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Carotid endarterectomy unexpectedly resulted in optimal blood pressure control

Ivan Kirin1, Marijan Kirin, Mario Sicaja

  • 1Department of Surgery, University Hospital Center Rijeka, Rijeka, Croatia.

Collegium Antropologicum
|January 28, 2010
PubMed

Insights

Resistant hypertension may be linked to carotid artery stenosis. Surgical treatment for carotid stenosis unexpectedly resolved this difficult-to-treat hypertension in one patient.

Area of Science:

  • Cardiology
  • Neurology

Background:

  • Resistant hypertension (RH) is defined as blood pressure (BP) above 140/90 mmHg despite three or more antihypertensive drugs.
  • RH is linked to poor clinical outcomes, necessitating aggressive treatment.

Observation:

  • A 70-year-old woman with RH, treated with a diuretic, ACE-inhibitor, calcium channel blocker, and moxonodine, had persistent BP >160/90 mmHg.
  • Diagnostic workup excluded secondary hypertension causes but revealed left internal carotid artery stenosis.

Findings:

  • Carotid endarterectomy was performed for cerebrovascular protection.
  • Post-operatively, the patient's BP normalized, requiring only one antihypertensive medication (BP <130/85 mmHg).

Implications:

  • This case suggests a potential association between resistant hypertension, carotid stenosis, and carotid sinus baroreceptor dysfunction.
  • Further studies are needed to confirm this link and its therapeutic implications.

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