Severe paroxysmal hypertension (Pseudopheochromocytoma)
- Samuel J. Mann
- … show all 1 hide
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
Paroxysmal hypertension always engenders a search for a catecholamine-secreting pheochromocytoma. Yet 98% of people with paroxysmal hypertension do not have this tumor. The cause and management of paroxysmal hypertension remain a mystery, and the subject of remarkably few papers. This review presents an approach to understanding and successfully treating this disorder. Patients experience symptomatic blood pressure surges likely linked to sympathetic nervous system stimulation. A specific personality profile associated with this disorder suggests a psychological basis, attributable to repressed emotion related to prior emotional trauma or a repressive (nonemotional) coping style. Based on this understanding, three forms of intervention, alone or in combination, appear successful: antihypertensive therapy with agents directed at the sympathetically mediated blood pressure elevation (eg, combined α- and β-blockade or central α-agonists such as clonidine); psychopharmacologic interventions including anxiolytic and/or antidepressant agents; and psychological intervention, particularly reassurance and increased psychological awareness. An appropriately selected intervention can reduce or eliminate attacks in most patients.
- Pacak K, Linehan WM, Eisenhofer G, et al.: Recent advances in genetics, diagnosis, localization, and treatment of pheochromocytoma. Ann Intern Med 2001, 134:315–329.
- Manger WM, Gifford RW, eds: Clinical and Experimental Pheochromocytoma, edn 2. Malden, MA: Blackwell Science; 1996:4.
- Mann SJ: Severe paroxysmal hypertension. An autonomic syndrome and its relationship to repressed emotions. Psychosomatics 1996, 37:444–450.
- Mann SJ: Severe paroxysmal hypertension (pseudopheochromocytoma): understanding its cause and treatment. Arch Intern Med 1999, 159:670–674. CrossRef
- Stein PP, Black HR: A simplified diagnostic approach to pheochromocytoma. A review of the literature and report of one institution’s experience. Medicine 1991, 70:46–66. CrossRef
- Manger WM, Gifford RW: Pheochromocytoma. In Hypertension: Pathophysiology, Diagnosis, and Management, edn 2. Edited by Laragh JH, Brenner BM. New York: Raven Press; 1995:2225–2244.
- Grossman A, Pacak K, Sawka A, et al.: Biochemical diagnosis and localization of pheochromocytoma: can we reach a consensus? Ann N Y Acad Sci 2006, 1073:332–347. CrossRef
- Bravo EL, Tarazi RC, Fouad FM, et al.: Clonidine-suppression test: a useful aid in the diagnosis of pheochromocytoma. N Engl J Med 1981, 305:623–626. CrossRef
- Balon R, Ortiz A, Pohl R, Yeragani VK: Heart rate and blood pressure during placebo-associated panic attacks. Psychosom Med 1988, 50:434–438.
- Kaplan NM: Anxiety-induced hyperventilation. A common cause of symptoms in patients with hypertension. Arch Intern Med 1997, 157:945–948. CrossRef
- Kosten TR, Mason JW, Gillen EL, et al.: Sustained urinary norepinephrine and epinephrine elevation in post-traumatic stress disorder. Psychoneuroimmunology 1987, 12:13–20.
- Kuchel O, Cusson JR, Larochelle P, et al.: Case report: posture-and emotion-induced severe hypertensive paroxysms with baroreceptor dysfunction. J Hypertens 1987, 5:277–283. CrossRef
- Aksamit TR, Floras JS, Victor RG, et al.: Paroxysmal hypertension due to sinoaortic baroreceptor denervation in humans. Hypertension 1987, 9:309–314.
- Kuchel O, Buu NT, Larochelle P, et al.: Episodic dopamine discharge in paroxysmal hypertension. Page’s syndrome revisited. Arch Intern Med 1986, 146:1315–1320. CrossRef
- Frohlich ED, Tarazi RC, Dustan HP: Hyperdynamic beta-adrenergic circulatory state: increased beta-receptor responsiveness. Arch Intern Med 1969, 123:1–7. CrossRef
- Streeten DH, Anderson GH Jr, Lebowitz M, et al.: Primary hyperepinephrinemia in patients without pheochromocytoma. Arch Intern Med 1990, 150:1528–1533. CrossRef
- McNeil JJ, Anderson AE, Louis WJ, Morgan DJ: Pharmacokinetics and pharmacodynamic studies of labetalol in hypertensive subjects. Br J Clin Pharmacol 1979, 8(Suppl 2):157S–161S.
- Mann SJ: Neurogenic essential hypertension revisited: the case for increased clinical and research attention. Am J Hypertens 2003, 16:881–888. CrossRef
- Morgan T: Clinical pharmacokinetics and pharmacodynamics of carvedilol. Clin Pharmacokinet 1994, 26:335–346. CrossRef
- Mann SJ, Gerber LM: Low dose alpha/beta blockade in the treatment of essential hypertension. Am J Hypertens 2001, 14:553–558. CrossRef
- Severe paroxysmal hypertension (Pseudopheochromocytoma)
Current Hypertension Reports
Volume 10, Issue 1 , pp 12-18
- Cover Date
- Print ISSN
- Online ISSN
- Current Science Inc.
- Additional Links
- Industry Sectors
- Samuel J. Mann (1)
- Author Affiliations
- 1. New York Presbyterian Hospital-Weill/Cornell Medical School, 450 East 69th Street, New York, NY, 10021, USA