The majority of people associate high blood pressure or hypertension with the lifestyle-related factors of diet, stress and ageing. But there’s a less prominent type which has its origin not just lifestyle but also in the nervous system. This is a condition known as neurogenic hypertension, and recognising how it differs from common hypertension is essential to getting the afflicted on the right road to treatment.
What distinguishes neurogenic hypertension?
At the core of neurogenic hypertension lies the dysfunction of the autonomic nervous system, which regulates vital bodily functions such as heart rate, digestion, and blood pressure. In individuals with this condition, the sympathetic nervous system is often overactive. This leads to chronic vasoconstriction (narrowing of blood vessels), increase in heart rate, and then high blood pressure.
When a neurological disorder or spinal cord injury prevents the body from being able to self-regulate properly, the individual is more likely to develop this type of hypertension. In such cases, they are generally treated with medicines that work at the nerve systems. An example of such medicine is the arkamin tablet that is a centrally acting alpha–agonist that calm the nerve signals that trigger high blood pressure.
This is different from the majority of antihypertensive agents prescribed for the treatment of essential hypertension, which typically exert their effects peripherally, acting on the heart or blood vessels rather than the CNS.
What is the Cause of Neurogenic Hypertension?
Some neurological disorders or injury can cause it, termed neurogenic hypertension. Here are the main reasons:
1. Spinal Cord Injuries:
Especially higher-level injuries (above T6) interrupt the balance of the autonomic nervous system, producing dangerously high blood pressure spikes known as autonomic dysreflexia.
2. Brain Tumors or Head Injury:
Injury to centers that regulate blood pressure such as the hypothalamus or medulla can result in inappropriate co-activation of the peripheral cardiovascular system.
3. MSA vs PD (Multiple System Atrophy vs Parkinson’s Disease):
Such neurodegenerative disorders impact blood pressure regulation by the body, sometimes causing the body to sway in the opposite direction, leading to extremes (including hypertension).
4. Overactivity due to Stress:
This overstimulation of the sympathetic nervous system by chronic stress can lead to neurogenic hypertension in those who are susceptible to this condition.
How Neurogenic Hypertension Differs from Typical Hypertension.
It is important to understand the distinction between these two conditions for appropriate management:
Feature: Neurogenic Hypertension Regular (Essential) Hypertension
Cause: Neurological disorders or injuries Lifestyle, genetics, unknown factors
Onset: Can be sudden or linked to neurological events Often gradual over years
Symptoms: May involve headaches, blurred vision, sweating, or neurological symptoms Often silent (asymptomatic)
Triggers: Stress, bladder/bowel distension (in spinal injury), nerve overactivity Salt intake, obesity, lack of exercise
Treatment Focus: Nervous system modulation Cardiovascular system regulation
Symptoms to Watch Out For:
Neurogenic hypertension may not manifest like standard hypertension. Common symptoms include:
- Sudden, severe headaches
- Excessive sweating
- Anxiety or panic
- Blurred vision
- Flushing of the skin
- Chest pain or flutter
- Nausea
They may come on suddenly and are typically triggered by things such as pain, full bladder, or stress, especially for those with spinal cord injury.
Diagnostic Approach:
The diagnosis of neurogenic hypertension is based on several factors:
- Medical history: Particularly of neurological conditions or injuries
- Blood pressure monitoring: Including 24-hour ambulatory blood pressure to pick up on variation
- Neurological examination: MRI or CT scans to identify HVAC roof problems with the brain or spine
- Autonomic function test: To evaluate how well the nervous system controls functions such as heart rate and blood pressure
As the problem is frequently buried in the nervous system, diagnosis may need a joint effort by neurologists and cardiologists.
Management Strategies:
Neurogenic hypertension treatment is more than just reduction of blood pressure, It needs to treat the root cause nervous system dysfunction. Management may include:
1. Medications:
Central alpha-agonists e.g pure arkamin tablet, which reduces nerve signals that tighten blood vessels.
Beta-blockers or calcium channel blockers: Used occasionally, especially when the symptoms overlap with classic hypertension (more like mixture).
Diuretics
2. Trigger Control:
For spinal patients, avoiding triggers such as having the bladder too full or being constipated will help avoid the incidence of autonomic dysreflexia.
Stress relief strategies, such as biofeedback or mindfulness, may be beneficial.
3. Physical Therapy:
Others experiencing difficulties in walking might increase circulation through regular physiotherapy, thereby alleviating orthostatic symptoms.
4. Lifestyle Adjustments:
Although corrective lifestyle measures may not fully rectify neurogenic hypertension, they continue to exert a salutary influence:
- Avoiding salt and caffeine
- Eating a healthy, heart-healthy diet
- Ensuring good hydration
- Going to bed (and getting up) at the same times each day
Long-Term Approach:
Neurogenic hypertension should be assessed continuously and treated according to the individual response. Any uncontrolled hypertension can result in complications such as stroke, heart attack, or damage to the kidneys. But the early diagnosis with proper medication can support people living with neurogenic hypertension to a stable and optimised life.
With increased awareness of this condition, novel treatment protocols are being developed. Providing a treatment plan that focuses on treating the symptoms of the disease and its neurological causes may rely on a working alliance between both healthcare professionals and the patient.
If you or someone you know has strange blood pressure spikes with neurological symptoms, it can really help to get specialist advice.
It is primarily to stabilise these unpredictable blood pressure fluctuations that the use of medications such as arkaneed tablet becomes essential in ensuring the well-being of our heart in the long run.
