Ambulatory Monitoring of Blood Pressure Disturbs Sleep and Raises Systolic Pressure at Night in Patients Suspected of Suffering from Sleep-Disordered Breathing

1996 ◽  
Vol 91 (1) ◽  
pp. 45-50 ◽  
Author(s):  
E. Heude ◽  
P. Bourgin ◽  
P. Feigel ◽  
P. Escourrou
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Sleep Disordered Breathing ◽  
Diastolic Pressure ◽  
Ambulatory Monitoring ◽  
Systolic Pressure ◽  
Aged Patients ◽  
Ambulatory Monitor ◽  
Disordered Breathing

1. The aim of the study was to assess the effect of ambulatory monitoring of blood pressure on sleep and on blood pressure in middle-aged patients. 2. Nine consecutive patients (seven men, two women; mean age 57 years) complaining of snoring and various degrees of excessive daytime somnolence were studied. Five patients were normotensive and four were being treated for hypertension. During one night standard laboratory polysomnography was performed with monitoring of blood pressure by a silent ambulatory monitor and continuous infrared blood pressure by photoplethysmography. 3. Ambulatory blood pressure significantly disturbs sleep architecture, causing EEG arousals in 64% of measurements, and induces a significant rise in blood pressure during systolic pressure measurement by the ambulatory monitor (rise in systolic pressure, 13.7 ± 15.9 mmHg, P > 0.001; rise in diastolic pressure, 3.7 ± 8.2 mmHg, P > 0.01). At the time of diastolic measurement, blood pressure had returned to the preinflation value. The rise in systolic blood pressure was higher when an arousal was associated with cuff inflation (P > 0.001). This rise in blood pressure is probably the consequence of sympathetic nervous system activation. 4. We conclude that ambulatory blood pressure recordings of systolic blood pressure during sleep should be interpreted with caution as systolic blood pressure may be significantly increased in patients suspected of suffering from sleep-disordered breathing.

scholarly journals Effects of transient intrathoracic pressure changes (hiccups) on systemic arterial pressure

1997 ◽  
Vol 83 (2) ◽  
pp. 371-375 ◽  
Author(s):  
Oommen P. Mathew
Keyword(s):  
Blood Pressure ◽  
Arterial Pressure ◽  
Stroke Volume ◽  
Systolic Blood Pressure ◽  
Cardiac Cycle ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Intrathoracic Pressure ◽  
Systemic Arterial Pressure ◽  
Pressure Changes

Mathew, Oommen P. Effects of transient intrathoracic pressure changes (hiccups) on systemic arterial pressure. J. Appl. Physiol. 83(2): 371–375, 1997.—The purpose of the study was to determine the effect of transient changes in intrathoracic pressure on systemic arterial pressure by utilizing hiccups as a tool. Values of systolic and diastolic pressures before, during, and after hiccups were determined in 10 intubated preterm infants. Early-systolic hiccups decreased systolic blood pressure significantly ( P < 0.05) compared with control (39.38 ± 2.72 vs. 46.46 ± 3.41 mmHg) and posthiccups values, whereas no significant change in systolic blood pressure occurred during late-systolic hiccups. Diastolic pressure immediately after the hiccups remained unchanged during both early- and late-systolic hiccups. In contrast, diastolic pressure decreased significantly ( P < 0.05) when hiccups occurred during diastole (both early and late). Systolic pressures of the succeeding cardiac cycle remained unchanged after early-diastolic hiccups, whereas they decreased after late-diastolic hiccups. These results indicate that transient decreases in intrathoracic pressure reduce systemic arterial pressure primarily through an increase in the volume of the thoracic aorta. A reduction in stroke volume appears to contribute to the reduction in systolic pressure.

scholarly journals Activity-Adjusted 24-Hour Ambulatory Blood Pressure and Cardiac Remodeling in Children with Sleep Disordered Breathing

Hypertension ◽  
2008 ◽  
Vol 51 (1) ◽  
pp. 84-91 ◽  
Author(s):  
Raouf Amin ◽  
Virend K. Somers ◽  
Keith McConnell ◽  
Paul Willging ◽  
Charles Myer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Cardiac Remodeling ◽  
Sleep Disordered Breathing ◽  
Disordered Breathing

scholarly journals Blood Pressure and Heart Rate Alterations through Music in Patients Undergoing Cataract Surgery in Greece

2015 ◽  
Vol 7 ◽  
pp. OED.S20960 ◽  
Author(s):  
Kyriakoula Merakou ◽  
Georgia Varouxi ◽  
Anastasia Barbouni ◽  
Eleni Antoniadou ◽  
Georgios Karageorgos ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Cataract Surgery ◽  
Coping Skills ◽  
Diastolic Pressure ◽  
Intervention Group ◽  
Systolic Pressure ◽  
Control Group ◽  
Stress Coping

Introduction Music has been proposed as a safe, inexpensive, nonpharmacological antistress intervention. The purpose of this study was to determine whether patients undergoing cataract surgery while listening to meditation music experience lower levels of blood pressure and heart rate. Methods Two hundred individuals undergoing cataract surgery participated in the study. Hundred individuals listened to meditation music, through headphones, before and during the operation (intervention group) and 100 individuals received standard care (control group). Patients stress coping skills were measured by the Sense of Coherence Scale (SOC Scale). Systolic and diastolic blood pressure and heart rate were defined as outcome measures. Results According to the SOC Scale, both groups had similar stress coping skills (mean score: 127.6 for the intervention group and 127.3 for the control group). Before entering the operating room (OR) as well as during surgery the rise in systolic and diastolic pressures was significantly lower in the intervention group ( P < 0.001). Among patients receiving antihypertensive therapy, those in the intervention group presented a lower increase only in systolic pressure ( P < 0.001) at both time recordings. For those patients in the intervention group who did not receive antihypertensive treatment, lower systolic blood pressure at both time recordings was recorded ( P < 0.001) while lower diastolic pressure was observed only during entry to the OR ( P = 0.021). Heart rate was not altered between the two groups in any of the recordings. Conclusions Meditation music influenced patients' preoperative stress with regard to systolic blood pressure. This kind of music can be used as an alternative or complementary method for blood pressure stabilizing in patients undergoing cataract surgery.

Abstract 284: A Pilot Study Comparing Two Ambulatory Blood Pressure Monitors Worn at the Same Time

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Radhakrishna R Kallem ◽  
Kevin Meyers ◽  
Deirdre Sawinski ◽  
Raymond R Townsend
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Diastolic Pressure ◽  
Blood Pressure Monitoring ◽  
Demographic Data ◽  
Systolic Pressure ◽  
University Of Pennsylvania ◽  
Public Health Importance ◽  
Blood Pressures ◽  
The University

Introduction Ambulatory blood pressure monitoring (ABPM) has been proposed as the most effective way to characterize a person’s BP profile. However, there are very limited data in the literature comparing two simultaneously worn ABPM devices. Therefore, we compared an eight hour daytime simultaneous ABPM using two monitors (Mobil-O-Graph [I.E.M., Stolberg, Germany] and Spacelabs 90207 [Spacelabs Medical, Issequah, WA]). Methods Simultaneous BP and heart rate data were measured on 13 adult volunteers at the University of Pennsylvania using the two monitors over an 8 hour period. Other demographic data were also collected. Standard seated BPs were obtained in triplicate at the beginning and end of the 8 hour monitoring period using an Accutor (Datascope, Mahwah, NJ) device. Three blood pressures were obtained at 1 minute intervals, recorded and averaged for each arm using the Accutor device. Results The data show high concordance of measured mean arterial pressures (Mobil-O-Graph 101.4 [SEM-2.0] mmHg, Spacelabs 100.6 [SEM-2.4] mmHg) and heart rates (Mobil-O-Graph measuring 82.4 [ SEM- 4.1] beats/minute, Spacelabs 81.7 [4.0] beats/minute) between the monitors. Spacelabs measured a 10 mmHg higher systolic pressure (p=0.0016) and a non-statistically significant, but numerically higher (2.8 mmHg) diastolic pressure (Figure 1). Conclusion The systolic BP difference between the two devices has public health importance. These differences if confirmed in larger cohorts, ABPM manufacturers should consider developing a normative database to help practitioners interpret ABPM data obtained with their device.

Twenty-four–hour Ambulatory Blood Pressure in Children with Sleep-disordered Breathing

2004 ◽  
Vol 169 (8) ◽  
pp. 950-956 ◽  
Author(s):  
Raouf S. Amin ◽  
John L. Carroll ◽  
Jenny L. Jeffries ◽  
Charles Grone ◽  
Judy A. Bean ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Sleep Disordered Breathing ◽  
Disordered Breathing

scholarly journals A new odissey for the clinical cardiologist: the difficult application of arterial hypertension guidelines in patients with chronic coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Cosmi ◽  
B Mariottoni ◽  
F Cosmi
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Systolic Blood Pressure ◽  
Diastolic Pressure ◽  
Age Groups ◽  
Systolic Pressure ◽  
Secondary Hypertension ◽  
Coronary Syndrome ◽  
Hypertension Guidelines ◽  
Asymptomatic Patients

Abstract Introduction In hypertensive patients with chronic coronary syndrome (CCS), the 2018 European Society of Cardiology (ESC) arterial hypertension guidelines recommend target pressure ranges that can be difficult to apply, leading to possible medico-legal and other not insignificant problems. Methods In 2019 we evaluated blood pressure values measured according to the ESC 2018 recommendations in 2,456 patients. We focused on 505 asymptomatic patients with CCS, already undergoing antihypertensive drug treatment. Patients with secondary hypertension, heart failure, atrial fibrillation, malignancies or life expectancy &lt;1 year were excluded. We analyzed the incidence of high systolic pressure coexisting with diastolic pressure lower than the indicated target and the incidence of blood pressure below the targets indicated in asymptomatic patients in the various age groups considered. Results In 24% of patients aged ≥80 years we found an office systolic blood pressure ≥140 mmHg together with a diastolic &lt;70 mmHg, confirmed at the 2- and 4-week control. These values were also recorded in 18% of patients aged 65–79 years and in 5% of those aged 18–65 years. In asymptomatic patients aged 18–65 years old we found a systolic blood pressure &lt;120 mmHg (considered not safe in the guidelines) in 4% of cases; SBP was &lt;130 mmHg in 14% of patients aged 65–79 years and in 7% of those aged ≥80 years (considered not safe in the guidelines in these age group) (See table 1). Conclusions The daily application of the ESC 2018 guidelines is challenging, due to contradictory suggestions (is it necessary to reduce a high systolic pressure ≥140 mmHg in the presence of a diastolic below the level considered dangerous &lt;70 mmHg?; in an asymptomatic patient should therapy be reduced or suspended if blood pressure levels are not within the range considered optimal and safe?). This problem does not occur in American and NICE guidelines. We think that this topic should be largely reconsidered; guidelines writers should ask themselves these questions in order not to make hypertension treatment difficult or arbitrary. Funding Acknowledgement Type of funding source: None

scholarly journals Prognostic value of ambulatory blood pressure in chronic kidney disease

2018 ◽  
Vol 5 (6) ◽  
pp. 1337
Author(s):  
S. Senthil Kumar ◽  
S. Vithiavathi ◽  
P. Parameswaran
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Ambulatory Blood Pressure ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Vascular Complications ◽  
Early Morning ◽  
Nocturnal Hypertension ◽  
The Mean

Background: Hypertension control is essential to prevent macro vascular complications in patients with chronic kidney disease. Ambulatory Blood Pressure Monitoring (ABPM) is the recognized gold standard for the assessment of hypertension and hence in this study ABPM assessment was done in 50 patients with dialysis dependant CKD to evaluate the adequacy of BP control and prevent adverse events.Methods: This study is a prospective observational study conducted at Aarupadai Veedu Medical College and Hospital, Pondicherry among hypertensive patients with dialysis dependant CKD patients as per standard criteria. A total of 50 patients participated in this study of both gender after obtaining written consent. Patients with coronary artery disease, diabetes mellitus, acute kidney injury were excluded from this study.Results: Out of the total 50 patients included in this study 72% had early morning dipping in BP and remaining 28% had non-dipping in systolic and diastolic pressure. The mean systolic pressure reached a maximum of 160.95mmHg to a minimum of 113.38mmHg and the mean diastolic pressure with a maximum of 98.47 to a minimum of 62.71mmHg on an overall 24 hours ABPM monitoring. The mean systolic and diastolic pressure was found to be more in the active period than in the passive period.Conclusions: Nocturnal BP is superior to day time BP in predicting CVD outcomes. This study shows both systolic and diastolic pressure variability over 24hrs maximum during night hours (nocturnal hypertension) and non-dipping of early morning BP. Both non-dipping status and nocturnal hypertension are associated with target organ damage and CV risk.

scholarly journals The Effect of Acupuncture on Blood Pressure in Hypertensive Patients Treated in a Complementary Medicine Clinic

2007 ◽  
Vol 2 ◽  
pp. 117863370700200 ◽  
Author(s):  
Nirit Weil ◽  
Michael Friger ◽  
Yan Press ◽  
Dror Tal ◽  
Tammy Soffer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Complementary Medicine ◽  
Diastolic Pressure ◽  
Experimental Studies ◽  
Systolic Pressure ◽  
Study Groups ◽  
Major Health Problem ◽  
Hypertensive Patients ◽  
Medicine Clinic

Background Hypertension is a major health problem with serious medical and financial consequences. Experimental studies in animals and clinical studies in humans have demonstrated that acupuncture can reduce blood pressure significantly in hypertensive patients. The objective was to assess the effect of acupuncture on blood pressure in hypertensive patients treated at a complementary medicine clinic. Methods Blood pressure values measured before and following acupuncture were recorded from the charts of hypertensive patients who came to the clinic for treatment of other problems. The therapy used was the Kiiko Matsumoto technique for blood pressure imbalance. Results Twenty-nine patients were studied (18 [62%] women). The mean age was 58.5 ± 16.3 years. Systolic blood pressure dropped significantly as a result of the treatment and there was a non-significant trend to reduced diastolic pressure. Weekly acupuncture therapy led to a continuous reduction in systolic blood pressure. Conclusions Acupuncture has a beneficial effect on hypertension, particularly on systolic pressure. Further studies with larger study groups for longer periods of time can confirm this observation and contribute to our understanding of combination therapy with acupuncture and conventional medications for hypertension.

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