Document Detail


Efficacy of clonidine in patients with essential hypertension with neurovascular contact of the rostral ventrolateral medulla.
MedLine Citation:
PMID:  20379192     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The rostral ventrolateral medulla (RVLM) is an important center for regulation of sympathetic nerve activity. Several clinical studies have suggested an association between neurovascular contact (NVC) of RVLM and essential hypertension. Microvascular decompression (MVD) of RVLM decreases blood pressure (BP) in hypertensive patients with NVC of this region. Therefore, MVD could be a useful therapeutic strategy to reduce BP in these patients. However, as MVD is an invasive procedure, it is worthy to seek useful antihypertensive agents for hypertensive patients with NVC. It is reported that sympathetic nerve activity is elevated in patients with hypertension accompanied by NVC of RVLM. It is anticipated that sympatholytic agents could be effective in lowering BP in these patients. In this study, we investigated the efficacy of clonidine, an alpha2 adrenergic agonist, in essential hypertensives with NVC of RVLM. Thirty consecutive essential hypertensive patients with NVC and 30 consecutive essential hypertensive patients without contact were treated with clonidine for 4 weeks, and decreases in BP and plasma norepinephrine levels were compared between the two groups. Decreases in BP and plasma norepinephrine levels were significantly greater in patients with NVC than in those without contact. These results suggest that clonidine exhibits significantly greater reductions of BP and sympathetic nerve activity in essential hypertensive patients with NVC compared with those without contact of the rostral ventrolateral medulla.
Authors:
Takao Sakuma; Satoshi Morimoto; Yasuko Aota; Nobuyuki Takahashi; Nagaoki Toyoda; Atsushi Kosaki; Minoru Maehara; Noboru Tanigawa; Koshi Ikeda; Satoshi Sawada; Toshiji Iwasaka
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-04-09
Journal Detail:
Title:  Hypertension research : official journal of the Japanese Society of Hypertension     Volume:  33     ISSN:  1348-4214     ISO Abbreviation:  Hypertens. Res.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-04     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9307690     Medline TA:  Hypertens Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  633-7     Citation Subset:  IM    
Affiliation:
Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan. sakumat@hirakata.kmu.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Antihypertensive Agents / therapeutic use*
Blood Pressure / drug effects*
Clonidine / therapeutic use*
Female
Humans
Hypertension / drug therapy*,  physiopathology
Male
Medulla Oblongata / drug effects*,  physiopathology
Middle Aged
Norepinephrine / blood
Sympathetic Nervous System / drug effects*,  physiopathology
Sympatholytics / therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Sympatholytics; 4205-90-7/Clonidine; 51-41-2/Norepinephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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