High blood pressure from the neck
High blood pressure from the neck
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Hypertension and its possible relationship to pathological changes in the cervical area Abstract This Review examines the possible Association between arterial hypertension (Hypertension) and pathological changes in the cervical area (neck, the spine and surrounding structures). Although the primary hypertension is multi-factorial, there is evidence to suggest that mechanical or neurogenic factors can exert in the neck area of an impact on blood pressure regulation. Introduction Arterial hypertension (high blood pressure) relates to the world about a third of the adult population, and diseases, is a major risk factor for cardiovascular disease. Most of the cases are classified as essential or primary hypertension, in which no definite cause can be identified. In rare cases, a secondary hypertension is caused by certain diseases or disorders. A hypothetical connection between the pathological Findings in the neck area (e.g., cervical Up-to-discus hernia, muscle tension), and increase in blood pressure is discussed in some studies. Possible mechanisms include: Irritation of nerve structures (e.g., sympathetic nervous system); mechanical impairment of the carotid artery or of the vertebral arteries; chronic pain conditions that lead to activation of the sympathetic nervous system. Pathophysiological Considerations The neck region contains important structures involved in the regulation of blood pressure: Carotid sinus: The carotid sinus in the region of the Carotid bifurcatio contains Baroreceptors regulate blood pressure. A mechanical compression or irritation of this Region could lead to a MIS-regulation. Sympathetic nervous system: irritation in the cervical area can increase the activity of the sympathetic system, which in turn leads to vasoconstriction and increase in blood pressure. Circulation problems: restrictions on the circulation in the brain stem (e.g. due to vertebral artery compression) can affect the Central blood pressure regulation mechanisms. Clinical Evidence Previous studies on the Association of cervical changes and hypertension are limited and show conflicting results: Some studies report that patients with cervical Up more frequently elevated blood pressure. Other studies have found no significant relationship. Case reports describe a reduction in blood pressure after surgical or manual procedures on the cervical spine area, however, is a lack of randomized controlled trials. Diagnostic Approach In patients with hypertension a systematic clarification should be carried out: Exclusion of secondary causes (renal disease, endocrine disorders, etc.). History and clinical examination for cervical pathology (pain, limitation of movement, neuro symptoms). Imaging procedures (x-ray, MRI of the cervical spine) in the case of suspected structural changes. Measurement of blood pressure in different body positions in order to capture a possible influence of postural changes. Therapeutic Implications If there is a connection between the neck findings and hypertension is suspected, can be drawn the following measures: Physiotherapy and exercise therapy to relaxation of the throat muscles. Manual therapy or osteopathy (with caution and after clarification). The treatment of pain and inflammation. Standard therapy of hypertension according to the guidelines (medication, lifestyle changes). Conclusion Although a direct causal relationship between pathological changes in the cervical area, and arterial hypertension is not clearly demonstrated, there is such an Association in individual patients. A differentiated evaluation is useful, especially if additional symptoms are present in the cervical area. Further research is required to understand the pathogenetic mechanisms and therapeutic options. Literature (Examples) WHO report on the Global hypertension epidemiology, 2023. German hypertension League: guideline for the diagnosis and therapy of arterial hypertension, 2022. Studies on the carotid sinus irritability, and blood pressure regulation.
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