Is Blood Pressure Variability Related to Activity of the Sympathetic System?

1979 ◽  
Vol 57 (s5) ◽  
pp. 217s-219s ◽  
Author(s):  
D. L. Clement ◽  
M. M. Mussche ◽  
G. Vanhoutte ◽  
R. Pannier
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Standard Deviation ◽  
Blood Pressure Variability ◽  
Plasma Catecholamines ◽  
Sympathetic Nerves ◽  
Supine Blood Pressure ◽  
Sympathetic Function ◽  
The Mean ◽  
Cold Pressure

1. In 70 patients with untreated essential hypertension, blood pressure variability was correlated to plasma catecholamines and to the response of blood pressure and peripheral flow to cold pressure and handgrip tests. 2. Supine blood pressure was recorded every 5 min, during 3 h. Variability was defined as the standard deviation of the mean of the readings in that period. 3. Blood pressure variability is positively and significantly correlated to the level of pressure and to age. 4. No significant correlation could be found with plasma catecholamines and sympathetic function tests. 5. It is concluded that blood pressure variability is related to the level of pressure but not to activity of the sympathetic nerves.

Long term habitual vigorous physical activity is associated with lower visit-to-visit systolic blood pressure variability

2020 ◽  
Author(s):  
Xiaoyong Xu ◽  
Xianghong Meng ◽  
Shin-ichi Oka
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Standard Deviation ◽  
Systolic Blood Pressure ◽  
Blood Pressure Variability ◽  
Vigorous Physical Activity ◽  
Systolic Blood Pressure Variability ◽  
Average Real Variability ◽  
Post Hoc

Abstract Objective Our work aimed to investigate the association between vigorous physical activity and visit-to-visit systolic blood pressure variability (BPV). Methods We conducted a post hoc analysis of SPRINT (Systolic Blood Pressure Intervention Trial), a well-characterized cohort of participants randomized to intensive (<120 mmHg) or standard (<140 mmHg) SBP targets. We assessed whether patients with hypertension who habitually engage in vigorous physical activity would have lower visit-to-visit systolic BPV compared with those who do not engage in vigorous physical activity. Visit-to-visit systolic BPV was calculated by standard deviation (SD), average real variability (ARV), and standard deviation independent of the mean (SDIM) using measurements taken during the 1-, 2-, 3-, 6-, 9- and 12-month study visits. A medical history questionnaire assessed vigorous physical activity, which was divided into three categories according to the frequency of vigorous physical activity. Results A total of 7571 participants were eligible for analysis (34.8% female, mean age 67.9±9.3 years). During a follow-up of 1-year, vigorous physical activity could significantly reduce SD, ARV, and SDIM across increasing frequency of vigorous physical activity. There were negative linear trends between frequency of vigorous physical activity and visit-to-visit systolic BPV. Conclusions Long-term engagement in vigorous physical activity was associated with lower visit-to-visit systolic BPV.

scholarly journals Blood pressure variability and silent cerebral damage in essential hypertension

2004 ◽  
Vol 17 (8) ◽  
pp. 696-700 ◽  
Author(s):  
E GOMEZANGELATS ◽  
A DELASIERRA ◽  
C SIERRA ◽  
G PARATI ◽  
G MANCIA ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Blood Pressure Variability ◽  
Cerebral Damage

scholarly journals Hemodynamic Status During Endovascular Stroke Treatment: Association of Blood Pressure with Functional Outcome

2021 ◽  
Author(s):  
Min Chen ◽  
Dorothea Kronsteiner ◽  
Johannes Pfaff ◽  
Simon Schieber ◽  
Laura Jäger ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Standard Deviation ◽  
Functional Outcome ◽  
Scale Score ◽  
Endovascular Therapy ◽  
National Institutes Of Health ◽  
Modified Rankin Scale ◽  
Vessel Occlusion ◽  
Stroke Treatment ◽  
The Mean

Abstract Background Optimal blood pressure (BP) management during endovascular stroke treatment in patients with large-vessel occlusion is not well established. We aimed to investigate associations of BP during different phases of endovascular therapy with reperfusion and functional outcome. Methods We performed a post hoc analysis of a single-center prospective study that evaluated a new simplified procedural sedation standard during endovascular therapy (Keep Evaluating Protocol Simplification in Managing Periinterventional Light Sedation for Endovascular Stroke Treatment). BP during endovascular therapy in patients was managed according to protocol. Data from four different phases (baseline, pre-recanalization, post recanalization, and post intervention) were obtained, and mean BP values, as well as changes in BP between different phases and reductions in systolic BP (SBP) and mean arterial pressure (MAP) from baseline to pre-recanalization, were used as exposure variables. The main outcome was a modified Rankin Scale score of 0–2 three months after admission. Secondary outcomes were successful reperfusion and change in the National Institutes of Health Stroke Scale score after 24 h. Multivariable linear and logistic regression models were used for statistical analysis. Results Functional outcomes were analyzed in 139 patients with successful reperfusion (defined as thrombolysis in cerebral infarction grade 2b–3). The mean (standard deviation) age was 76 (10.9) years, the mean (standard deviation) National Institutes of Health Stroke Scale score was 14.3 (7.5), and 70 (43.5%) patients had a left-sided vessel occlusion. Favorable functional outcome (modified Rankin Scale score 0–2) was less likely with every 10-mm Hg increase in baseline (odds ratio [OR] 0.76, P = 0.04) and pre-recanalization (OR 0.65, P = 0.011) SBP. This was also found for baseline (OR 0.76, P = 0.05) and pre-recanalization MAP (OR 0.66, P = 0.03). The maximum Youden index in a receiver operating characteristics analysis revealed an SBP of 163 mm Hg and MAP of 117 mm Hg as discriminatory thresholds during the pre-recanalization phase to predict functional outcome. Conclusions In our protocol-based setting, intraprocedural pre-recanalization BP reductions during endovascular therapy were not associated with functional outcome. However, higher intraprocedural pre-recanalization SBP and MAP were associated with worse functional outcome. Prospective randomized controlled studies are needed to determine whether BP is a feasible treatment target for the modification of outcomes.

scholarly journals Antihypertensive drug classes have different effects on short-term blood pressure variability in essential hypertension

2014 ◽  
Vol 37 (6) ◽  
pp. 585-590 ◽  
Author(s):  
Natacha Levi-Marpillat ◽  
Isabelle Macquin-Mavier ◽  
Anne-Isabelle Tropeano ◽  
Gianfranco Parati ◽  
Patrick Maison
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Antihypertensive Drug ◽  
Blood Pressure Variability ◽  
Short Term ◽  
Drug Classes

An Unsuccessful Attempt to Treat Hypertension with Acupuncture

1977 ◽  
Vol 05 (01) ◽  
pp. 39-44 ◽  
Author(s):  
K. Sugioka ◽  
W. Mao ◽  
J. Woods ◽  
R. A. Mueller
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Acupuncture Treatment ◽  
Plasma Catecholamines ◽  
Systemic Blood Pressure ◽  
Patient Acceptance ◽  
Unsuccessful Attempt ◽  
Poor Patient ◽  
Beneficial Response

The effectiveness of 5 sets of acupuncture loci in decreasing systemic blood pressure was compared with chlorthalidone and propranolol in patients with essential hypertension. No statistically significant acute or long-term changes in plasma catecholamines, renin activity, or blood pressure and pulse rate were observed as a result of acupuncture treatment. The decrease in blood pressure was significantly less than the observed with propranolol, but not significantly less than produced by chlorthalidone. Because of the poor patient acceptance of acupuncture and in the absence of a beneficial response, we feel acupuncture as employed in this study is of limited value in the management of patients with essential hypertension.

Abstract 16967: Increased Blood Pressure Variability is Associated With Worse Outcome in Acute Ischemic Stroke

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Adam de Havenon ◽  
Haimei Wang ◽  
Greg Stoddard ◽  
Lee Chung ◽  
Jennifer Majersik
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Blood Pressure Variability ◽  
Harmful Effect ◽  
Final Analysis ◽  
Ordinal Logistic Regression ◽  
Stroke Severity ◽  
The Mean

Background: Increased blood pressure variability (BPV) is detrimental in the weeks to months after ischemic stroke, but it has not been adequately studied in the acute phase. We hypothesized that increased BPV in acute ischemic stroke (AIS) patients would be associated with worse outcome. Methods: We retrospectively reviewed inpatients at our hospital between 2010-2014 with an ICD-9 code of AIS; 213 were confirmed to have AIS by a vascular neurologist. A modified Rankin Score (mRS) after discharge was available in 148/213, at a mean of 86 ± 60 days. In 45/213 the discharge mRS was either 0 or 6, in which case they were included in the final analysis. BPV was measured as the standard deviation (SD) of each patient’s systolic blood pressure readings during the first 24 hours and 5 days of hospitalization (9,844 total readings), or until discharge if discharged in <5 days (Figure 1). The SBP SD was further divided in quartiles. A multivariate ordinal logistic regression with the outcome of mRS, the primary predictor of quartiles of SBP SD, and baseline NIH stroke scale (NIHSS) to control for initial stroke severity. Results: Mean±SD age was 64.2 ± 16.3 years, NIHSS was 12.6 ± 7.9, and mRS was 2.7 ± 2.1. The mean SBP SDs for the first 24 hours and 5 days were 12.1 ± 6.2 mm Hg and 14.1 ± 4.9 mm Hg. In the ordinal logistic regression model, the quartiles of SBP SD for the first 24 hours and 5 days were positively associated with higher mRS (OR = 1.37, 95% CI 1.01 - 1.74, p = 0.009; OR = 1.30, 95% CI 1.03 - 1.63, p = 0.028). This effect became even more pronounced in patients with the highest quartile of variability (OR = 2.76, 95% CI 1.29 - 5.88, p = 0.009; OR = 2.10, 95% CI 1.01 - 4.36, p = 0.046). Conclusion: In our cohort of 193 patients with AIS, there was a significant association between increased systolic BPV and worse functional outcome, after controlling for initial stroke severity. This data suggests that increased BPV may have a harmful effect for AIS patients, which warrants a prospective observational study.

Solitary Kidney and Ageing as Causes of Low Renin and Aldosterone Concentrations: Relevance to ‘Low-Renin’ Essential Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 177s-180s ◽  
Author(s):  
R. Gordon ◽  
Freda Doran ◽  
M. Thomas ◽  
Frances Thomas ◽  
P. Cheras
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Plasma Volume ◽  
Plasma Renin ◽  
Renin Activity ◽  
Dietary Sodium ◽  
Sodium Restriction ◽  
Normotensive Subjects ◽  
The Mean

1. As experimental models of reduced nephron population in man, (a) twelve men aged 15–32 years who had one kidney removed 1–13 years previously and (b) fourteen normotensive men aged 70–90 years were studied. Results were compared with those in eighteen normotensive men aged 18–28 years and eleven men aged 19–33 years with essential hypertension. 2. While the subjects followed a routine of normal diet and daily activity, measurements were made, after overnight recumbency and in the fasting state, of plasma volume and renin activity on one occasion in hospital and of blood pressure on five to fourteen occasions in the home. Blood pressure was also measured after standing for 2 min and plasma renin activity after 1 h standing, sitting or walking. Twenty-four hour urinary aldosterone excretion was also measured. 3. The measurements were repeated in the normotensive subjects and subjects in (a) and (b) above after 10 days of sodium-restricted diet (40 mmol of sodium/day). 4. The mean plasma renin activity (recumbent) in essential hypertensive subjects was higher than in normotensive subjects. In subjects of (a) and (b) above, it was lower than normotensive subjects, and was not increased by dietary sodium restriction in subjects of (a). 5. The mean aldosterone excretion level was lower in old normotensive subjects than in the other groups, and increased in each group after dietary sodium restriction. 6. Mean plasma volume/surface area was not different between the four groups and in normotensive, essential hypertensive and nephrectomized subjects but not subjects aged 70–90 years was negatively correlated with standing diastolic blood pressure.

scholarly journals THE ASSAY OF HYPERTENSIN FROM THE ARTERIAL BLOOD OF NORMOTENSIVE AND HYPERTENSIVE HUMAN BEINGS

1952 ◽  
Vol 95 (6) ◽  
pp. 523-529 ◽  
Author(s):  
Joseph R. Kahn ◽  
Leonard T. Skeggs ◽  
Norman P. Shumway ◽  
Paul E. Wisenbaugh
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Normal Blood ◽  
Moderate Degree ◽  
Human Beings ◽  
Normal Blood Pressure ◽  
Arterial Blood ◽  
The Mean ◽  
Mean Concentration ◽  
Benign Group

Hypertensin has been assayed in the blood of patients with normal blood pressure and in those with essential hypertension in both the benign and malignant phases. 250 ml. samples of arterial blood were obtained, chemically purified, and concentrated to a volume of 1 ml. These extracts were then assayed in anesthetized rats. The concentrations of hypertensin in the blood of patients with the malignant phase of essential hypertension were found to be greatly increased. The concentrations of hypertensin found in patients with benign hypertension had a moderate degree of overlapping with those found in the normotensive group, but the mean concentration of hypertensin in the former group was twice that of the controls. Although these results are statistically significant, the amounts of hypertensin recovered in the benign group are so small that no conclusions can be drawn as to its effectiveness in producing vasoconstriction in these patients.

Abstract TMP97: Autonomic Nervous System Dysfunction Correlates With Increased Blood Pressure Variability After Acute Ischemic, But Not Hemorrhagic, Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam H de Havenon ◽  
Melissa Cortez ◽  
Cecilia Peterson ◽  
Fa Tuuhetaufa ◽  
Nils Petersen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Blood Pressure Variability ◽  
Hemorrhagic Stroke ◽  
Light Stimulus ◽  
Pupillary Response ◽  
Autonomic Nervous System Dysfunction ◽  
Autonomic Nervous ◽  
The Mean

Background: Elevated blood pressure variability (BPV) in the days after acute stroke onset is associated with worse outcome. However, the mechanism of increased BPV remains unknown, but may be due to dysfunction of the autonomic nervous system, which can be measured by pupil response to a light stimulus. Methods: This is a retrospective study of 109 patients in a neurocritical care unit: 45 with acute ischemic stroke (AIS), 44 with intracerebral hemorrhage (ICH), and 20 with subarachnoid hemorrhage (SAH). The primary outcome is BPV, measured as standard deviation of SBP (SD), using all blood pressures from admission to 72 hours later. The primary predictors are pupillary light reflexes (PLR) from the same period, measured with a bedside pupilometer, the NPi-200. We used linear regression to evaluate the association between PLRs and BPV, and adjusted for patient age and gender. Results: The mean (SD) age was 60.7 (16.4) and 58.7% were male. The mean (SD) number of blood pressure and PLR measurements were 30.0 (9.0) and 10.4 (7.3). We found that parasympathetically mediated PLR measures were associated with BPV in AIS patients (Table 1), but no consistent pattern emerged in ICH or SAH patients (all p>0.05). The relationships between BPV and PLR for AIS patients were linear in nature (Figure 1), and were consistent with parasympathetic hypofunction in patients with the greatest BPV. Conclusions: Elevated BPV is associated with parasympathetic hypofunction, as measured by pupillary response to light, after acute ischemic, but not hemorrhagic, stroke. Further research is needed to better understand this relationship as it may represent a therapeutic target for BPV reduction.

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