Arterial hypertensionand carotic arteriaatherosclerosis: diagnosticpeculiarities, course andprinciples of surgical correction

Arterial hypertension with the stenosis of carotid bifurcation is hardly corrected by
medicines and traditional anti-hypertensive therapy is ineffective.
The aim of our investigation is to reveal the relationship between arterial hypertension
and hemodynamically important stenosis of carotid bifurcation, to study the course of
arterial hypertension before and after the operation of carotid endarterectomia. The
investigation is performed on bases of chair of inner diseases and facultate surgery of Samara
state medical university. It includes 176 patients at the age of 39-69 years old. All the patients
are divided into 3 main groups: 1st - the control group (52 patients); 2nd(124)- patients
with the hemodynamically important stenosis of carotid bifurcation before the operation
of carotid endarterectomia; 3rd (124)- the same patients after the operation of carotid
endarterectomia. All the patients are performed 24-hours monitoring of blood pressure and
the additional instrumental investigations to reveal the possible reasons of the secondary
arterial hypertension. After our investigation we revealed that the level of blood pressure
after the operation of carotid endarterectomia became lower than before the operation.
We study this phenomenon and we insist in calling this type of arterial hypertension - the
secondary cerebrovascular arterial hypertension. We describe three types of the secondary
cerebrovascular arterial hypertension. After our investigation also we recommend to
perform the operation of carotid endarterectomia by the classical method without resection
of carotid glomus nerve in cases of the second-side operation of the same patient.

arterial hypertension, hemodynamically important stenosis, carotid endarterectomia