Extent of autonomic activation following cerebral ischemia is different in hypertensive and normotensive humans.
OBJECTIVE
To evaluate whether the extent of autonomic activation following brain infarction differs between hypertensive and normotensive humans, and to investigate the role of the insular cortex for this sympathetic activation.


METHODS
Prospective, hospital-based study.


METHODS
Department of Neurology of a university medical center.


METHODS
Forty-two patients with essential hypertension and 45 patients who were normotensive.


METHODS
Extent of autonomic activation following stroke as indicated by circadian blood pressure patterns, serum norepinephrine levels, and cardiovascular variables.


RESULTS
Normotensive patients with insular infarction showed a significantly reduced circadian blood pressure variation and a higher frequency of nocturnal blood pressure increase compared with patients suffering from essential hypertension and insular stroke. These findings were also associated with higher serum norepinephrine concentrations and more frequent electrocardiographic abnormalities. No significant changes in these variables were seen between normotensive and hypertensive patients without insular involvement.


CONCLUSIONS
Our findings suggest a difference in cortical control of autonomic function between hypertensive and normotensive patients after stroke and point to a possible role of the insular cortex in the pathogenesis of essential hypertension.
Sander
D
D
Department of Neurology, Technical University of Munich, Germany.
Klingelhöfer
J
J
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000503:physiopathology; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001794:Blood Pressure; D002545:Brain Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002544:Cerebral Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009638:Norepinephrine / Q000097:blood; D014057:Tomography, X-Ray Computed
D009638:Norepinephrine