Hypertension as an Underlying Cause of Headache or Dizziness and the Usefulness of Choto-San for Both Diagnostic and Therapeutic Purposes

Background Though headache, head discomfort, and dizziness are major complaints in neurosurgical outpatient departments in Japan, these nonspecific complaints are sometimes troublesome to treat, and most symptomatic treatments are not always sufficient to resolve patients' complaints. Objective This retrospective study was conducted to identify potential hypertension underlying symptoms relating to the head by prescribing choto-san, because patients with such symptoms were found to have relatively high blood pressure, and we realized that Kampo medicine was potentially effective for resolving the patients' conditions. Methods A total of 171 patients making their first visit to the neurosurgical outpatient division of our institution from January 2020 to June 2022 were investigated retrospectively. Symptoms were classified into three categories: headache, head discomfort, and dizziness. The effectiveness of choto-san, the rate of potential hypertension, and whether improvement in symptoms had a strong relationship with the prescription of choto-san were investigated. Results Choto-san significantly improved outcomes, with an odds ratio of 3.13 (95% confidence interval 1.83-5.35, p<0.001) for choto-san and 5.50 (95% confidence interval 1.24-24.4, p=0.025) for antihypertensives. The rate of choto-san prescription was significantly higher in patients who were diagnosed with hypertension (test of independence p<0.001). Choto-san was thought to be the most effective for the aforesaid symptoms with accompanying potential hypertension. Conclusion Hypertension was shown to be one of the main causes of various nonspecific complaints. Choto-san was an effective medicine not only for improving patients' subjective symptoms but also for identifying potential hypertension, which may lead to the prevention of cerebrovascular diseases.