Heterogeneity of autonomic regulation in hypertension and neurovascular contact

Journal of Hypertension
Jens JordanF C Luft

Abstract

Brainstem neurovascular contact (NVC) may interfere with central autonomic regulation and contribute to essential hypertension. We have previously shown that patients with autosomal-dominant hypertension, brachydactyly, and NVC feature extreme phenylephrine hypersensitivity due to impaired baroreflex buffering. We tested the hypothesis that similar abnormalities are present in patients with essential hypertension who have NVC. Six patients with NVC and essential hypertension and five patients with NVC and monogenic hypertension and brachydactyly were studied. Responses to incremental phenylephrine doses were assessed before and during ganglionic blockade with trimethaphan. Supine blood pressure was 172 +/- 8.8/89 +/- 6.1 mmHg before ganglionic blockade. Blood pressure decreased 47 +/- 5/18 +/- 3 mmHg with trimethaphan (16 +/- 4.4/4 +/- 4.0 mmHg in autosomal-dominant hypertension, P < 0.05). Before ganglionic blockade, 25 microg phenylephrine increased systolic blood pressure 17 +/- 4 mmHg in patients with essential hypertension and 30 +/- 3 mmHg in patients with autosomal-dominant hypertension (P < 0.05). During ganglionic blockade, the same dose increased systolic blood pressure 32 +/- 1 and 33 +/- 4 mmHg in patients with esse...Continue Reading

References

Sep 1, 1973·Journal of Medical Genetics·N BilginturanT Pirnar
Mar 1, 1984·Journal of the American College of Cardiology·D RobertsonR M Robertson
Sep 26, 1997·Stroke; a Journal of Cerebral Circulation·R NaraghiF C Luft
May 12, 1998·Hypertension·J JordanD Robertson
Apr 25, 2000·American Journal of Hypertension·J TankM Weck
Jun 14, 2000·Circulation·J R ShannonI Biaggioni
Feb 24, 2001·Hypertension·Henriette HohenbleicherArya M. Sharma

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Citations

Sep 17, 2014·The Journal of Physiology·Jens Jordan
Jun 18, 2017·Current Hypertension Reports·Jens Jordan
Mar 5, 2016·Journal of Hypertension·Jens Jordan, Guido Grassi
Jun 30, 2016·Journal of Hypertension·Jens JordanJens Tank
Jul 24, 2020·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Jens Jordan, Jens Tank

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