Document Detail


Severe paroxysmal hypertension (pseudopheochromocytoma).
MedLine Citation:
PMID:  18367021     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Paroxysmal hypertension always engenders a search for a catecholamine-secreting pheochromocytoma. Yet 98% of people with paroxysmal hypertension do not have this tumor. The cause and management of paroxysmal hypertension remain a mystery, and the subject of remarkably few papers. This review presents an approach to understanding and successfully treating this disorder. Patients experience symptomatic blood pressure surges likely linked to sympathetic nervous system stimulation. A specific personality profile associated with this disorder suggests a psychological basis, attributable to repressed emotion related to prior emotional trauma or a repressive (nonemotional) coping style. Based on this understanding, three forms of intervention, alone or in combination, appear successful: antihypertensive therapy with agents directed at the sympathetically mediated blood pressure elevation (eg, combined alpha- and beta-blockade or central alpha-agonists such as clonidine); psychopharmacologic interventions including anxiolytic and/or antidepressant agents; and psychological intervention, particularly reassurance and increased psychological awareness. An appropriately selected intervention can reduce or eliminate attacks in most patients.
Authors:
Samuel J Mann
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current hypertension reports     Volume:  10     ISSN:  1534-3111     ISO Abbreviation:  Curr. Hypertens. Rep.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-03-27     Completed Date:  2008-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888982     Medline TA:  Curr Hypertens Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  12-8     Citation Subset:  IM    
Affiliation:
New York Presbyterian Hospital-Weill/Cornell Medical School, 450 East 69th Street, New York, NY 10021, USA. sjmann@med.cornell.edu
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MeSH Terms
Descriptor/Qualifier:
Adrenal Gland Neoplasms / complications,  diagnosis
Anti-Anxiety Agents / therapeutic use
Antidepressive Agents / therapeutic use
Antihypertensive Agents / therapeutic use
Blood Pressure Monitoring, Ambulatory
Diagnosis, Differential
Emotions*
Humans
Hypertension / drug therapy*,  physiopathology,  psychology*,  therapy
Panic Disorder / complications
Pheochromocytoma / complications,  diagnosis
Psychotherapy
Stress Disorders, Post-Traumatic / complications,  diagnosis*
Sympathetic Nervous System / physiopathology
Chemical
Reg. No./Substance:
0/Anti-Anxiety Agents; 0/Antidepressive Agents; 0/Antihypertensive Agents

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


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