Analysis of late risk of systemic blood pressures <120/80 mm Hg

2004 ◽  
Vol 94 (12) ◽  
pp. 1575-1576
Author(s):  
Shubha Ananthakrishnan ◽  
Arthur L. Klatsky ◽  
Natalia Udaltsova ◽  
Carlos Iribarren ◽  
Ursula Guidry
Keyword(s):  
Systemic Blood ◽  
Blood Pressures

Closed Chest Cardiac Massage in the Newborn Infant

PEDIATRICS ◽  
1988 ◽  
Vol 81 (4) ◽  
pp. 552-554
Author(s):  
Ronald David
Keyword(s):  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Cardiac Massage ◽  
Systemic Blood ◽  
Closed Chest ◽  
Cardiac Compression ◽  
History Of ◽  
Blood Pressures ◽  
In Infants And Children

The recommended techniques for external cardiac compression during cardiopulmonary resuscitation of the newborn are reviewed. The American Heart Association advises the rescuer to depress the infant's midsternum with the index and forefingers. An alternative recommendation is to encircle the chest with both hands and appose the thumbs on the midsternum. The cases reported here prove the superiority of the latter maneuver over the former in improving cardiac output and systemic blood pressures. The history of external cardiac compression in infants and children is briefly reviewed, further supporting the conclusion that the technique of encircling the chest with thumbs at midsternum is more efficacious and hence the preferred approach to closed chest cardiac massage in the newborn.

scholarly journals Page kidney: A rare cause of secondary hypertension

2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Ilonka Warnich ◽  
Mark Nicolaou ◽  
Zelia Sofianos ◽  
Jacobus A. Pienaar ◽  
Jacob Varghese
Keyword(s):  
Hypertensive Patient ◽  
Systemic Blood Pressure ◽  
Secondary Hypertension ◽  
Refractory Hypertension ◽  
Systemic Blood ◽  
Page Kidney ◽  
Blood Pressures ◽  
Post Traumatic ◽  
Subsequent Activation ◽  
Renal Hypoperfusion

Page kidney is a rare phenomenon that can present with hypertension. The presence of a subcapsular perirenal collection causes parenchymal compression leading to renal hypoperfusion. Subsequent activation of the renin–angiotensin–aldosterone system results in an increase in systemic blood pressure. The causes of renal subcapsular collections are varied, with most cases being secondary to post-traumatic haematomas. We present the case of a young hypertensive patient, treated as primary hypertension with persistently uncontrolled blood pressures. This was despite good treatment adherence. On further investigation, imaging identified the presence of bilateral subcapsular collections. This case illustrates the importance of a thorough workup in a young hypertensive patient with refractory hypertension. Given that Page kidney is curable, timeous intervention can save the patient from unnecessary medications and the morbidity of uncontrolled blood pressures.

Plasma volume and electrolyte shifts with heavy exercise in sitting and supine positions

1979 ◽  
Vol 236 (3) ◽  
pp. R206-R214 ◽  
Author(s):  
J. E. Greenleaf ◽  
W. Van Beaumont ◽  
P. J. Brock ◽  
J. T. Morse ◽  
G. R. Mangseth
Keyword(s):  
Plasma Volume ◽  
Protein Concentration ◽  
Peak Oxygen Uptake ◽  
Bicycle Ergometer ◽  
Heavy Exercise ◽  
Systemic Blood ◽  
Percentage Loss ◽  
Capillary Membrane ◽  
Blood Pressures ◽  
Selective Retention

Plasma volume (PV) and electrolyte shifts were measured before and for 60 min after a continuous peak oxygen uptake (VO2 peak) test in four men (26-45 yr) on a bicycle ergometer. Mean (+/-SE) sitting VO2peak (3.16 +/- 0.32 1/min) was the same as supine VO2peak (3.13 +/- 0.33 1/min). In recovery (R + 1.5 min), mean PV had decreased by 477 ml (-16.1%, P less than 0.05) in the sitting and by 548 ml (-17.6%, P less than 0.05) in the supine positions, whereas total osmolality increased progressively with its peak at R + 3.5 min. The percentage losses of protein, total Ca2+, and ionized Cai2+ were about half as great as the percentage loss in PV, indicating a selective retention of these constituents. Calculated osmolality (sigma Na+, K+, Cl-, Cai2+) returned to control levels within 1.5 min after sitting exercise but required about 15 min after supine exercise. These small increases in protein concentration were not likely to significantly aid restitution of plasma volume and the ions were probably in equilibrium across the capillary membrane. So a change in hydrostatic and/or systemic blood pressures most likely provided the force for restitution of plasma volume.

scholarly journals THE PHYSIOLOGY OF THE ALLIGATOR HEART: LEFT AORTIC FLOW PATTERNS AND RIGHT-TO-LEFT SHUNTS

1993 ◽  
Vol 176 (1) ◽  
pp. 247-270 ◽  
Author(s):  
D. R. Jones ◽  
G. Shelton
Keyword(s):  
Cardiac Output ◽  
Flow Pattern ◽  
Pulmonary Arteries ◽  
Systemic Blood Pressure ◽  
Aortic Flow ◽  
Pharmacological Intervention ◽  
Systemic Blood ◽  
Blood Pressures ◽  
Alkaline Tide ◽  
The Right

Blood pressures have been recorded in the heart along with pressures and flow in the aortic arches of anaesthetized and awake alligators. Systemic blood pressures were significantly lower [5.22+/−0.57 kPa (N=3) versus 9.85+/−0.46 kPa (N=5)] and cardiac outputs higher [51.6+/−3.5 ml min-1 kg-1 (N=3) versus 25.5+/−8.2 ml min-1 kg-1 (N=5)] in awake compared with anaesthetized animals. Using pharmacological interventions, two types of right-to-left shunt could be induced in all alligators. In one, established after acetylcholine (ACh) injection into the right side of the circulation, left aortic flow was an anterograde monophasic pulse which occurred when pulmonary pressure exceeded systemic blood pressure. Hence, this left aortic flow pattern could also be induced by mechanical occlusion of both pulmonary arteries. About one-quarter of cardiac output could bypass the lungs during this shunt. However, this left aortic flow pattern was never seen under any conditions other than pharmacological intervention. In the other type of shunt, induced pharmacologically by ACh injection into the left side of the circulation, left aortic flow was biphasic with a period of backflow, initiated during systole, being progressively shortened by the onset of forward flow from the right ventricle. Establishment of this type of shunt depended on the magnitude of both the systemic pressure and the pressure generated by right ventricular contraction after closure of the pulmonary outflow tract. The amount of blood bypassing the lungs during this shunt was small (13.7+/−5 % of cardiac output) but, at maximum, could be almost 25 % of cardiac output. This shunt occurred naturally in resting animals and could be maintained for substantial periods (13.2 min). The present observations confirm those made previously on anaesthetized alligators and extend previous work by showing two potential types of shunt. Finally, we suggest that right-to-left blood shunting in crocodilians may be related to the ‘alkaline tide’ that occurs after feeding, so the unique design of the central cardiovascular system in crocodilians could relate to both gastrointestinal and cardiorespiratory physiology.

scholarly journals The Physiology of the Alligator Heart: the Cardiac Cycle

1991 ◽  
Vol 158 (1) ◽  
pp. 539-564 ◽  
Author(s):  
G. SHELTON ◽  
D. R. JONES
Keyword(s):  
Right Ventricle ◽  
Cardiac Cycle ◽  
Pulmonary Arteries ◽  
Outflow Tract ◽  
Pressure Gradients ◽  
Aortic Valves ◽  
Systemic Blood ◽  
Second Stage ◽  
Blood Pressures ◽  
The Right

Pressure recordings from the heart and major arteries of the alligator show that a conventional relationship exists between the left ventricle and the right aorta. Pressure gradients from ventricle to aorta during systole are very small. Right aortic blood flow rises rapidly to a single peak and then falls more gradually until aortic valve closure. The right ventricle is connected both to the pulmonary arteries and to the left aorta. Right ventricular pressures show that systole is a two-stage process. Initially, blood leaves to the low-resistance lung circuit, though appreciable pressure gradients exist across the pulmonary outflow tract. Active contraction of the pulmonary outflow tract stops pulmonary ejection and a second-stage pressure rise is seen in the right ventricle. When systemic blood pressures are high, this second-stage pressure does not reach the levels recorded in the left aorta, and the left aortic valves remain closed so that lung and body circuits are functionally separate. An alternation of flow is found in the left aorta under these conditions, with reversed flow during systole and forward flow during diastole. Flow rates are extremely low, compared with those in the right aorta or pulmonary arteries, and the foramen of Panizza has very little significance in the cardiac cycle. If the systemic blood pressures are low, the second stage of systole in the right ventricle gives rise to pressures that are higher than those in the left aorta, the left aortic valves open and blood is ejected to the systemic circulation, giving a right-to-left shunt. This can occur with no changes in pulmonary pressures or flows. Left aortic flow is not dependent on increased constriction of the pulmonary outflow tract, which continues to function as an on-off active valve. Constriction within the lung vasculature may, on some occasions, be significant in establishing left aortic flow, but it is clear from the present work that low systemic blood pressure is a factor of crucial importance.

Systemic Blood Pressure Is Associated with Anemia and Placenta Growth Factor In Sickle Cell Anemia

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2644-2644 ◽  
Author(s):  
Payal C. Desai ◽  
Julia Brittain ◽  
Allison Deal ◽  
Susan Jones ◽  
Alan Hinderliter ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Growth Factor ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
White Blood Count ◽  
Cell Disease ◽  
Placenta Growth Factor ◽  
Systemic Blood ◽  
History Of ◽  
Blood Pressures

Abstract Abstract 2644 Introduction: The seventh report of the Joint National Committee (JNC 7) defines hypertension as blood pressure (BP) ≥ 140/90 and pre-hypertension as BP ≥ 120/80. Data from the National Health and Nutrition Examination Survey (NHANES) shows that 42% of African American patients over the age of 20 are classified as hypertensive. Previous studies in patients with sickle cell disease (SCD) have reported that systemic blood pressures (BP) are lower than age- and race-matched controls. The purpose of this study was to evaluate the clinical and laboratory factors associated with systolic and diastolic blood pressures in SCD. Methods: The data for this study was obtained from an ongoing study to determine the natural history of pulmonary hypertension in SCD. The first available systemic BP measurement for each patient was recorded, along with clinical and laboratory parameters. We evaluated associations between systolic and diastolic BP and 25 clinical and laboratory covariates using Spearman's correlation coefficient, and Wilcoxon Rank Sum tests for categorical covariates. Patients were stratified based on age and SCD genotype (SS, Sb0, SD vs. SC, Sb+). Blood pressures from our SCD patients were compared to median values obtained from the Cooperative Study of Sickle Cell Disease (CSSCD) using Wilcoxon Signed Rank tests. Results: Blood pressures were evaluated in 153 separate patients (SS = 115, SC = 18, Sb0 = 10, Sb+ = 9, SD =1), with a median age of 37 years (range 18 – 71 years). Thirty two (21%) patients had a known history of hypertension and 38 (25%) patients were on at least one antihypertensive medication for either hypertension or proteinuria. The mean (STD) systolic and diastolic BP for the patients with SS, Sb0 thalassemia, and SD (N=126) were 122 mm Hg (±15) and 69 mm Hg (±10), respectively; and the median systolic and diastolic BP for patients with SC and Sb+ thalassemia (N=27) were 131 mm Hg (±12) and 75 mm Hg (±13), respectively. We observed significant correlations between systolic BP and age (r=0.36, p=<.0001) and body mass index (BMI) (r=0.42, p=<.0001). We also observed significant correlations between SBP and hemoglobin (r=0.20, p=0.01); reticulocyte count (r=-0.29, p=0.0003); lactate dehydrogenase (r= −0.18, p=0.02); total bilirubin (r=−0.28, p=0.0008); indirect bilirubin (r=−0.28, p=0.001); white blood count (WBC) (r=−0.24, p=0.0023); absolute neutrophil count (r=−0.24, p=0.005); and placenta growth factor (PIGF) (r=−0.36, p=0.02). When compared to patients from the CSSCD, systolic BP was significantly higher in females ages 25–34 and 35–44, and in males ages 25–34 and 35–44 (Table 1). Conclusion: The low systemic BP in SCD patients may be related to their lower BMI, combined with biologic factors such as anemia, hemolysis as well as increased levels of the vascular endothelial growth factor (VEGF) family member, placenta growth factor. The higher BP in our patient population compared to values in the CSSCD may be related to differences in BMI, degree of anemia, and levels of PlGF. With the increasing survival of SCD patients, studies are required to determine the appropriate BP levels to initiate anti-hypertensive therapy. Disclosures: No relevant conflicts of interest to declare.

Interaction of hypertension and caloric restriction on cardiac mass and isomyosin expression

1995 ◽  
Vol 268 (1) ◽  
pp. R33-R39 ◽  
Author(s):  
S. J. Swoap ◽  
P. Boddell ◽  
K. M. Baldwin
Keyword(s):  
Blood Pressure ◽  
Body Weight ◽  
Caloric Restriction ◽  
Left Ventricular ◽  
Cardiac Mass ◽  
Aortic Constriction ◽  
Systemic Blood ◽  
Abdominal Aortic ◽  
Induced Hypertension ◽  
Blood Pressures

Previous studies show that elevations in blood pressure induce concomitant increases in both cardiac mass and slow beta-myosin heavy chain (MHC) expression in rodents, whereas caloric restriction of 50% (CR) causes an increase in beta-MHC while modestly lowering blood pressure in normotensive rats. The goals of this study were to 1) determine if beta-MHC expression could be independently regulated by CR and hypertension when these two interventions are combined and 2) determine if CR exerts a lowering of blood pressure in two contrasting models of rodent hypertension. Rodents were assigned to the following groups: 1) normal control (NC); 2) abdominal aortic constriction (Abcon), a model that induces hypertension via renin-angiotensin II; 3) nephrectomy-deoxycorticosterone acetate treatment (DOCA), a model that induces hypertension through increased salt retention; 4) CR; 5) Abcon+CR; 6) DOCA+CR. Results show that both Abcon and DOCA induced significant increases in systemic blood pressures, left ventricular (LV) weight/body weight, and the relative content of beta-MHC compared with NC. When applied in combination with either Abcon or DOCA, CR significantly blunted the changes observed in both systemic blood pressures and LV weight/body weight. In contrast, CR in conjunction with DOCA augmented % beta-MHC expression relative to either DOCA or CR alone. These data suggest 1) caloric restriction exerts a powerful impact on reducing experimentally induced hypertension in rodents and 2) the regulation of beta-MHC expression appears to be regulated by at least two processes, one associated with the stimulus of hypertension and the other involving an independent pathway linked to caloric restriction.

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