title: Revisiting the link between hypertension and hemifacial spasm.
abstract: The relationship between hypertension and hemifacial spasm (HFS) has been debated. Microvascular decompression surgery is effective in some HFS patients with uncontrolled hypertension. To address current gaps in knowledge, we conducted a meta-analysis of case-control studies that have examined the prevalence of hypertension in HFS patients compared to non-HFS controls. We also evaluated the implications and limitations of the pooled studies. We identified 62 studies from PubMed, The Cochrane Library, Web of Science and Scholar.google.com and six studies that fit our inclusion criteria were included. A random-effects model was used to derive the pooled estimate of the Odds Ratio. The data was plotted on a Forest plot. A pooled analysis involving 51585 subjects, 549 cases, 720 neurological controls and 50316 controls from the general population, showed that HFS patients had a higher chance of developing hypertension (OR = 1.72, 95% CI = (1.12, 2.31), p-value  <0.001). The prevalence of hypertension was higher in HFS patients as compared to non-HFS patients. This meta-analysis highlights a positive correlation between hypertension and HFS. Blood pressure should be closely monitored during the follow-up of HFS patients. Preliminary links between ventrolateral medullary (VLM) compression and HFS should be further evaluated in future studies.
authors.affiliation: National University of Singapore, Yong Loo Lin School of Medicine, Singapore, 119077, Singapore.
authors.forename: Jia-Li
authors.initials: JL
authors.lastname: Leong
authors.affiliation: Singapore General Hospital, Health Services Research and Biostatistics Unit, Division of Research, Singapore, 169608, Singapore.
authors.forename: Hui-Hua
authors.initials: HH
authors.lastname: Li
authors.affiliation: Singapore General Hospital, Departments of Diagnostic Radiology and Neurology, National Neuroscience Institute, Singapore, 169608, Singapore.
authors.forename: Ling-Ling
authors.initials: LL
authors.lastname: Chan
authors.affiliation: Singapore General Hospital, Departments of Diagnostic Radiology and Neurology, National Neuroscience Institute, Singapore, 169608, Singapore.|Duke NUS Graduate Medical School, Singapore, 169857, Singapore.
authors.forename: Eng-King
authors.initials: EK
authors.lastname: Tan
mesh_terms: D001794:Blood Pressure; D016022:Case-Control Studies; D005260:Female; D019569:Hemifacial Spasm / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D018810:Magnetic Resonance Angiography; D008297:Male; D016017:Odds Ratio; D015995:Prevalence