanced sympathetic nerve activity and reduces left ventricular mass in hypertensive patients with neurovascular compression of the rostral ventrolateral medulla.

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Section: Ne (Pg/mlmentioning

confidence: 99%

Efficacy of an L- and N-type calcium channel blocker in hypertensive patients with neurovascular compression of the rostral ventrolateral medulla

et al. 2009

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“…6 In our previous work, we described positive MRA findings in 43 of 50 primary HT patients. In 18 cases, a successful NVD was performed, and after follow-up of 9 patients for 2 years, the BP values and the therapeutic effort were decreased compared with the preoperative period.…”

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confidence: 81%

Effect of left-sided brain stem decompression on blood pressure and short-term cardiovascular regulation in resistant hypertension

et al. 2012

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“…Since Jannetta's papers many studies have confirmed that an NVD of the RVLM on the left side decreases the BP value, even lasting for many years (10,13,108,109 In a previous work we described that 2 years after a successful NVD the BP values and the therapeutic efforts were decreased compared to the pre-operative period (111).…”

Section: Discussionmentioning

confidence: 92%

The role of the sympathetic nervous system in the pathomechanism and the therapy of hypertension

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Prevalence of neurovascular compression in patients with essential and secondary hypertension

Cited by 5 publications

References 0 publications

Efficacy of an L- and N-type calcium channel blocker in hypertensive patients with neurovascular compression of the rostral ventrolateral medulla

Efficacy of an L- and N-type calcium channel blocker in hypertensive patients with neurovascular compression of the rostral ventrolateral medulla

Effect of left-sided brain stem decompression on blood pressure and short-term cardiovascular regulation in resistant hypertension

The role of the sympathetic nervous system in the pathomechanism and the therapy of hypertension

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