Background: Hypertension is one of the most important public
health problems worldwide. Central nervous system dysfunctions are common in
these patients due to micro-infarctions caused by arteriolar spasm of cerebral
blood vessels. Though hypertension is a silent disease, it doubles the risk of
coronary heart disease (CHD), congestive heart failure (CHF), stroke, renal
failure, and peripheral arterial disease. Thus, it affects almost all organ
systems of the body and contributes to major morbidity and mortality. This will
lead to hypoperfusion, subcortical white matter demyelination, and cognitive decline.
The Brainstem auditory evoked potentials (BAEP) are far-field subcortical
electrical potentials which provide an objective electrophysiological method
for assessing the auditory pathway from auditory nerve to the brainstem.
Aim: The aim of the study was to assess the effect of
increasing severity of hypertension on the brainstem auditory pathway, among
patients with essential hypertension.
Methods: A total of 75 subjects aged 30 to 60 years were
included in the study. Patients having systolic BP ≥140mmHg and diastolic
BP≥90mmHg were included in this study as the study group. Blood pressure was
measured by using a mercury sphygmomanometer. Among them, 25 were healthy age
and sex matched controls (Group I), 25 were stage 1 hypertensives (Group IIa), and
25 were stage 2 hypertensives (Group IIb) as per JNC 7 criteria. The absolute
latencies I, III, V and interpeak latencies (IPL) I-III, III-V, I-V were
recorded by using Neuroperfect EMG 2000 system with installed BAER, and data
were statistically analysed using Student's unpaired t test.
Results and Discussion: All the hypertensive (Group IIa and
IIb) patients were found to have significantly prolonged absolute latency of
wave III, V and IPL III-V, I-V as compared to that of normal healthy controls.
The wave V latency was prolonged as the severity of hypertension increased.
Intergroup comparison among hypertensive patients (Group IIa and IIb) revealed
a significant prolongation of absolute latency of Wave III, V and IPL III-V,
I-V. The results of the present study are consistent with several studies where
BAEP wave latencies and inter-peak latencies were found to be prolonged in
hypertensive patients when compared to healthy controls. The results suggest
the involvement of the auditory pathway at the level of the inner ear and the
auditory pathway up to the medulla, and also that the auditory processing time
along the auditory pathway prolongs as the severity of hypertension increases.
Conclusions: The results show that there exists a sensory
deficit along with synaptic delay across the auditory pathway in hypertensive
patients, and the sensory deficit progresses with the severity of the disease.
So, it is recommended that an integrated work of otorhinolaryngologists and
audiologists, along with cardiologists, is necessary to improve the quality of
care in the therapy and rehabilitation of these patients.
Author(s) Details
Roseline Jesintha V.
Government Madurai Medical College, Madurai, Tamil Nadu, India.
Vinupradha P.
Government Coimbatore Medical College, Coimbatore, Tamil Nadu, India.
Please
see the book here:- https://doi.org/10.9734/bpi/msraa/v8/5915
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