title: Effects of carotid body tumor resection on the blood pressure of essential hypertensive patients.
abstract: Removal of carotid body (CB) improves animal models of hypertension (HTN) and heart failure, via withdrawal of chemoreflex-induced sympathetic activation. Effect of CB tumor (CBT) resection on blood pressure (BP) in subjects with HTN is unknown. A retrospective analysis of 20 subjects with HTN (BP≥140/90 mmHg or anti-hypertensives use) out of 134 with CBT resection. Short-term (30 days from surgery) and long-term (slope of regressions on time over the entire follow-up) changes in BP and heart rate were adjusted for covariates (interval between readings, total follow-up, number of readings and changes in therapy). Age and duration of HTN were 56±4 and 9±5 years. Adjusted short-term decreases in systolic (SBP: -9.9±3.1, p<0.001) and pulse pressures (PP: -7.9±2.7, p<0.002) were significant and correlated with their respective long-term changes (SBP: r=0.47, p=0.047; PP: r=0.54, p=0.019). There was a strong relationship between adjusted short-term changes in SBP and PP (r=0.64, p<0.004). Six (50% of responders or 33% of the total) had short-term falls of SBP ≥10 mmHg and of PP ≥ 5 mmHg. First study to show that unilateral CBT resection is associated with sustained reduction of BP in hypertensive patients. Targeted CB chemoreflex removal could play a role in the therapy of human HTN.
authors.affiliation: Internal Medicine Department, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: Marat.Fudim@vanderbilt.edu.
authors.forename: Marat
authors.initials: M
authors.lastname: Fudim
authors.affiliation: Division of Head and Neck Oncologic Surgery, Department of Otolaryngology, Head and Neck Surgery, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Groom
authors.affiliation: Division of Clinical Pharmacology, Department of Medicine, The Vanderbilt Comprehensive Hypertension Center, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Laffer
authors.affiliation: Division of Head and Neck Oncologic Surgery, Department of Otolaryngology, Head and Neck Surgery, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Netterville
authors.affiliation: Department of Pharmacology, Vanderbilt University, Nashville, TN, USA; Autonomic Dysfunction Center, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: David
authors.initials: D
authors.lastname: Robertson
authors.affiliation: Division of Clinical Pharmacology, Department of Medicine, The Vanderbilt Comprehensive Hypertension Center, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Elijovich
mesh_terms: D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D018660:Blood Pressure Monitoring, Ambulatory; D002345:Carotid Body Tumor / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D013997:Time Factors
chemical_list: D000959:Antihypertensive Agents
keywords: Chemoreflex; hypertension; pulse pressure; sympathetic nervous system