The Influence of Physical Activity on Arterial Pressure during Ambulatory Recordings in Man

1980 ◽  
Vol 58 (1) ◽  
pp. 115-117 ◽  
Author(s):  
D. B. Rowlands ◽  
T. J. Stallard ◽  
R. D. S. Watson ◽  
W. A. Littler

1. Ambulatory blood pressure recordings were made over a 48 h period on six hypertensive patients. The conditions of study were standardized, particularly with regard to physical activity, and during one period of each day the patients were randomly allocated to be active or inactive. 2. Results show that blood pressure was highest during physical activity and lowest during sleep. There was no significant difference between the arterial pressures measured during the same physical activities carried out at the same time each day. However, during the same time on consecutive days when activity was randomized, there was a significant difference between the pressure recordings during physical activity compared with those during inactivity. Heart rate changes showed a similar trend during the randomized period. 3. Physical activity and sleep have a profound effect on continuous arterial blood pressure recordings and these are independent of time alone. These observations should be taken into account when using this ambulatory system to assess hypotensive therapy.

1979 ◽  
Vol 57 (s5) ◽  
pp. 375s-377s ◽  
Author(s):  
S. Mann ◽  
M. W. Millar Craig ◽  
D. G. Altman ◽  
D. I. Melville ◽  
E. B. Raftery

1. Continuous monitoring of arterial pressure was performed via an indwelling cannula over 24 h in 12 hypertensive patients before treatment and again 2–4 months after starting metoprolol (100 mg twice daily). 2. During treatment, heart rate and systolic and diastolic pressures were significantly reduced. 3. The circadian patterns of heart rate and blood pressure changes were similar before and during therapy.


2014 ◽  
Vol 23 (1) ◽  
pp. 8-13
Author(s):  
Idris Ali ◽  
Amirul Islam ◽  
Golam Morshed ◽  
Nurul Islam ◽  
Ashia Ali ◽  
...  

Background: Adjuvant used with local anaesthetic agent in caudal is more effective for post operative analgesia in children . Aim and objective: To find out the duration and quality of caudal analgesia in children undergoing genitourinary surgery by combination of bupivacaine and midazolam. Methods: A total number of sixty patients ASA grade I&II were selected randomly as per inclusion & exclusion criteria in two groups. Thirty in each group. In group A, caudal block was given by bupivacainemidazolam mixture and in group B, caudal block was given by bupivacaine in lateral decubitus position, just after completion of surgery before reversed from GA. In post operative period arterial blood pressure, heart rate, and duration of analgesia were recorded. Results: There was no significant difference between the groups of blood pressure, heart rate, and pain score up to 30 min but after one hour of post operative period pain scores were significant(p<0.05). Conclusion: Midazolam improves the duration and quality of analgesic effect of bupivacaine. DOI: http://dx.doi.org/10.3329/jbsa.v23i1.18152 Journal of BSA, 2010; 23(1): 8-13


Author(s):  
V.S. Pasko

The aim of the study was to determine the peculiarities of ABPM indices in middle-aged and elderly hypertensive patients depending on the daily BP profile. Material and methods. Indices of ambulatory blood pressure monitoring were identified in 57 middle-aged patients (45-59 years) (group I) and 43 elderly patients (60-74 years) (group II), who underwent two-week in-patient treatment. The control group consisted of 15 patients for every of the surveyed categories (group III - middle-aged and group IV – elderly respectively) matched with basic by age and gender. Results. We have shown that one of the factors that determines the change in hemodynamics in patients with essential hypertension is age, with the age patients experience the decrease in diastolic blood pressure with steadily increased systolic blood pressure, that should be considered in the prescription of antihypertensive treatment. With age, a gradual increase in systolic blood pressure is associated with the increased aortic stiffness, partially with the increase in collagen and the decrease in elastic fibrils and the formation of isolated systolic hypertension. Thus, it is proved that in the formation of isolated hypertension the growth of pulse blood pressure for more than 60 mm Hg is unfavorable in a development of cerebrovascular events. Pulse arterial blood pressure was stronger risk factor than systolic blood pressure and diastolic blood pressure or average arterial pressure in the elderly. Recently, taking into account age characteristics, all three indices were recognized as comparable predictors at the age of 50-59 years as the transitional period, and at the age of 60-79 years diastolic blood pressure adversely affecting the cardiovascular risk, increased pulse blood pressure prognostically above the level of systolic arterial pressure.


2020 ◽  
Vol 9 (1) ◽  
pp. 8-15
Author(s):  
Arya Justisia Sani ◽  
Ardhana Tri Arianto ◽  
Muhammad Husni Thamrin

Latar Belakang dan Tujuan: Peningkatan respon hemodinamik yang disebabkan oleh nyeri dapat menyebabkan peningkatan aliran darah otak dan tekanan intrakranial. Blok scalp pada kraniotomi menumpulkan respon hemodinamik karena rangsangan nyeri serta mengurangi penambahan analgesi lain. Penelitian ini bertujuan untuk mengetahui efektifitas blok scalp sebagai analgetik pada kraniotomi.Subjek dan Metode: Penelitian ini menggunakan uji klinik acak tersamar ganda pada 36 pasien dengan status fisik ASA 1–3 dilakukan operasi kraniotomi eksisi dan memenuhi kriteria inklusi. Sampel dibagi menjadi kelompok I (dengan blok scalp) dan kelompok II (tanpa blok scalp). Blok dilakukan sesaat setelah induksi anestesi. Digunakan levobupivakain 0,375% sebanyak 3 ml tiap insersi, pada masing-masing saraf. Tekanan darah, tekanan arteri rata-rata, detak jantung sebelum intubasi dan setelah intubasi, pemasangan pin, insisi kulit dan insisi duramater serta total kebutuhan fentanyl tambahan dicatat. Data yang diperoleh dianalisis dengan program komputer SPSS versi 17 lalu diuji menggunakan uji Kruskal-Wallis atau One-way ANOVA. Batas kemaknaan yang diambil adalah p < 0,05.Hasil: Selama kraniotomi, detak jantung, tekanan darah, tekanan arteri rata-rata secara signifikan lebih tinggi pada pasien tanpa blok scalp terutama pada saat pemasangan pin. Hasil uji statistik menunjukkan perbedaan signifikan, penambahan fentanyl pada pasien dengan blok scalp lebih sedikit dibandingkan tanpa blok scalp, p=0,000 (p<0,05).Simpulan: Blok scalp levobupivakain efektif dalam menurunkan respon hemodinamik terutama pada saat pemasangan pin. Pasien kraniotomi dengan blok scalp membutuhkan penambahan fentanyl lebih sedikit. Differences on Hemodynamic Response with Levobupivacaine Scalp Block in Craniotomy SurgeryAbstractBackground and Objective: Increased hemodynamic response caused by pain can lead to increased cerebral blood flow and intracranial pressure. Scalp block in craniotomy blunts hemodynamic response due to pain and reduce other analgesics addition. This study aims to determine effectiveness of scalp blocks as analgesic in craniotomy.Subject and Method: This study used a double-blind randomized clinical trial in 36 patients with physical status ASA 1-3 who underwent craniotomy and met inclusion criteria. Samples were divided into group I (with scalp block) and group II (without scalp block). Scalp Block was performed right after anesthesia induction. Using levobupivacaine 0.375% 3 ml for each insertion. Blood pressure, mean arterial pressure, heart rate before and after intubation, during pin placement, skin incision and duramater incision and total need for additional fentanyl were recorded. SPSS version 17 was used and data were analysed using Kruskal-Wallis or One-way ANOVA. Statistical significance was accepted at p < 0.05.Result: During craniotomy, heart rate, blood pressure, mean arterial pressure were significantly higher in patients without scalp block especially during pin placement. Statistical test showed significant difference, additional fentanyl in patients with scalp blocks was lesser, p = 0.000 (p <0.05). Conclusion: Levobupivacaine scalp block was effective to blunt hemodynamic response especially during pin placement. Scalp block also decreased additional fentanyl in craniotomy.


1988 ◽  
Vol 254 (4) ◽  
pp. R706-R710 ◽  
Author(s):  
N. D. Ray ◽  
C. S. Turner ◽  
N. M. Rawashdeh ◽  
J. C. Rose

Given the necessity of the adrenal gland in maintaining cardiovascular function in adults of various species, these experiments were conducted to determine if fetal bilateral adrenalectomy results in altered resting heart rate, hypotension, and decreased basal blood volume as well as a diminished ability of the fetus to maintain arterial pressure and restore blood volume in response to hemorrhage. We studied heart rate, arterial blood pressure, and blood volume changes in response to hemorrhage of 20% of blood volume at 2%/min in seven adrenalectomized and six intact chronically cannulated unanesthetized lambs between 119 and 133 days of gestation. Blood volumes and percent restitution of shed volume were determined using 51Cr-tagged red blood cells and changes in hematocrit. There was no significant difference between groups in basal heart rate, mean arterial pressure, hematocrit, and blood volume. The two groups were similar to hemorrhage-induced changes in these and restitution of volume. Therefore, fetal adrenal glands are not necessary for basal cardiovascular function or regulation subsequent to moderate hemorrhage in the late gestation ovine fetus.


1996 ◽  
Vol 271 (2) ◽  
pp. H812-H822 ◽  
Author(s):  
W. C. Rose ◽  
J. S. Schwaber

Vagal control of the heart is the most rapidly responding limb of the arterial baroreflex. We created a mathematical model of the left heart and vascular system to evaluate the ability of heart rate to influence blood pressure. The results show that arterial pressure depends nonlinearly on rate and that changes in rate are of limited effectiveness, particularly when rate is increased above the basal level. A 10% change in heart rate from rest causes a change of only 2.4% in arterial pressure due to the reciprocal relation between heart rate and stroke volume; at higher rates, insufficient filling time causes stroke volume to fall. These findings agree well with published experimental data and challenge the idea that changes in heart rate alone can strongly and rapidly affect arterial pressure. Possible implications are that vagally mediated alterations in inotropic and dromotropic state, which are not included in this model, play important roles in the fast reflex control of blood pressure or that the vagal limb of the baroreflex is of rather limited effectiveness.


Pharmacology ◽  
2019 ◽  
Vol 104 (1-2) ◽  
pp. 1-6
Author(s):  
Alfredo Costa ◽  
Daniele Bosone ◽  
Matteo Cotta Ramusino ◽  
Giulia Perini ◽  
Natascia Ghiotto ◽  
...  

Aim: To assess the effects of chronic evening oral administration of bromazepam alone or in combination with propranolol on ambulatory blood pressure (BP) and heart rate (HR) in mild hypertensive subjects. Methods: Thirty-seven mild hypertensive patients after a 2-week placebo period were randomized to bromazepam 3 mg, propranolol 40 mg, bromazepam 3 mg plus propranolol 40 mg or placebo for 2 weeks according to a double-blind, double dummy, cross-over design. After each treatment period, 24-h BP and HR ambulatory monitoring was performed by using a non-invasive device. Results: Ambulatory monitoring showed that during night-time SBP and DBP values were unaffected by bromazepam as compared to placebo, whereas SBP was significantly reduced by propranolol both when taken alone and in combination with bromazepam. HR nocturnal values were significantly reduced by propranolol, whereas they were significantly increased by bromazepan both when taken alone (+11.5%, p < 0.05 vs. placebo) and in combination with propranolol (+12.8%, p < 0.05 vs. propranolol). No significant difference in day-time values of SBP, DBP and HR was observed among the 4 treatment groups. Conclusions: In mild hypertensive patients, evening consumption of bromazepam for a 2-week period did not affect BP, while it increased nocturnal HR. Such an increase was observed both when bromazepam was taken alone and in combination with propranolol, which suggests that it depends on a bromazepam mediated decrease in vagal tone. Whatever the mechanism, the HR nocturnal increase might be of clinical relevance, due to the role of high HR as cardiovascular risk factor, particularly in already at risk hypertensive subjects.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C A Paterno Marchioli

Abstract Background Protective effect of Angiotensin-II Receptor Blockers (ARBs) on major cardiovascular events might be partly independent of the degree of blood pressure reduction. Calcium channel blockers (CCBs), lower arterial pressure by decreasing total peripheral resistance without reducing cardiac output. Hydrochlorothiazide (Hctz) is one of the most commonly prescribed antihypertensive drugs worldwide, but associated with more frequent adverse effects, such as hypokalaemia, hyponatraemia, hyperuricaemia and may increase the glycaemia, It sensitizes the endothelium to the action of angiotensin II, might act on the aldosterone release. The phenomenon of “aldosterone escape” occurs even in the presence of combination therapy with ARBs. The harmful effects of aldosterone are innumerable: induced cardiac and renal fibrosis, sodium and water retention, inflammation, oxidative stress, arrhythmias, glucose intolerance, insulin resistance, among others, that are involved in arterial and myocardium remodelling. Mineralocorticoid Receptor Antagonists (MRAs) therapy improve diastolic function, decrease plasma volume and vascular/myocardial fibrosis. Purpose This study aimed to assess the responses of two groups of therapy such as ARBs associated to MRAs or to CCBs+Hctz according to central haemodynamic parameters (CHPs) in hypertensive patients, both genders, with normal kidney function. Methods For this cross-sectional retrospective study, data were collected from 391 hypertensive patients who were assisted in the hypertension centre. Female/male 239/152, each gender divided into two groups of therapy: ARB+MRA/ARB+CCB+Hctz. Female 210/29 (average age 57/70) and male 125/27 (average age 55/61). The CHPs were measured with a SphygmoCor System PVX (AtCor-Medical Australia), a validated device employing the high-fidelity technique of applanation tonometry according to established protocols. Also, the difference of Augmentation Index (Diff-AIx) between the observed values and the expected levels was assessed according to normal range by age. No patients had cardiovascular, endocrine, renal and metabolic decompensated diseases. Results After measuring the body mass index, waist circumference and heart rate, the two therapy groups were confronted, both genders, had not found the statistically significant difference. The results of CHPs (Central Aortic Pressure, End-Systolic Pressure, Mean Arterial Pressure, Pulse Pressure, Augmentation Pressure), systolic and diastolic blood pressure during association of ARBs+MRAs therapy compared to ARBs+CCBs+Hctz, both genders, showed the lowest values with a highly statistically significant difference. In the female/male the Diff-AIx was found p=0.05/0.04. Conclusion These findings suggest that ARBs+MRAs treatment reaches the best haemodynamic conditions because improve the levels of CHPs and arterial stiffness (Diff-AIx) giving an adequate reduction of the stress to the arterial-ventricular coupling.


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