Neurovascular compression of the left rostral ventrolateral medulla is not associated with arterial hypertension in a population-based MRI study in Germany

Abstract

PURPOSE: Neurovascular compression (NVC) of the rostral ventrolateral medulla (RVLM) is discussed as a cause for arterial hypertension (aHT). This study aimed to investigate the prevalence and the extent of NVC of the RVLM and to evaluate association with aHT in Germany. METHODS: In a population-based sample of 3044 subjects of the "Study of Health in Pomerania" (SHIP), brain imaging including T1-weighted MPRAGE with 1 mm isotropic voxel-size and time-of-flight angiography was obtained. We determined prevalence and extent of neurovascular contact or NVC grade I, II or III of the RVLM in all individuals. Statistical analysis included descriptive and comparative cohort characterisation, as well as contingency analysis for NVC and aHT. RESULTS: Prevalence of neurovascular contact and NVC grades I-III was 12.6% (n = 384). Within the NVC group, half showed mild compression (NVC I: n = 70, 50.7%) and only a minority had grade III NVC (n = 12, 8.7%). Information on the prevalence of aHT was available for a subgroup of 2824 probands. Subgroup analysis revealed an aHT prevalence of 50.1%. Contingency analysis revealed no significant association between NVC of the RVLM and aHT. CONCLUSION: No association between any type of neurovascular contact or NVC of the RVLM and aHT was found in a large representative sample of general adult population in Germany. Therefore, NVC on its own as either a cause or an effect of aHT seems questionable and careful interpretation of NVC is warranted if found in individuals with aHT.