Management of blood pressure disorders in individuals with spinal cord injury

2022 ◽  
Vol 62 ◽  
pp. 60-63
Author(s):  
Jill M. Wecht
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cord Injury

scholarly journals Postprandial Hypotension and Spinal Cord Injury

2021 ◽  
Vol 10 (7) ◽  
pp. 1417
Author(s):  
Rikke Middelhede Hansen ◽  
Klaus Krogh ◽  
Joan Sundby ◽  
Andrei Krassioukov ◽  
Ellen Merete Hagen
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cardiovascular Mortality ◽  
Blood Pressure Measurement ◽  
Ambulatory Blood Pressure Measurement ◽  
Postprandial Hypotension ◽  
Cord Injury ◽  
Time Since Injury ◽  
Median Change

Postprandial hypotension (PPH) is defined as a fall of ≥20 mmHg in systolic blood pressure (SBP) or a SBP of <90 mmHg after having been >100 mmHg before the meal within two hours after a meal. The prevalence of PPH among persons with spinal cord injury (SCI) is unknown. Ambulatory blood pressure measurement was performed in 158 persons with SCI, 109 men, median age was 59.1 years (min.:13.2; max.: 86.2). In total, 78 persons (49.4%) had PPH after 114 out of 449 meals (25.4%). The median change in SBP during PPH was −28 mmHg (min.: −87; max.: −15 mmHg) and 96% of the PPH episodes were asymptomatic. The occurrence of PPH was correlated to older age (p = 0.001), level of injury (p = 0.023), and complete SCI (p = 0.000), but not, gender or time since injury. Further studies are needed to elucidate if PPH contributes to the increased cardiovascular mortality in the SCI population.

Diurnal Blood Pressure Variation in Quadriplegic Chronic Spinal Cord Injury Patients

1991 ◽  
Vol 80 (3) ◽  
pp. 271-276 ◽  
Author(s):  
Henry Krum ◽  
William J. Louis ◽  
Douglas J. Brown ◽  
Graham P. Jackman ◽  
Laurence G. Howes
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Ambulatory Monitoring ◽  
Pressure Variation ◽  
Night Time ◽  
Cord Injury ◽  
Blood Pressure Variation ◽  
Neurologically Intact

1. Measurement of blood pressure and heart rate over a 24 h period was peformed in 10 quadriplegic spinal cord injury patients and 10 immobilized, neurologically intact orthopaedic subjects by using the Spacelabs 90207 automated ambulatory monitoring system. 2. Systolic and diastolic blood pressure fell significantly at night in orthopaedic subjects but not in quadriplegic patients, and night-time blood pressures were similar in both groups. 3. Cumulative summation of differences from a reference value (cusum analysis) confirmed a markedly diminished diurnal blood pressure variation in the quadriplegic patients. 4. These findings could not be accounted for on the basis of blood pressure variations during chronic postural change. 5. Heart rate fell significantly at night in both groups. 6. The findings suggest that the increase in blood pressure during waking hours in neurologically intact subjects is a consequence of a diurnal variation in sympathetic activity (absent in quadriplegic patients with sympathetic decentralization) which is independent of changes in physical activity.

scholarly journals Cerebral Autoregulation during Postural Change in Patients with Cervical Spinal Cord Injury—A Carotid Duplex Ultrasonography Study

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1321
Author(s):  
Joo-Hyun Kee ◽  
Jun-Hyeong Han ◽  
Chang-Won Moon ◽  
Kang Hee Cho
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Blood Flow ◽  
Cerebral Autoregulation ◽  
Duplex Ultrasonography ◽  
Postural Change ◽  
Carotid Duplex ◽  
Cord Injury ◽  
Carotid Duplex Ultrasonography

Patients with a spinal cord injury (SCI) frequently experience sudden falls in blood pressure during postural change. Few studies have investigated whether the measurement of blood flow velocity within vessels can reflect brain perfusion during postural change. By performing carotid duplex ultrasonography (CDU), we investigated changes in cerebral blood flow (CBF) during postural changes in patients with a cervical SCI, determined the correlation of CBF change with presyncopal symptoms, and investigated factors affecting cerebral autoregulation. We reviewed the medical records of 100 patients with a cervical SCI who underwent CDU. The differences between the systolic blood pressure, diastolic blood pressure, and CBF volume in the supine posture and after 5 min at 50° tilt were evaluated. Presyncopal symptoms occurred when the blood flow volume of the internal carotid artery decreased by ≥21% after tilt. In the group that had orthostatic hypotension and severe CBF decrease during tilt, the body mass index and physical and functional scores were lower than in other groups, and the proportion of patients with a severe SCI was high. The higher the SCI severity and the lower the functional score, the higher the possibility of cerebral autoregulation failure. CBF should be assessed by conducting CDU in patients with a high-level SCI.

Increased vascular resistance in paralyzed legs after spinal cord injury is reversible by training

2002 ◽  
Vol 93 (6) ◽  
pp. 1966-1972 ◽  
Author(s):  
Maria T. E. Hopman ◽  
Jan T. Groothuis ◽  
Marcel Flendrie ◽  
Karin H. L. Gerrits ◽  
Sibrand Houtman
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Blood Flow ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Vascular Resistance ◽  
Arterial Blood Flow ◽  
Arterial Blood ◽  
Cord Injury

The purpose of the present study was to determine the effect of a spinal cord injury (SCI) on resting vascular resistance in paralyzed legs in humans. To accomplish this goal, we measured blood pressure and resting flow above and below the lesion (by using venous occlusion plethysmography) in 11 patients with SCI and in 10 healthy controls (C). Relative vascular resistance was calculated as mean arterial pressure in millimeters of mercury divided by the arterial blood flow in milliliters per minute per 100 milliliters of tissue. Arterial blood flow in the sympathetically deprived and paralyzed legs of SCI was significantly lower than leg blood flow in C. Because mean arterial pressure showed no differences between both groups, leg vascular resistance in SCI was significantly higher than in C. Within the SCI group, arterial blood flow was significantly higher and vascular resistance significantly lower in the arms than in the legs. To distinguish between the effect of loss of central neural control vs. deconditioning, a group of nine SCI patients was trained for 6 wk and showed a 30% increase in leg blood flow with unchanged blood pressure levels, indicating a marked reduction in vascular resistance. In conclusion, vascular resistance is increased in the paralyzed legs of individuals with SCI and is reversible by training.

scholarly journals Associations between arterial stiffness and blood pressure fluctuations after spinal cord injury

Spinal Cord ◽  
2019 ◽  
Vol 57 (12) ◽  
pp. 1057-1063 ◽  
Author(s):  
Katharine D. Currie ◽  
Michèle Hubli ◽  
Maureen J. MacDonald ◽  
Andrei V. Krassioukov
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Arterial Stiffness ◽  
Pressure Fluctuations ◽  
Cord Injury

scholarly journals Blood Pressure Instability in Persons With SCI: Evidence From a 30-Day Home Monitoring Observation

2019 ◽  
Vol 32 (10) ◽  
pp. 938-944 ◽  
Author(s):  
Caitlyn G Katzelnick ◽  
Joseph P Weir ◽  
April Jones ◽  
Marinella Galea ◽  
Trevor A Dyson-Hudson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Medical Center ◽  
Pressure Fluctuations ◽  
Home Monitoring ◽  
Extended Period ◽  
Blood Pressure Monitor ◽  
Pressure Monitor ◽  
Cord Injury

Abstract Background To determine the degree of blood pressure instability over a 30-day home observation in participants with spinal cord injury grouped by level of injury pertaining to cardiovascular autonomic regulation. Methods This is an observational study completed at the Kessler Foundation and James J. Peters Veterans Medical Center. Seventy-two participants with tetraplegia (C1–T1), 13 with high thoracic (T2–T4), and 28 with low thoracic (T5–T12) injury participated in this study. Participants were asked to record their blood pressure using an ambulatory blood pressure monitor three times a day for 30 days. Results The number of blood pressure fluctuations was significantly increased in the tetraplegia group compared with the paraplegia groups. Age and duration of injury contributed to an increase in the observation of 30-day blood pressure instability; however, completeness of injury did not. Conclusion The data indicate significant blood pressure instability that may not be exclusive to persons with tetraplegia; in fact, individuals with low thoracic injuries demonstrated severe blood pressure fluctuations. The use of a monitor at home for an extended period may help document dangerous and extreme fluctuations in blood pressure and should be considered an important adjunctive clinical practice for tracking of the secondary consequences in the spinal cord injury population.

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