Cognitive Dysfunction and Greater Visit-to-Visit Systolic Blood Pressure Variability

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.

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Correction: Prognostic impact of systolic blood pressure variability in people with diabetes

PLoS ONE ◽

10.1371/journal.pone.0224538 ◽

2019 ◽

Vol 14 (10) ◽

pp. e0224538

Author(s):

Katy J. L. Bell ◽

Lamiae Azizi ◽

Peter M. Nilsson ◽

Andrew Hayen ◽

Les Irwig ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Blood Pressure Variability ◽

Prognostic Impact ◽

Systolic Blood Pressure Variability

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Nighttime blood pressure, systolic blood pressure variability, and left ventricular mass index in children with hypertension

Pediatric Nephrology ◽

10.1007/s00467-013-2468-x ◽

2013 ◽

Vol 28 (8) ◽

pp. 1275-1282 ◽

Cited By ~ 39

Author(s):

Ajay P. Sharma ◽

Javed Mohammed ◽

Benson Thomas ◽

Nathan Lansdell ◽

Kambiz Norozi ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Left Ventricular Mass ◽

Blood Pressure Variability ◽

Left Ventricular Mass Index ◽

Left Ventricular ◽

Ventricular Mass Index ◽

Ventricular Mass ◽

Nighttime Blood Pressure ◽

Systolic Blood Pressure Variability

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Feedback effects of circulating norepinephrine on sympathetic outflow in healthy subjects

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00540.2004 ◽

2005 ◽

Vol 288 (2) ◽

pp. H710-H715 ◽

Cited By ~ 16

Author(s):

Mikko P. Tulppo ◽

Heikki V. Huikuri ◽

Elli Tutungi ◽

Derek S. Kimmerly ◽

Adrian W. Gelb ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Sympathetic Activity ◽

Healthy Subjects ◽

Blood Pressure Variability ◽

Feedback Inhibition ◽

Adrenergic Blockade ◽

Sympathetic Outflow ◽

Systolic Blood Pressure Variability ◽

Normalized Units

The amplitude of low-frequency (LF) oscillations of heart rate (HR) usually reflects the magnitude of sympathetic activity, but during some conditions, e.g., physical exercise, high sympathetic activity results in a paradoxical decrease of LF oscillations of HR. We tested the hypothesis that this phenomenon may result from a feedback inhibition of sympathetic outflow caused by circulating norepinephrine (NE). A physiological dose of NE (100 ng·kg−1·min−1) was infused into eight healthy subjects, and infusion was continued after α-adrenergic blockade [with phentolamine (Phe)]. Muscle sympathetic nervous activity (MSNA) from the peroneal nerve, LF (0.04–0.15 Hz) and high frequency (HF; 0.15–0.40 Hz) spectral components of HR variability, and systolic blood pressure variability were analyzed at baseline, during NE infusion, and during NE infusion after Phe administration. The NE infusion increased the mean blood pressure and decreased the average HR ( P < 0.01 for both). MSNA (10 ± 2 vs. 2 ± 1 bursts/min, P < 0.01), LF oscillations of HR (43 ± 13 vs. 35 ± 13 normalized units, P < 0.05), and systolic blood pressure (3.1 ± 2.3 vs. 2.0 ± 1.1 mmHg2, P < 0.05) decreased significantly during the NE infusion. During the NE infusion after PHE, average HR and mean blood pressure returned to baseline levels. However, MSNA (4 ± 2 bursts/min), LF power of HR (33 ± 9 normalized units), and systolic blood pressure variability (1.7 ± 1.1 mmHg2) remained significantly ( P < 0.05 for all) below baseline values. Baroreflex gain did not change significantly during the interventions. Elevated levels of circulating NE cause a feedback inhibition on sympathetic outflow in healthy subjects. These inhibitory effects do not seem to be mediated by pressor effects on the baroreflex loop but perhaps by a presynaptic autoregulatory feedback mechanism or some other mechanism that is not prevented by a nonselective α-adrenergic blockade.

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Diurnal systolic blood pressure variability is the strongest predictor of early carotid atherosclerosis

Neurology ◽

10.1212/wnl.47.2.500 ◽

1996 ◽

Vol 47 (2) ◽

pp. 500-507 ◽

Cited By ~ 41

Author(s):

D. Sander ◽

J. Klingelhofer

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Blood Pressure Variability ◽

Carotid Atherosclerosis ◽

Systolic Blood Pressure Variability

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Learned Control of Heart Rate and Blood Pressure

Perceptual and Motor Skills ◽

10.2466/pms.1971.33.1.219 ◽

1971 ◽

Vol 33 (1) ◽

pp. 219-226 ◽

Cited By ~ 5

Author(s):

Michael Hnatiow

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Systolic Blood Pressure ◽

Blood Pressure Variability ◽

Visual Display ◽

Waveform Analysis ◽

Target Range ◽

Heart Rates ◽

Systolic Blood Pressure Variability ◽

Continuous Measures

Cardiac rate-variability control and an initial demonstration of systolic blood-pressure variability control using visual feedback of physiological information were examined. Continuous measures of respiration, heart rate, EXG waveform analysis, and systolic blood pressure were obtained for both experimental groups and for yoked controls who saw the same visual display as the experimental Ss. Ss successful at reducing heart-rate variability showed clear changes in the P-R wave relationships of the EKG, indicating possible direct attempts to manipulate heart rate so as to reduce variability. Ss controlling blood-pressure variability who had high heart rates were more successful in reducing variability than those with low rates, possibly because of differential feedback to Ss with high and low heart rates. In addition, apparently as a reaction to E's adjustment of the visual target range, experimental Ss showed decreases in mean blood-pressure levels.

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Abstract MP33: Association Between Neurologic Outcomes and Temporal Profile of Systolic Blood Pressure Variability After Endovascular Thrombectomy

Stroke ◽

10.1161/str.52.suppl_1.mp33 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Ayush Prasad ◽

Jessica Kobsa ◽

Sreeja Kodali ◽

Cindy Khanh Nguyen ◽

Darko Quispe Orozco ◽

...

Keyword(s):

Blood Pressure ◽

Standard Deviation ◽

Systolic Blood Pressure ◽

Functional Outcome ◽

Blood Pressure Variability ◽

Treatment Strategies ◽

Vessel Occlusion ◽

Endovascular Thrombectomy ◽

Increased Risk ◽

Systolic Blood Pressure Variability

Introduction: Higher systolic blood pressure variability (BPV) after endovascular thrombectomy (EVT) has been associated with an increased risk of hemorrhagic transformation and worse functional outcomes. However, the time-varying behavior of BPV after EVT and its effects on functional outcome have not been well characterized. Methods: We analyzed data from an international cohort of patients with acute large-vessel occlusion stroke who underwent EVT at 11 centers across North America, Europe, and Asia. Repeated time-stamped blood pressure data were recorded for the first 72 hours after thrombectomy. Parameters of BPV were calculated in 12-hour epochs using five established methodologies: standard deviation (SD), coefficient of variation (CV), average real variability (ARV), successive variation (SV), and residual SD (rSD). Patients’ overall mean BPV was then used to assign patients into tertiles for regression analysis: low BPV, intermediate BPV, and high BPV. Functional outcome was measured with the modified Rankin Scale (mRS) at 90 days. Results: Of the 1,791 patients (age 69 ± 14, NIHSS 15 ± 6) included in our analysis, 1,085 (60.6%) had a poor 90-day outcome (mRS >3). Patients with poor outcome had significantly higher systolic BPV (p<0.05) measured as standard deviation (SBP SD) at each epoch (Figure 1B). Compared to patients with low BPV, those in the highest tertile group had significantly greater odds of a poor functional outcome after adjusting for age, sex, hypertension, NIHSS, ASPECT, tPA, time to reperfusion, and TICI score (OR 1.5; 95% CI 1.2-2; p=0.001). Patients in the highest tertile of BPV demonstrated time-dependent variability with the highest SBP SD during the first 24 hours after thrombectomy (Figure 1A). Conclusions: Higher BPV measured by SBP SD appears to be associated with poor 90-day outcome in EVT-treated stroke patients. Early treatment strategies targeting early high BPV warrant further prospective investigation.

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