Tuesday, September 1, 2009

Blood Pressure Emergency

HYPERTENSIVE Emergency Returns Within Minutes to the Pre-crisis Level Following an Upper Cervical Spinal Adjustment

Paul Mullin, D.C., and Robert Sinnott, D.C., L.C.P. (Hon.)


Objective: To define hypertension, hypertensive emergency, and to report a case in which a patient found immediate resolution of a hypertensive emergency subsequent to the delivery of an upper cervical adjustment. Authors are cited who have published hypotheses attempting to explain a possible link between upper cervical dynamics and lowered blood pressure.

Clinical Features: A 71-year-old male, who was experiencing a hypertensive emergency (300/204 mm Hg) with signs of encephalopathy, found immediate resolution following an upper cervical adjustment when four days of hospitalization and pharmaceutical measures had failed.

Intervention and Outcome: Upper cervical X-rays were analyzed for subluxation. A thermal pattern of the cervical spine, implying subluxation, was established using the Tytron 3000 paraspinal scanner.

The subluxation was then adjusted using the Palmer Upper Cervical Specific Toggle Recoil on a Zenith toggle table with a drop headpiece. The patient experienced immediate relief from the vertigo, and the blood pressure quickly returned to a pre-crisis level of 156/96 mm Hg. The patient has been feeling well, and his blood pressure has been stable for more than two years. The atlas subluxation has only been adjusted twice during the entire time frame.

Conclusion: The prompt drop in blood pressure and remission of associated symptoms following an upper cervical adjustment begs the question: Is there a relationship between these seemingly unrelated entities? Previous reports and hypotheses regarding hypertension and hypertensive emergencies are cited in an attempt to explain possible mechanisms.

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