Blood pressure stability: a road to better outcomes

This study focused on the influence of habitual endurance exercise training (i.e., committed runner or nonrunner) on the regulation of muscle sympathetic nerve activity (MSNA) and arterial pressure in middle-aged (50 to 63 yr, n = 23) and younger (19 to 30 yr; n = 23) normotensive men. Hemodynamic and neurophysiological assessments were performed at rest. Indices of vascular sympathetic baroreflex function were determined from the relationship between spontaneous changes in diastolic blood pressure (DBP) and MSNA. Large vessel arterial stiffness and left ventricular stroke volume also were measured. Paired comparisons were performed within each age category. Mean arterial pressure and basal MSNA bursts/min were not different between age-matched runners and nonrunners. However, MSNA bursts/100 heartbeats, an index of baroreflex regulation of MSNA (vascular sympathetic baroreflex operating point), was higher for middle-aged runners ( P = 0.006), whereas this was not different between young runners and nonrunners. The slope of the DBP-MSNA relationship (vascular sympathetic baroreflex gain) was not different between groups in either age category. Aortic pulse wave velocity was lower for runners of both age categories ( P < 0.03), although carotid β-stiffness was lower only for middle-aged runners ( P = 0.04). For runners of both age categories, stroke volume was larger, whereas heart rate was lower (both P < 0.01). In conclusion, we suggest that neural remodeling and upward setting of the vascular sympathetic baroreflex compensates for cardiovascular adaptations after many years committed to endurance exercise training, presumably to maintain arterial blood pressure stability. NEW & NOTEWORTHY Exercise training reduces muscle sympathetic burst activity in disease; this is often extrapolated to infer a similar effect in health. We demonstrate that burst frequency of middle-aged and younger men committed to endurance training is not different compared with age-matched casual exercisers. Notably, well-trained, middle-aged runners display similar arterial pressure but higher sympathetic burst occurrence than untrained peers. We suggest that homeostatic plasticity and upward setting of the vascular sympathetic baroreflex maintains arterial pressure stability following years of training.

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Impact of continuous noninvasive arterial blood pressure monitoring on blood pressure stability during general anaesthesia in orthopaedic patients

10.26226/morressier.57108e2cd462b80290b49bb5 ◽

2016 ◽

Author(s):

Agnes Sophia Meidert

Keyword(s):

Blood Pressure ◽

General Anaesthesia ◽

Arterial Blood Pressure ◽

Blood Pressure Monitoring ◽

Pressure Monitoring ◽

Arterial Blood ◽

Orthopaedic Patients ◽

Pressure Stability

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P11 Los-dose vs. high dose nitroglycerin impact on blood pressure stability in acute myocardial infarction

Resuscitation ◽

10.1016/0300-9572(94)90258-5 ◽

1994 ◽

Vol 28 (2) ◽

pp. S41

Author(s):

K. Hellwagner ◽

M. Müllner ◽

W. Schreiber ◽

W. Schörkhuber ◽

A. Zeiner ◽

...

Keyword(s):

Myocardial Infarction ◽

Blood Pressure ◽

Acute Myocardial Infarction ◽

High Dose ◽

Pressure Stability

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Abstract P637: Blood Pressure Stability Has a Closer Relationship With Atherosclerosis Burden of Carotid Sinuses Than Atherosclerosis Burden of Aortic Arch

Stroke ◽

10.1161/str.52.suppl_1.p637 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Xin Ma ◽

Qi Kong ◽

Chen Wang ◽

Xiangying Du

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Blood Pressure ◽

Ischemic Stroke ◽

Aortic Arch ◽

Computed Tomography Angiography ◽

Vascular Risk ◽

Arterial Baroreflex ◽

Ambulatory Bp Monitoring ◽

Pressure Stability

Background: Instable blood pressure (BP) increased vascular risk independently of high BP level, which might be partially attributed to impaired arterial baroreflex. The receptors of baroreflex mainly distributed at carotid sinuses and aortic arch, where atherosclerosis (AS) is common in patients with ischemic stroke (IS) and potentially blunts the baroreflex. We aimed to test whether AS conditions of carotid sinuses and aortic arch would equally indicate BP instability in IS patients. Methods: The daytime and nighttime standard derivations (SDs) of systolic BP (SBP) and diastolic BP (DBP) were recorded by ambulatory BP monitoring on the sixth day after IS to measure BP stability (higher SD indicates less stability). Using computed tomography angiography, AS conditions of carotid sinuses (6 segments) and aortic arch (4 segments) were scored based on AS percentage of each segment circumference (0, none; 1, <25%; 2, 25%~49%; 3, 50%~74%; 4, ≥75%) and summed into “carotid sinuses AS burden (CSAB)” and “aortic arch AS burden (AAAB)”. AS conditions of cervicocephalic arteries were also scored. Results: Of the 245 patients with IS, 65.7% had carotid sinuses AS and 69.4% had aortic arch AS. Daytime SBP SD was positively correlated with CSAB ( r =0.230; P <0.001) rather than AAAB ( P =0.103). Patients with CSAB above the median had significantly higher daytime SBP SD than those with less CSAB (median 14 mmHg vs. 12 mmHg, P =0.001). CSAB remained related to ln- transformed daytime SBP SD after adjusting for age, sex, vascular risk factors, weighted 24-hour means of SBP and DBP, and cervicocephalic AS score (adjusted B =0.012; 95% CI, 0.004-0.020). In contrast, DBP SD and nighttime SBP SD had no statistically significant association with both CSAB and AAAB. Conclusions: Higher CSAB was independently associated with SBP instability during the daytime, while AAAB was less relevant to BP stability. Compared with AAAB, evaluating CSAB might be more important in the prediction of BP instability.

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