Descending vestibular nucleus forms arterial hypertension

Background. The popular idea that cardiovascular disorders cause dizziness has a weak evidence base. Therefore, the objective of this research was to identify the relationship between vestibular and vascular dysfunctions. Materials and methods. 123 patients were examined, 42 males and 81 females. Blood pressure was increased in 51 people (43.09 %, the main group). Patients with normal blood pressure formed the control group (72 people, 56.91 %). Results. The greatest changes in patients with hypertension compared to those with normal blood pressure were registered during posturography on a stable platform with eyes closed. The largest increase in the swing area was in patients with hypertension — from 0.08 ± 0.05 m2 to 0.34 ± 1.00 m2, the coefficient of difference (Cd) was 325.00 %, the significance of difference according to the F-test p = 1.89 (E-24) and the T-test p = 0.18, which indicates the presence of a qualitative difference between the groups related to hypertension. The largest Cd of the swing area confirms the opinion that it is the vestibular disorder at the level of the medulla oblongata that is the primary leading pathological process that results in quality change — the appearance of hypertension. Some smaller changes were recorded while conducting a pendulum test at a frequency of 0.16 Hz, where an increase in the shift phase was noted in patients with hypertension: 6.56 ± 9.41 and 19.14 ± 26.02, respectively, Cd = 191.77 %, the significance of difference accor­ding to the F-test p = 0.00068, according to the T-test p = 0.036. The phase at this frequency was within the normal range only in people with normal blood pressure, it was increased in patients with hypertension. The significance of difference was confirmed by both qualitative and quantitative tests, which indicates the additional participation of the vestibular nuclei of the midbrain in the formation of hypertension. Even smaller differences in Cd between 80 and 90 % were noted in rotational tests, in which the upper vestibular nucleus participates. The obtained results are discussed from the point of view of the primary role of the complex of the descending vestibular nucleus and the vasomotor nuclei located next to it in the formation of hypertension. Conclusions. In the formation of primary hypertension, the main role of the complex of the descending vestibular nucleus and the vasomotor nuclei of the medulla oblongata was revealed in the central nervous system. The vestibular nuclei of the pons Varolii and midbrain play an additional role in the formation of hypertension. Romberg’s test is important for determining the vestibular origin of hypertension.