TY - JOUR
T1 - Infiltration of the sphenopalatine ganglion decreases blood pressure in newly diagnosed and never treated patients with essential hypertension
AU - Triantafyllidi, Helen
AU - Arvaniti, Chrysa
AU - Palaiodimos, Leonidas
AU - Vlachos, Stefanos
AU - Schoinas, Antonios
AU - Batistaki, Chrysanthi
AU - Kostopanagiotou, Georgia
AU - Lekakis, John
N1 - Publisher Copyright:
© 2016 Elsevier Ireland Ltd
PY - 2016/11/15
Y1 - 2016/11/15
N2 - Background Sphenopalatine ganglion (SPG), an extracranial structure, is connected with the central nervous system (CNS) through sympathetic and parasympathetic nerves. We hypothesized that SPG block through sympathetic nerves anesthesia might decrease blood pressure (BP) in recently diagnosed and never treated middle-aged patients with essential hypertension. Methods We performed SBG block in 22 hypertensive patients (mean age 45 ± 12 years, 15 men). All patients have been subjected to 24 hour ambulatory blood pressure monitoring a week prior the procedure as well as in a period of 21–30 days after the SBG block in order to estimate differences in 24 h average systolic (24 h SBP) and diastolic blood pressure (24 h DBP), daytime, nighttime, pre-awake and early morning SBP and DBP as well as BP load. Results We found that 24 h SBP (p = 0.001) and 24 h DBP (p < 0.001), daytime SBP and DBP (p < 0.001) as well as daytime SBP and DBP load (p = 0.002 and p < 0.001, respectively) were decreased in total population at 21–30 days after SPG block. In 11/22 responders (24 h SBP decrease ≥ 5 mm Hg), SBP and DBP were reduced during overall 24 h and daytime (p < 0.001) and nighttime periods (p = 0.01 and p = 0.06, respectively) while pre-awake SBP (p = 0.09) along with daytime SBP and DBP load (p = 0.07 and p = 0.06, respectively) were also almost decreased. Conclusions SBG block might be a promising, non-invasive, safe, painless and easy to perform therapeutic option of BP decrease. As with renal denervation, SBG should be effective in those hypertensive patients with an activated SNS, so a period of patient selection should precede the application of this procedure.
AB - Background Sphenopalatine ganglion (SPG), an extracranial structure, is connected with the central nervous system (CNS) through sympathetic and parasympathetic nerves. We hypothesized that SPG block through sympathetic nerves anesthesia might decrease blood pressure (BP) in recently diagnosed and never treated middle-aged patients with essential hypertension. Methods We performed SBG block in 22 hypertensive patients (mean age 45 ± 12 years, 15 men). All patients have been subjected to 24 hour ambulatory blood pressure monitoring a week prior the procedure as well as in a period of 21–30 days after the SBG block in order to estimate differences in 24 h average systolic (24 h SBP) and diastolic blood pressure (24 h DBP), daytime, nighttime, pre-awake and early morning SBP and DBP as well as BP load. Results We found that 24 h SBP (p = 0.001) and 24 h DBP (p < 0.001), daytime SBP and DBP (p < 0.001) as well as daytime SBP and DBP load (p = 0.002 and p < 0.001, respectively) were decreased in total population at 21–30 days after SPG block. In 11/22 responders (24 h SBP decrease ≥ 5 mm Hg), SBP and DBP were reduced during overall 24 h and daytime (p < 0.001) and nighttime periods (p = 0.01 and p = 0.06, respectively) while pre-awake SBP (p = 0.09) along with daytime SBP and DBP load (p = 0.07 and p = 0.06, respectively) were also almost decreased. Conclusions SBG block might be a promising, non-invasive, safe, painless and easy to perform therapeutic option of BP decrease. As with renal denervation, SBG should be effective in those hypertensive patients with an activated SNS, so a period of patient selection should precede the application of this procedure.
KW - 24 h blood pressure measurement (24 h ABPM)
KW - Arterial hypertension
KW - Neural block
KW - Sphenopalatine ganglion
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U2 - 10.1016/j.ijcard.2016.08.230
DO - 10.1016/j.ijcard.2016.08.230
M3 - Article
C2 - 27543707
AN - SCOPUS:84987881676
SN - 0167-5273
VL - 223
SP - 345
EP - 351
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -