モリモト　サトシ   Morimoto Satoshi   森本　聡    所属   医学部 医学科（東京女子医科大学病院）    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Neurovascular decompression of the rostral ventrolateral medulla decreases blood pressure and sympathetic nerve activity in patients with refractory hypertension.
掲載誌名	正式名：Journal of clinical hypertension (Greenwich, Conn.) 略　 称：J Clin Hypertens (Greenwich) ISSNコード：17517176/15246175
掲載区分	国外
巻・号・頁	13(11),pp.818-20
著者・共著者	Sasaki Susumu, Tanda Shuji, Hatta Tsuguru, Morimoto Satoshi, Takeda Kazuo, Kizu Osamu, Tamaki Shinji, Saito Mitsuru, Tamura Yoji, Kondo Akinori
発行年月	2011/11
概要	Recently, the authors experienced four patients who had refractory hypertension and neurovascular compression of the rostral ventrolateral medulla (RVLM). One of them, a 49-year-old woman, had undergone continuous intravenous drip injections of calcium channel blockers and β-blockers for more than 3 years because of severe and refractory hypertension. The patients had undergone microvascular decompression (MVD) of the RVLM, and the changes in blood pressure (BP) and sympathetic nerve activities were recorded. In these patients, BP decreased to the normal range without any antihypertensive drugs 2 to 3 months after MVD. The tibial sympathetic nerve activities under resting and stress conditions significantly decreased, and plasma levels of norepinephrine, urinary levels of adrenaline, and plasma renin activity were also significantly decreased after MVD of RVLM. In some patients with refractory hypertension, arterial compression of the RVLM enhances sympathetic nerve activity and renin-angiotensin system to thereby increase BP. In these patients, the operative decompression of the RVLM could lower BP via restoration of sympathetic nerve activities and the renin-angiotensin system.
DOI	10.1111/j.1751-7176.2011.00522.x
PMID	22051426