Drug resistant hypertension treated with brain stimulator in case study

Kathleen Blanchard's picture
Hypertension
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A case study has shown deep brain stimulation might treat difficult to control high blood pressure.

The finding, published January 25, 2011 in the journal, American Academy of Neurology highlights how a man treated for regional pain with an implantable deep brain stimulator, experience the unanticipated effect of lower blood pressure that had been resistant to drug treatment.

The 55-year-old man had suffered a stroke, leading to the pain. Despite treatment with four antihypertensive drugs, his blood pressure remained high. Deep pain stimulation failed to control the man’s pain, but treated his blood pressure successfully . The man was able to stop taking all four of his blood pressure medications.

Nikunj K. Patel, BSc MBBS, MD, FRCS, of Frenchay Hospital in Bristol, UK, who documented the findings said, “This is an exciting finding as high blood pressure affects millions of people and can lead to heart attack and stroke, but for about one in 10 people, high blood pressure can’t be controlled with medication or they cannot tolerate the medication.”

The findings were confirmed as being the result of the stimulator that eventually implanted into the area of the patient’s brain that regulates pain, and remained controlled during the 3-year follow up. Dr. Patel says the lower blood pressure was not the result of other changes in the man’s condition.

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"More research is needed to confirm these results in larger numbers of people, but this suggests that (deep brain) stimulation can produce a large, sustained lowering of blood pressure,” Patel said. “With so many people not responding to blood pressure medications, we are in need of alternative strategies such as this one."

Each time the brain stimulator was turned off, the man’s blood pressure increased an average of 18mm/Hg systolic and 5mm/Hg diastolic. When the stimulator was turned back on, blood pressure dropped by an average of 32/12 mmHg. The researchers repeatedly tested the response for confirmation.

The authors found the stimulator did not permanently alleviate pain, but it did control blood pressure, eliminating the need for medications that persisted during the 3-year follow up.

The findings show deep brain stimulation might treat high blood pressure that is difficult to treat with medications. The device used in the study is similar to a cardiac pacemaker, but sends electrical impulses to the brain rather than the heart.

AACN

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