Baroreflex failure as a long-term sequela of head and neck irradiation.

Dear Sirs, Radiotherapy for patients with node-positive head and neck cancer (HNC) and certain subtypes of lymphoma improves overall survival but can result in longer term damage to the carotid arteries and carotid sinus, including blood pressure regulatory structures [[1]-[3]]. In our patients, baroreflex failure occurred independently of carotid stenosis; only one patient (Case 2) had significant carotid disease. The magnitude of early BP lability may reflect the degree of baroreflex dysfunction or variability in compensatory BP regulation from non-baroreflex pathways including central mechanisms, adaptation of the renin-angiotensin-aldosterone system, or cardio-pulmonary reflexes [[5], [9]]. Fluctuating blood pressure (BP) was defined as excessive diurnal fluctuation in BP according to the expert clinician (documented history of labile or fluctuating hypertension). [Extracted from the article]