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Published on: June 7, 2013

Neurogenic essential hypertension revisited: the case for increased clinical and research attention

Samuel J Mann1

  • 1Department of Medicine, New York Presbyterian Hospital--Weill/Cornell Medical School, New York, New York 10021, USA. sjmann@med.cornell.edu

American Journal of Hypertension
|October 14, 2003
PubMed

Insights

Essential hypertension management often fails to normalize blood pressure (BP). This review highlights neurogenic hypertension, emphasizing the need for alternative treatments beyond standard BP medications.

Area of Science:

  • Cardiology
  • Nephrology
  • Neurology

Background:

  • Current essential hypertension management relies on diuretics, ACE inhibitors, and ARBs targeting blood volume and the renin-angiotensin system.
  • These standard treatments frequently fail to achieve normal blood pressure (BP) in many patients.
  • This suggests other pathophysiologic mechanisms contribute to hypertension, necessitating alternative pharmacotherapies.

Purpose of the Study:

  • To re-focus attention on the under-recognized condition of neurogenic hypertension.
  • To provide a clinically focused overview of neurogenic hypertension's causes and clinical presentations.
  • To discuss the therapeutic implications of identifying neurogenic hypertension.

Main Methods:

  • Literature review and clinical case analysis.
  • Synthesis of existing research on neurogenic hypertension.
  • Clinical guideline review for hypertension management.

Main Results:

  • Neurogenic hypertension is a significant, often overlooked, cause of refractory hypertension.
  • Identifying neurogenic hypertension requires considering mechanisms beyond volume and renin-angiotensin system.
  • Pharmacotherapy targeting neurogenic pathways offers potential for improved BP control.

Conclusions:

  • Neurogenic hypertension requires greater clinical recognition and research.
  • Effective management of resistant hypertension may involve addressing neurogenic mechanisms.
  • Further investigation into neurogenically mediated hypertension is crucial for advancing patient care.

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