Hemodynamic Stress Response in Controlled Hypertensive Patients- A Randomized Comparison of I-Scope Video Laryngoscope and Macintosh Laryngoscope

Background: Laryngoscopy and intubation cause activation of the sympathetic nervous system and can results in tachycardia, arrhythmias and hypertension. Hypertensive patients demonstrate a relatively greater rise in catecholamine secretion and an increased sensitivity to them. Aim of the study is to compare the haemodynamic stress response associated with orotracheal intubation using videolaryngoscope or Macintosh laryngoscope in controlled hypertensive patients. Methods: Sixty hypertensive, American Society of Anesthesiologist’s class II, patients were randomly divided in to two groups. In group V (videolaryngoscope), intubation was done with i-scope videolaryngoscope. In group M (Macintosh), intubation was done using Macintosh laryngoscope. Primary objectives of the study pulse rate (PR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP) were noted immediately after and at 1, 2, 3, 5 and 10 minutes after intubation. Results: The demographic data were comparable in both groups. There was no significant difference at baseline for mean (SD) PR, SBP, DBP and MBP at baseline and after induction/before intubation (p>0.05). The mean (SD) PR, SBP, DBP and MBP were significantly higher in Macintosh laryngoscope group as compared to i-scope videolaryngoscope immediately after intubation, 1, 2, 3, 5 and 10 minutes after intubation (p<0.001). Conclusion: We found that intubation with the use of i-scope videolaryngoscope results in less haemodynamic stress response than Macintosh laryngoscope in controlled hypertensive patients.

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Attenuation of extubation responses: Comparison of prior treatment with verapamil and dexmedetomidine

Journal of Neuroanaesthesiology and Critical Care ◽

10.4103/2348-0548.173234 ◽

2016 ◽

Vol 03 (01) ◽

pp. 033-039 ◽

Cited By ~ 3

Author(s):

Tuhin Mistry ◽

Shobha Purohit ◽

Gunjan Arora ◽

Nitesh Gill ◽

Jaya Sharma

Keyword(s):

Blood Pressure ◽

Stress Response ◽

Tracheal Extubation ◽

Group V ◽

Airway Response ◽

Significant Attenuation ◽

American Society ◽

Airway Responses ◽

Group D

Abstract Background: Tracheal extubation is almost always associated with stress response, airway response, and arrhythmias. There are many ways to attenuate this stress response. We have compared verapamil and dexmedetomidine on attenuation of these responses. Materials and Methods: Thirty patients (American Society of Anaesthesiologists Grade I, II) scheduled for spinal surgeries under general anaesthesia were randomly divided into two groups. At the end of surgery, after return of spontaneous efforts (bispectral index >80), in “Group V” verapamil 0.1 mg/kg and in “Group D” dexmedetomidine 0.3 mcg/kg were administered as bolus intravenously over one minute. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded just before (T0) and 2 min after intravenous administration of study medications (TM), just after oral suction (TS), immediately after extubation (TE) and 1, 3, 5 and 10 min postextubation (E1, E3, E5, E10). Duration of emergence and extubation, quality of extubation, Richmond Agitation Sedation Scale (RASS) score and time to reach modified Aldrete score ≥9 were compared. Results: HR, SBP, DBP, MAP were higher in Group V than Group D, but statistically insignificant (P > 0.05). Extubation quality scores was 1 for 20%, 2 for 60% and 3 for 20% patients in Group V, whereas 1 in 80%, 2 in 20% in Group D. There was occurrence of bradycardia within 2 min of administration of drug in one patient in Group D. RASS score was in the range of -1 to +1 in >90% patient in Group V, whereas -3 to -1 in 80% cases in Group D. Conclusion: Single dose of dexmedetomidine (0.3 mcg/kg) given before extubation produced significant attenuation of circulatory and airway responses during extubation as compared to verapamil (0.1 mg/kg).

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Analysis of Urea, Creatinine, and Platelet Indices in Hypertensive Patients

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v27i2.1666 ◽

2021 ◽

Vol 27 (2) ◽

pp. 117

Author(s):

Ratna Delima Hutapea ◽

Yuyun Widaningsih ◽

Fitriani Mangarengi ◽

Darwati Muhadi

Keyword(s):

Blood Pressure ◽

Renal Function ◽

Systolic Blood Pressure ◽

Demographic Data ◽

Fisher Exact Test ◽

Hypertensive Patients ◽

Platelet Indices ◽

Bivariate Correlation ◽

Significant Difference ◽

Spearman Test

Hypertension may lead to complications of kidneys and blood vessels. Measurement of urea, creatinine, and platelet indices can be markers of renal function and endothelial dysfunction in hypertensive patients. This study aimed to analyze the profile and correlation between renal function parameters such as urea and creatinine and platelet indices (MPV, PDW, and PCT) with blood pressure in hypertensive patients. One hundred and thirty-third hypertensive patients treated at Wahidin Sudirohusodo Hospital from April to July 2019 were involved in this cross-sectional study. Researchers collected demographic data, blood pressure degrees (based on ESC 2018), systolic and diastolic blood pressure, and urea, creatinine, and platelet index value (MPV, PDW, and PCT) data from the medical record. Descriptive analysis, Spearman test, Fisher exact test, and Kruskal-Wallis test were used confidence interval of 95%. A total of 133 participants were involved in this research. There were significant difference between the mean age (p=0.023), MPV (p=0.032), and PCT (p=0.019) to the degree of hypertension, while gender (p=0.185), urea (p=0.106), creatinine (p=0.498), platelet (p=0.094) and PDW (0.826) showed no significant difference. The bivariate correlation test showed that urea (rs= -0.232 p=0.007) and creatinine (rs= -0.180 p=0.038) had a positive correlation with systolic blood pressure. Platelets index, MPV (rs=0.285 p=0.001), and PDW (rs=0.179) were positively correlated to systolic blood pressure. Also, urea levels and creatinine were positively correlated with MPV value. There was an increase in MPV along with the increase of urea, creatinine. An increase in MPV could be a predictor of endothelial damage and the risk of atherothrombosis.

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The Relationship Between Blood Pressure Variability And Renal Progression In Hypertensive Patients With Chronic Kidney Disease

Gevher Nesibe Journal, IESDR ◽

10.46648/gnj.270 ◽

2021 ◽

Vol 6 (14) ◽

pp. 80-88

Author(s):

Huseyin Duru ◽

Ekrem KARA

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Blood Pressure Measurement ◽

Rapid Progression ◽

Night Time ◽

Hypertensive Patients ◽

Significant Difference ◽

Renal Progression

Objective: To evaluate the effect of 24 hour systolic blood pressure (SBP) and diastolic blood pressure (DBP) variability (BPV) on renal progression in hypertensive patients with chronic kidney disease (CKD) Methods: A total 59 hypertensive patients (mean age: 54.2±14.6 years, 50.8% male) with CKD who underwent 24 hours ambulatory blood pressure measurement (ABPM) were included. Data on SBP, DBP, BPV coefficients (VC) for SBP (SBP-CV) and DBP (DBP-CV) were recorded. A decrease in e-GFR of <5 ml/min/year was considered as normal renal progression and a decrease in ≥5 ml/min/year was considered as rapid renal progression. Results: Overall, 40.6% of the patients had uncontrolled HT, while 45.8% had non-dipper pattern. Mean±SD daytime and night-time SBP and SBP-VC values were 135.3±17.9 mmHg, 128.6±23.0 mmHg, 11.7±2.8 and 9.5±3.6, respectively. Mean±SD daytime and nigh-time DBP and DBP-VC values were 84.5±13.4 mmHg, 77.2±16.1 mmHg, 13.8±3.8 and 12.0±3.7, respectively. Rapid renal progression was detected in 25.4% of patients with no significant difference in daytime, night-time and total SBP, SBP-VC, DBP and DBP-VC values between patients with rapid vs. natural renal progression. The regression analysis adjusted for age, gender, presence of DM, baseline e-GFR and dipping status revealed no significant impact of SBP-VC and DBP-VC in predicting rapid progression (p> 0.05). Conclusion: In conclusion, our finding revealed no significant association between BPV and renal progression in hypertensive patients with CKD. Larger scale prospective, randomized controlled trials with longer follow-up are needed to clarify this issue.

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Association of blood pressure with diabetic retinopathy and its severity in patients of type-II diabetics.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.03.6322 ◽

2021 ◽

Vol 28 (03) ◽

pp. 422-427

Author(s):

Kanwal Ijaz ◽

Muhammad Luqman Ali Bahoo ◽

Beenish Karamat ◽

Asia Aziz

Keyword(s):

Blood Pressure ◽

Diabetic Retinopathy ◽

Diastolic Blood Pressure ◽

Demographic Data ◽

Study Results ◽

Significant Difference ◽

Qualitative Variables ◽

Type Ii Diabetics ◽

Study Participants ◽

Study Setting

Objective: To identify the association of blood pressure with DR and its severity in type two diabetics. Study Design: Descriptive, Correlational study. Setting: Outpatient Department of Layton Rahmatulla Benevolent Trust Eye Hospital, Lahore. Period: 1st July, 2016 to 30th August, 2016. Materials & Method: After recording of demographic data, 80 type two diabetics of age 45-65 years of both genders were evaluated by consultant ophthalmologist for status and grading of diabetic retinopathy. Blood pressure was recorded with the help of mercury sphygmomanometer. Data were entered and analyzed on SPSS version 22. Qualitative variables were mentioned as percentages. For comparison of quantitative variables, student ”t” test or mann whiten U test as per distribution of data, were applied. For exploring the association between blood pressure and diabetic retinopathy, spearman rho correlation test was employed. Results: Out of total 80 patients, 42 had DR of varying grade. Most of the study participants were females (62.5 %). On comparison between two groups, systolic blood pressure was not significantly different however, diastolic blood pressure had significant difference. Both systolic and diastolic blood pressure had significant association with severity of DR in both eyes of the patients with only exception of diastolic blood pressure with severity in left eye, which had non-significant correlation. Conclusion: The study results suggest that, blood pressure should be considered as a contributing factor for development and progression of diabetic retinopathy.

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Perbedaan Derajat Ansietas antara Penyandang Hipertensi Belum Terkontrol dengan yang Terkontrol

e-CliniC ◽

10.35790/ecl.v7i2.26283 ◽

2019 ◽

Vol 7 (2) ◽

Author(s):

Cerelia E. C. Sugeng ◽

Emma Sy. Moeis ◽

Glady I. Rambert

Keyword(s):

Blood Pressure ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Blood Pressure Monitoring ◽

Office Blood Pressure ◽

Generalized Anxiety ◽

Pressure Monitoring ◽

Hypertensive Patients ◽

Significant Difference ◽

The Difference

Abstract: Hypertension and anxiety are among the group of the most common chronic disease worldwide, and according to numerous studies they are oftentimes associated each other. Patients suffered from chronic illnesses, such as hypertension, may have negative emotion that increases the risk of mental disorders, most commonly anxiety disorder. This study was aimed to assess the difference of anxiety degree between uncontrolled and controlled hypertensive patients. This was an observational analytical study with a cross-sectional design. Subjects were divided into two groups: controlled and uncontrolled hypertensive patients. Measurement of blood pressure parameter was performed by using office blood pressure monitoring. Anxiety parameter was classified based on the scoring of the Generalized Anxiety Disorder Scale (GAD-7). Data were analyzed by using the Mann-Whitney test. Subjects consisted of 60 hypertensive patients (35 males and 25 females), aged 30-70 years (mean 56.48 years). There were 35 controlled hypertension patients and 22 uncontrolled hypertensive patients. The results showed that the difference in anxiety degree based on GAD-7 between controlled hypertensive and uncontrolled hypertensive groups obtained a p-value of 0.000. In conclusion, there was a significant difference in anxiety degree between uncontrolled and controlled hypertensive patients. Screening for anxiety among hypertensive patients is a simple and cost-effective tool that may improve outcomes.Keywords: anxiety, uncontrolled hypertension, controlled hypertension Abstrak: Hipertensi dan ansietas merupakan kelompok penyakit kronik yang paling umum di seluruh dunia. Berdasarkan banyak penelitian kedua penyakit ini saling berhubungan satu sama lain. Penyandang hipertensi mungkin memiliki emosi negatif yang meningkatkan risiko terjadinya gangguan mental berupa ansietas. Ansietas dan dukungan sosial rendah akan menghambat proses penyembuhan terutama dalam mengontrol tekanan darah. Penelitian ini bertujuan untuk menge-tahui apakah terdapat perbedaan derajat ansietas antara penyandang hipertensi belum terkontrol dengan hipertensi terkontrol. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Subyek penelitian dibagi menjadi dua kelompok, yaitu kelompok penyandang hipertensi belum terkontrol dan hipertensi terkontrol. Pengukuran parameter tekanan darah dilakukan dengan menggunakan alat Oscillometric digital dengan cara Office Blood Pressure Monitoring (OBPM). Parameter ansietas diklasifikasikan berdasarkan skala Generalized Anxiety Disorder Scale (GAD-7). Adanya perbedaan derajat ansietas antara kedua kelompok dinilai dengan uji Mann-Whitney. Subyek penelitian terdiri dari 60 penyandang hipertensi (35 laki-laki dan 25 perempuan) berusia 30-70 tahun (rerata 56,48 tahun). Terdapat 25 penyandang hipertensi yang belum terkontrol dan 35 penyandang hipertensi terkontrol. Hasil penelitian menunjukkan bahwa terdapat perbedaan derajat ansietas berdasarkan GAD-7 antara kedua kelompok (p=0,000). Simpulan penelitian ini ialah terdapat perbedaan bermakna dalam derajat ansietas antara penyandang hipertensi yang belum terkontrol dengan yang terkontrol. Skrining ansietas pada penyandang hipertensi merupakan modalitas penting dalam penatalaksanaan penyandang hipertensi.Kata kunci: ansietas, hipertensi belum terkontrol, hipertensi terkontrol

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Effects of Confounding Factors on Blood Pressure in Hypertensive Patients: A Cross Sectional Study

10.21203/rs.3.rs-283642/v1 ◽

2021 ◽

Author(s):

Emrah Ersoy ◽

Cuneyt Ardic

Keyword(s):

Blood Pressure ◽

Blood Pressure Control ◽

Pressure Control ◽

Control Group ◽

Poor Sleep ◽

Study Group ◽

Confounding Factors ◽

Cross Sectional ◽

Hypertensive Patients ◽

Significant Difference

Abstract Background Blood pressure is influenced by biopsychosocial factors such as physical, environmental, emotional, cognitive and behavioral in hypertensive patients. ObjectiveThe aim of this study is to investigate confounding factors in hypertensive patients who have poor blood pressure control.DesignThis study was designed as a cross-sectional study.ParticipantsOur sample was 407 patients with hypertension in Rize, a Northern city in the Black Sea Region of Turkey. In study group, there were 207 hypertensive patients who had admission to emergency department due to high blood pressure. In control group, there were 200 hypertensive patients visiting family physician,who defined themselves as having regulated blood pressure over the past six months.Main MeasuresPatients completed the questionnaire including sociodemographic data, lifestyle behaviors, health risks and confounding factors via the face-to-face interview method. Key ResultsOf the hypertensive patients, 81.2% (n=168) of the study group and 34.0% (n=68) of the control group had confounding factors. There was a significant difference between the hypertensive patients of study and control group in terms of their confounding factors (p<0.001). When we asked the patients of study group questions to reveal their confounding factors, 21.3% (n=44) stated ‘anger’, 12.6% (n=26) ‘sadness’, 11.1% (n=23) ‘anxiety’, 10.6% (n=22) ‘depressed’, 9.2% (n=19) ‘unhealthy diet’, 7.2% (n=15) ‘fatigue and poor sleep quality’, and 3.9% (n=8) ‘irregular medication’. Mean systolic and diastolic blood pressure were significantly higher in hypertensive patients having confounding factors than those without confounding factors (p=0.001, p=0.001, respectively). Mean systolic blood pressure of hypertensives who stated their confounding factor as ‘anger’ was significantly higher than those the remaining groups (p<0.001).ConclusionsThis study has shown that confounding factors impair blood pressure control in patients with hypertension. Confounding factors should be kept in mind and revealed in case of poor blood pressure control in hypertensive patients.

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The Influence of Physical Activity on Arterial Pressure during Ambulatory Recordings in Man

Clinical Science ◽

10.1042/cs0580115 ◽

1980 ◽

Vol 58 (1) ◽

pp. 115-117 ◽

Cited By ~ 45

Author(s):

D. B. Rowlands ◽

T. J. Stallard ◽

R. D. S. Watson ◽

W. A. Littler

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Heart Rate ◽

Arterial Pressure ◽

Ambulatory Blood Pressure ◽

Physical Activities ◽

Hypertensive Patients ◽

Arterial Blood ◽

Significant Difference ◽

Hypotensive Therapy

1. Ambulatory blood pressure recordings were made over a 48 h period on six hypertensive patients. The conditions of study were standardized, particularly with regard to physical activity, and during one period of each day the patients were randomly allocated to be active or inactive. 2. Results show that blood pressure was highest during physical activity and lowest during sleep. There was no significant difference between the arterial pressures measured during the same physical activities carried out at the same time each day. However, during the same time on consecutive days when activity was randomized, there was a significant difference between the pressure recordings during physical activity compared with those during inactivity. Heart rate changes showed a similar trend during the randomized period. 3. Physical activity and sleep have a profound effect on continuous arterial blood pressure recordings and these are independent of time alone. These observations should be taken into account when using this ambulatory system to assess hypotensive therapy.

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Effect of Evening Bromazepam Administration on Blood Pressure and Heart Rate in Mild Hypertensive Patients

Pharmacology ◽

10.1159/000499371 ◽

2019 ◽

Vol 104 (1-2) ◽

pp. 1-6

Author(s):

Alfredo Costa ◽

Daniele Bosone ◽

Matteo Cotta Ramusino ◽

Giulia Perini ◽

Natascia Ghiotto ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Ambulatory Monitoring ◽

Night Time ◽

Double Blind ◽

Hypertensive Patients ◽

Treatment Groups ◽

Significant Difference ◽

Nocturnal Increase ◽

Mild Hypertensive

Aim: To assess the effects of chronic evening oral administration of bromazepam alone or in combination with propranolol on ambulatory blood pressure (BP) and heart rate (HR) in mild hypertensive subjects. Methods: Thirty-seven mild hypertensive patients after a 2-week placebo period were randomized to bromazepam 3 mg, propranolol 40 mg, bromazepam 3 mg plus propranolol 40 mg or placebo for 2 weeks according to a double-blind, double dummy, cross-over design. After each treatment period, 24-h BP and HR ambulatory monitoring was performed by using a non-invasive device. Results: Ambulatory monitoring showed that during night-time SBP and DBP values were unaffected by bromazepam as compared to placebo, whereas SBP was significantly reduced by propranolol both when taken alone and in combination with bromazepam. HR nocturnal values were significantly reduced by propranolol, whereas they were significantly increased by bromazepan both when taken alone (+11.5%, p < 0.05 vs. placebo) and in combination with propranolol (+12.8%, p < 0.05 vs. propranolol). No significant difference in day-time values of SBP, DBP and HR was observed among the 4 treatment groups. Conclusions: In mild hypertensive patients, evening consumption of bromazepam for a 2-week period did not affect BP, while it increased nocturnal HR. Such an increase was observed both when bromazepam was taken alone and in combination with propranolol, which suggests that it depends on a bromazepam mediated decrease in vagal tone. Whatever the mechanism, the HR nocturnal increase might be of clinical relevance, due to the role of high HR as cardiovascular risk factor, particularly in already at risk hypertensive subjects.

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P4559Assess of angiotensin receptor blockers therapy associated to mineralocorticoid receptor antagonists or to calcium channel blockers plus hydrochlorothiazide according central haemodynamic parameters

European Heart Journal ◽

10.1093/eurheartj/ehz745.0950 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

C A Paterno Marchioli

Keyword(s):

Blood Pressure ◽

Angiotensin Ii ◽

Arterial Pressure ◽

Mineralocorticoid Receptor ◽

Channel Blockers ◽

Mineralocorticoid Receptor Antagonists ◽

Hypertensive Patients ◽

Haemodynamic Parameters ◽

Significant Difference ◽

Receptor Blockers

Abstract Background Protective effect of Angiotensin-II Receptor Blockers (ARBs) on major cardiovascular events might be partly independent of the degree of blood pressure reduction. Calcium channel blockers (CCBs), lower arterial pressure by decreasing total peripheral resistance without reducing cardiac output. Hydrochlorothiazide (Hctz) is one of the most commonly prescribed antihypertensive drugs worldwide, but associated with more frequent adverse effects, such as hypokalaemia, hyponatraemia, hyperuricaemia and may increase the glycaemia, It sensitizes the endothelium to the action of angiotensin II, might act on the aldosterone release. The phenomenon of “aldosterone escape” occurs even in the presence of combination therapy with ARBs. The harmful effects of aldosterone are innumerable: induced cardiac and renal fibrosis, sodium and water retention, inflammation, oxidative stress, arrhythmias, glucose intolerance, insulin resistance, among others, that are involved in arterial and myocardium remodelling. Mineralocorticoid Receptor Antagonists (MRAs) therapy improve diastolic function, decrease plasma volume and vascular/myocardial fibrosis. Purpose This study aimed to assess the responses of two groups of therapy such as ARBs associated to MRAs or to CCBs+Hctz according to central haemodynamic parameters (CHPs) in hypertensive patients, both genders, with normal kidney function. Methods For this cross-sectional retrospective study, data were collected from 391 hypertensive patients who were assisted in the hypertension centre. Female/male 239/152, each gender divided into two groups of therapy: ARB+MRA/ARB+CCB+Hctz. Female 210/29 (average age 57/70) and male 125/27 (average age 55/61). The CHPs were measured with a SphygmoCor System PVX (AtCor-Medical Australia), a validated device employing the high-fidelity technique of applanation tonometry according to established protocols. Also, the difference of Augmentation Index (Diff-AIx) between the observed values and the expected levels was assessed according to normal range by age. No patients had cardiovascular, endocrine, renal and metabolic decompensated diseases. Results After measuring the body mass index, waist circumference and heart rate, the two therapy groups were confronted, both genders, had not found the statistically significant difference. The results of CHPs (Central Aortic Pressure, End-Systolic Pressure, Mean Arterial Pressure, Pulse Pressure, Augmentation Pressure), systolic and diastolic blood pressure during association of ARBs+MRAs therapy compared to ARBs+CCBs+Hctz, both genders, showed the lowest values with a highly statistically significant difference. In the female/male the Diff-AIx was found p=0.05/0.04. Conclusion These findings suggest that ARBs+MRAs treatment reaches the best haemodynamic conditions because improve the levels of CHPs and arterial stiffness (Diff-AIx) giving an adequate reduction of the stress to the arterial-ventricular coupling.

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Microvascular decompression for the treatment of neurogenic hypertension with trigeminal neuralgia

BMC Neurology ◽

10.1186/s12883-019-1569-y ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Wenchao Lu ◽

Hui Wang ◽

Zhongnan Yan ◽

Yuangang Wang ◽

Hongmin Che

Keyword(s):

Blood Pressure ◽

Trigeminal Neuralgia ◽

Trigeminal Nerve ◽

Microvascular Decompression ◽

Effective Rate ◽

Ventrolateral Medulla ◽

Control Group ◽

Hypertensive Patients ◽

Significant Difference ◽

Experimental Group

Abstract Background To evaluate the efficacy of microvascular decompression (MVD) in reducing hypertension (HTN) in hypertensive patients with trigeminal neuralgia (TN). Methods The clinical data of 58 cases of neurogenic HTN with TN treated in our hospital were retrospectively reviewed. Preoperative MR revealed abnormal blood pressure in the left rostral ventrolateral medulla (RVLM) and the posterior cranial nerve root entry zone (REZ). The patients were divided into control group: only trigeminal nerve was treated with MVD; experimental group: trigeminal nerve, RVLM and REZ were treated with MVD at the same time. The patients were followed up for 6 months to 1 year to observe the changes of blood pressure. Results There was no significant difference in gender, age, course of TN, course of HTN, grade of HTN and preoperative blood pressure between the two groups. After operation, the effective rate of HTN improvement with MVD was 32.1% in the control group. There was no significant difference in the preoperative and post operative blood pressure. (P△SBP = 0.131; P△BDP = 0.078). In the experimental group, the effective rate was 83.3%. The postoperative blood pressure was significantly lower than preoperative values. (P△SBP < 0.001; P△DBP < 0.001). Conclusions MVD is an effective treatment for neurogenic HTN. However, the criteria for selecting hypertensive patients who need MVD to control their HTN still needs to be further determined. Possible indications may include: left trigeminal neuralgia, neurogenic HTN; abnormal blood pressure compression in the left RVLM and REZ areas on MR; and blood pressure in these patients can not be effectively controlled by drugs.

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