Arterial hypertension treatment

Arterial hypertension treatment

There are anatomical and physiological evidences that the ventrolateral (VL) region of the medulla plays an important role in blood pressure regulation and that dysfunction at this level may generate hypertension (HT). Vascular compression by a megadolicho-artery from the vertebrobasilar arterial system at the root entry/exit zone (REZ) of the glossopharyngeal nerve (IXth) and vagal nerve(Xth) cranial nerves (CNs) and the adjacent VL aspect of the medulla has been postulated as a causal factor for HT from neurogenic origin. The first attempts at microvascular decompression (MVD) of the IX-Xth CNs together with the neighbouring VL brainstem was revealed promising. Established criteria for an indication of MVD as an aetiological treatment of apparent essential HT are still needed 1).

Angiotensin-converting enzyme inhibitor.

Angiotensin II receptor blocker.


To treat hypertension patients with COVID-19 caused pneumonia, anti-hypertensive drugs (ACEs and ARBs) may be used according to the relative guidelines. The treatment regimen with these drugs does not need to be altered for the COVID-19 patients 2).

Nicardipine

Clevidipine

Nitroglycerin

Labetalol

Enalaprilat

Esmolol

Fenoldopam

Propranolol


1)

Sindou M. Is There a Place for Microsurgical Vascular Decompression of the Brainstem for Apparent Essential Blood Hypertension? A Review. Adv Tech Stand Neurosurg. 2015;42:69-76. PubMed PMID: 25411145.
2)

Wang W, Zhao X, Wei W, Fan W, Gao K, He S, Zhuang X. Angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARBs) may be safe for COVID-19 patients. BMC Infect Dis. 2021 Jan 25;21(1):114. doi: 10.1186/s12879-021-05821-5. PMID: 33494713.

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