Early effect of carotid endarterectomy on arterial blood pressure measured with an ambulatory monitor

Background Carotid artery disease and hypertension are associated, and carotid endarterectomy is often followed by acute changes in blood pressure. As the carotid sinus is responsible for short-term blood pressure control, occlusive carotid disease may contribute to the mechanism of preoperative hypertension. Methods Ten patients undergoing carotid endarterectomy and eight having a peripheral bypass procedure were studied 2 weeks before and 2 weeks after operation, using home ambulatory blood pressure measurement. Results A significant fall in both mean systolic (−14·4 mmHg) and mean diastolic (−12·7 mmHg) pressure was observed after carotid endarterectomy (P < 0·006), whereas no change was seen in controls. Conclusion These results suggest that there is an increase in carotid sinus activity in patients following carotid endarterectomy and supports the hypothesis that carotid sinus dysfunction contributes to hypertension in patients with carotid artery disease.