MORIMOTO Satoshi
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Efficacy of clonidine in patients with essential hypertension with neurovascular contact of the rostral ventrolateral medulla.
Journal Formal name:Hypertension research : official journal of the Japanese Society of Hypertension
Abbreviation:Hypertens Res
ISSN code:13484214/09169636
Domestic / ForeginForegin
Volume, Issue, Page 33(6),pp.633-7
Author and coauthor Sakuma Takao, Morimoto Satoshi*, Aota Yasuko, Takahashi Nobuyuki, Toyoda Nagaoki, Kosaki Atsushi, Maehara Minoru, Tanigawa Noboru, Ikeda Koshi, Sawada Satoshi, Iwasaka Toshiji
Authorship 2nd author,Corresponding author
Publication date 2010/06
Summary The rostral ventrolateral medulla (RVLM) is an important center for regulation of sympathetic nerve activity. Several clinical studies have suggested an association between neurovascular contact (NVC) of RVLM and essential hypertension. Microvascular decompression (MVD) of RVLM decreases blood pressure (BP) in hypertensive patients with NVC of this region. Therefore, MVD could be a useful therapeutic strategy to reduce BP in these patients. However, as MVD is an invasive procedure, it is worthy to seek useful antihypertensive agents for hypertensive patients with NVC. It is reported that sympathetic nerve activity is elevated in patients with hypertension accompanied by NVC of RVLM. It is anticipated that sympatholytic agents could be effective in lowering BP in these patients. In this study, we investigated the efficacy of clonidine, an alpha2 adrenergic agonist, in essential hypertensives with NVC of RVLM. Thirty consecutive essential hypertensive patients with NVC and 30 consecutive essential hypertensive patients without contact were treated with clonidine for 4 weeks, and decreases in BP and plasma norepinephrine levels were compared between the two groups. Decreases in BP and plasma norepinephrine levels were significantly greater in patients with NVC than in those without contact. These results suggest that clonidine exhibits significantly greater reductions of BP and sympathetic nerve activity in essential hypertensive patients with NVC compared with those without contact of the rostral ventrolateral medulla.
DOI 10.1038/hr.2010.41
PMID 20379192