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Severe paroxysmal hypertension (Pseudopheochromocytoma)

Current Hypertension Reports volume 10, pages 12–18 (2008)Cite this article

Abstract

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.

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Affiliations

  1. New York Presbyterian Hospital-Weill/Cornell Medical School, 450 East 69th Street, New York, NY, 10021, USA

    Samuel J. Mann

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  1. Samuel J. Mann
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Correspondence to Samuel J. Mann.

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Mann, S.J. Severe paroxysmal hypertension (Pseudopheochromocytoma). Current Science Inc 10, 12–18 (2008). https://doi.org/10.1007/s11906-008-0005-2

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  • DOI: https://doi.org/10.1007/s11906-008-0005-2

Keywords

  • Clonidine
  • Blood Pressure Elevation
  • Panic Disorder
  • Labetalol
  • Alprazolam