Identification of Essential Hypertension in Patients with Labile Blood Pressures

¹ Department of Medicine, Mount Sinai School of Medicine, City University of New York, New York
² Assistant Professor of Pharmacology, New York University Medical Center, New York, NY

Three objective tests were utilized to identify hereditary essential hypertension, namely: digital vascular reactivity (DVR), apparent norepinephrine secretion rate (ANESR) and tritiated norepinephrine uptake (TNEU) in 18 cases of labile hypertension. In nine cases, the digital vascular reactivity test was within the normal range. In the cases in which the ANESR and TNEU tests were carried out, they were largely normal. These patients were therefore considered to have anxiety hypertension only. This diagnosis can be confirmed, however, only by prolonged follow-up. In the remaining nine cases, the digital vascular reactivity test was within the range for established essential hypertension. In the cases in which ANESR and TNEU tests were carried out, they too, with a few exceptions, were in the essential hypertensive range. These patients were therefore diagnosed as having hereditary essential hypertension. Self-determined home blood pressures tended to be normal in the anxiety hypertension and elevated in the essential hypertension group.