Cerebral Atherosclerosis Causes Neurogenic Hypertension

To the Editor: Su et al1 presented an excellent report regarding “the hypothesis that hypertension has a major role in the pathogenesis of atherosclerosis.” The results of their study were very similar to other findings previously reported.2 Both groups defended that essential arterial hypertension (EAH) is the major risk factor in the development of atherosclerosis. However, I offer some opposing comments upheld by many authors, based on clinical and neurosurgical evidences. First, EAH represents 90% to 95% of all cases of hypertension and is the main factor of risk in the generation of cerebrovascular and cardiovascular diseases. Second, generally there is a close correlation between age (about 35 years) and the incidence of essential hypertension3 as well as the onset of cerebral atherosclerosis.4,5⇓ Third, 5 areas are associated with EAH6,7⇓: denervation of the baroreceptors from the carotid sinus and aortic arc by atherosclerosis, and ischemia in the posterior hypothalamus and medulla oblongata (A1 …