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What is Hypertension? Hypertension is high blood pressure. Blood pressure is generally considered to be "high" when it is measured above 140/90 millimeters of mercury. About one in five persons in the US has hypertension. The initial diagnosis is confirmed by repeated measurement and monitoring, using the familiar inflatable arm-cuff and squeeze pump that almost every medical patient sees when we go to a doctor's office. Additional testing may be required, to investigate possible causes of your high blood pressure. Hypertension may be caused by a large number of different factors. These include overweight, excess dietary sodium (salt), habitual and excessive use of alcohol, some medications, habitual severe anxiety, diseases of the blood vessels or heart, thrombosis, and embolism (among many others). How is Hypertension Treated? Treatment for hypertension due to known causes may involve changes in diet, weight loss, exercise to improve heart function, or a program of medication. Several medications have proven to be highly effective in many cases. In a high proportion of all cases of high blood pressure, no specific external cause of the condition can be positively identified. This category of high blood pressure is called "essential hypertension." Understandably, for such a common but essentially undefined disorder, there has long been a high level of interest among doctors, researchers, and patients concerning new treatments. One promising avenue of research has revealed that in some patients there seems to be a link between essential hypertension and physical compressions of nerves within a region of the brain, due to small blood vessels pulsing against the nerve. This is called called "neurovascular compression". The key region of the brain is the "rostral ventrolateral medulla." Not all essential hypertension patients have such nerve compressions. However, studies have established that magnetic resonance imaging (MRI) can frequently reveal this condition if it exists. Moreover, doctors now working at Allegheny General Hospital have shown that when compressions are confirmed and relieved by neurosurgery, blood pressure may be reduced into the normal range for many patients. The following abstracts from the National Library of Medicine (MEDLINE) summarize what is known about the relationship between nerve compression and essential hypertension, and outline the results of treatment by microvascular decompression. Abstracts in simple text files or full length articles in PDF format may be downloaded. Be advised, however, that PDF files are quite long, and may require several minutes to transfer. You will also need a copy of Adobe Acrobat Reader to view the papers. Adobe Acrobat Reader is available free from www.adobe.com. Studies in animals: Segal R, Jannetta PJ, Wolfson SK Jr, Dujovny M, Cook EE Neurogenic
hypertension: etiology and surgical treatment. II. Observations in an experimental
nonhuman primate model. [Abstract] Jannetta PJ, Segal R, Wolfson
SK Jr, Dujovny M, Semba A, Cook EE
Experience with medical patients Neurogenic
Hypertension: Etiology and Surgical Treatment [Absract]
Jannetta PJ, Segal R, Wolfson SK Jr.Essential Hypertension Caused by Arterial Depression of the Left Lateral Medulla: A Follow-Up. [Full Text PDF] Jannetta PJ, Hamm IS, Jho HD, Saiki IPulsatile compression of the rostral ventrolateral medulla in hypertension. [Abstract] [Full Text PDF] Morimoto S, Sasaki S, Miki S, Kawa T, Itoh H, Nakata T, Takeda K, Nakagawa M, Naruse S, Maeda T Posterior
fossa neurovascular anomalies in essential hypertension [Abstract]. Naraghi R, Geiger H, Crnac J, Huk W, Fahlbusch R, Engels G, Luft FC Microvascular
decompression of the left lateral medulla oblongata for severe refractory
neurogenic hypertension [Abstract].
Levy
EI, Clyde B, McLaughlin MR, Jannetta PJ
Where Can I Find a Healthcare Professional Who Treats Hypertension? Many primary care physicians in general practice treat hypertension. The neurosurgical team at West Penn Allegheny Health System also includes specialists who treat cases where essential hypertension may be due to nerve compression. The Treatment Team at WPAHS Peter Jannetta, M.D., Professor of Neurosurgery, Allegheny General Hospital.Patient Support Groups and Bulletin Boards Hyperension bulletin board: at Support Groups.Com (traffic appears limited). Mediconsult: Basic hypertension guide, with a professionally moderated hypertension discussion group (Registration at the top right of the menu). Additional Information on the Internet Health A to Z -- Reviewed Web Sites for Hypertension. Extensive references to both consumer resources and doctor-oriented information. This site may require a free registration to gain access to some on-site resources.
DISCLAIMER:Every effort has been made by the author(s) to provide accurate, up-to-date information. However, the medical knowledge base is dynamic and errors can occur. By using the information contained herein, the viewer willingly assumes all risks in connection with such use. Neither the author nor WPAHS shall be held responsible for errors, omissions in information herein nor liable for any special, consequential, or exemplary damages resulting, in whole or in part, from any viewer(s)' use of or reliance upon, this material. CLINICAL DISCLAIMER:Clinical information is provided for educational purposes and not as a medical or professional service. Person(s) who are not medical professionals should have clinical information reviewed and interpreted or applied only by the appropriate health professional(s). |
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Frequently Asked Questions on Healthcare Face Pain Overview * Trigeminal Neuralgia * Hemifacial Spasm * Meniere's Disease * Vertigo * Tinitis * Hypertension * Torticalis and Spasmodic Torticalis For questions or comments, please contact: aghneuro@wpahs.org * Department of Neurosurgery * Allegheny General Hospital * 320 East North Ave. * Pittsburgh, PA 15212 * (412) 359-6200 * Toll Free: 877-284-2000 © 2008 West Penn Allegheny
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