Association between ibrutinib treatment and hypertension

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319110
Author(s):  
Dae Hyun Lee ◽  
Fahad Hawk ◽  
Kieun Seok ◽  
Matthew Gliksman ◽  
Josephine Emole ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Repeated Measures ◽  
Treatment Initiation ◽  
Kinase Inhibitor ◽  
Pressure Change ◽  
Exact Test ◽  
N 93 ◽  
Pressure Changes ◽  
Over Time

BackgroundIbrutinib is a tyrosine kinase inhibitor most commonly associated with atrial fibrillation. However, additional cardiotoxicities have been identified, including accelerated hypertension. The incidence and risk factors of new or worsening hypertension following ibrutinib treatment are not as well known.MethodsWe conducted a retrospective study of 144 patients diagnosed with B cell malignancies treated with ibrutinib (n=93) versus conventional chemoimmunotherapy (n=51) and evaluated their effects on blood pressure at 1, 2, 3 and 6 months after treatment initiation. Descriptive statistics were used to compare baseline characteristics for each treatment group. Fisher’s exact test was used to identify covariates significantly associated with the development of hypertension. Repeated measures analyses were conducted to analyse longitudinal blood pressure changes.ResultsBoth treatments had similar prevalence of baseline hypertension at 63.4% and 66.7%, respectively. There were no differences between treatments by age, sex and baseline cardiac comorbidities. Both systolic and diastolic blood pressure significantly increased over time with ibrutinib compared with baseline, whereas conventional chemoimmunotherapy was not associated with significant changes in blood pressure. Baseline hypertensive status did not affect the degree of blood pressure change over time. A significant increase in systolic blood pressure (defined as more than 10 mm Hg) was noted for ibrutinib (36.6%) compared with conventional chemoimmunotherapy (7.9%) at 1 month after treatment initiation. Despite being hypertensive at follow-up, 61.2% of patients who were treated with ibrutinib did not receive adequate blood pressure management (increase or addition of blood pressure medications). Within the ibrutinib group, of patients who developed more than 20 mm Hg increase in systolic blood pressure, only 52.9% had hypertension management changes.ConclusionsIbrutinib is associated with the development of hypertension and worsening of blood pressure. Cardiologists and oncologists must be aware of this cardiotoxicity to allow timely management of blood pressure elevations.

scholarly journals Variation of blood pressure during change of posture

2019 ◽  
Vol 51 (1-2) ◽  
pp. 16-20
Author(s):  
Md Nazrul Islam ◽  
SK Kamal ◽  
Md Sirajul Islam ◽  
Sk Amir Hossain
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Repeated Measures ◽  
Body Position ◽  
Standing Position ◽  
Specific Pattern ◽  
Healthy Adult Male ◽  
Pressure Changes ◽  
Post Hoc

Background: Many factors can influence blood pressure, one of which is body position. The aim of present study was to establish a specific pattern of blood pressure (BP) changes in accordance with posture changes in healthy adults. Objective: Aim of present study was to establish a specific pattern of blood pressure (BP) changes in accordance with posture changes in healthy adult male and females. Methods: Blood pressure was recorded by aneroid sphygmomanometer in supine, sitting and standing posture on both arms. Mean ± standard deviation of the observation for all the parameters were calculated and comparison in supine, sitting and standing position was done by repeated measures Analysis was done by ANOVA test and tukey's post hoc test. Results: Fifty healthy males and fifty healthy female took part in this study. BP varies according to body position. Both Systolic blood pressure and diastolic blood pressure was significantly decreased (P<0.05) while changing posture from supine to standing. But blood pressure changes during change of posture from supine to sitting or from sitting to standing was not significant (P>0.05). Conclusions: Change in body posture changes systolic blood pressure as well as diastolic blood pressure. Bang Med J (Khulna) 2018; 51 : 16-20

Heart Rate Signal Decomposition

2000 ◽  
Vol 39 (02) ◽  
pp. 200-203
Author(s):  
H. Mizuta ◽  
K. Yana
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Pressure Change ◽  
Normal Subjects ◽  
Signal Decomposition ◽  
Large Individual ◽  
Heart Rate Fluctuations ◽  
Type Pattern ◽  
Signal Cancellation ◽  
Pressure Changes

Abstract:This paper proposes a method for decomposing heart rate fluctuations into background, respiratory and blood pressure oriented fluctuations. A signal cancellation scheme using the adaptive RLS algorithm has been introduced for canceling respiration and blood pressure oriented changes in the heart rate fluctuations. The computer simulation confirmed the validity of the proposed method. Then, heart rate fluctuations, instantaneous lung volume and blood pressure changes are simultaneously recorded from eight normal subjects aged 20-24 years. It was shown that after signal decomposition, the power spectrum of the heart rate showed a consistent monotonic 1/fa type pattern. The proposed method enables a clear interpretation of heart rate spectrum removing uncertain large individual variations due to the respiration and blood pressure change.

Abstract 14652: Systolic Blood Pressure Trajectories and Cardiovascular Outcomes in SPRINT

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Charles A German ◽  
Tali Elfassy ◽  
Matthew J Singleton ◽  
Carlos J Rodriguez ◽  
Walter T Ambrosius ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Latent Class ◽  
Stable Group ◽  
Coronary Syndrome ◽  
Average Blood Pressure ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Over Time

Introduction: Blood pressure trajectories have been associated with cardiovascular disease (CVD) in observational studies. It is unclear whether these associations are independent of average blood pressure over time. Methods: We used data from SPRINT to identify systolic blood pressure (SBP) trajectories among a cohort of 8901 participants by incorporating SBP measures during the first 12 months of the trial post randomization. Trajectories were identified using latent class based modeling. Study outcomes included incident CVD, defined as myocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure, or death attributable to CVD, and all-cause mortality. Cox proportional hazards models were used to evaluate associations between SBP trajectories and our outcomes of interest. Results: Four distinct SBP trajectories were identified: ‘low decline’ (40%), ‘high decline’ (6%), ‘low stable’ (48%), and ‘high stable’ (5%) (Figure 1). Relative to the low decline group, the low stable group was associated with a 29% increased risk of CVD (HR: 1.29, 95%CI: 1.06-1.57) and the high stable group was associated with a 76% increased risk of all-cause mortality (HR: 1.76, 95%CI: 1.15-2.68) after baseline multivariable adjustment. Relative to the low stable group, the high stable group was associated with a 54% increased risk of all-cause mortality (HR: 1.54, 95%CI: 1.05-2.28). When adjusting for average blood pressure across the 12 month time period, there were no significant differences in outcomes. Conclusion: We identified 4 SBP trajectories using data from SPRINT and found differences in the risk of CVD and all-cause mortality after baseline adjustment. However, there were no differences in the risk of these outcomes after adjusting for average blood pressure over time. These results suggest that the pattern of blood pressure control may not be relevant as long as the target blood pressure is achieved.

Electrocardiographic and arterial pressure changes in female dogs subjected to epidural anesthesia with different doses of morphine

2017 ◽  
Vol XXII (130) ◽  
pp. 60-70
Author(s):  
Mariana Werneck Fonseca ◽  
Verônica Batista de Albuquerque ◽  
Gabriel T. N. Martins Ferreira ◽  
Marcelo Augusto de Araújo ◽  
Wagner Luis Ferreira ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Blood Lactate ◽  
Rectal Temperature ◽  
Epidural Anesthesia ◽  
Epidural Morphine ◽  
Pressure Changes ◽  
Different Doses

This article investigates the electrocardiographic and blood pressure changes caused by different doses of morphine administered epidurally to bitches undergoing elective ovariohysterectomy. Twenty-four healthy bitches weighing 9.8 ± 4.1 kg were assigned to three experimental groups (in each group, n = 8): (i) group M0.1: 0.1 mg/kg morphine; (ii) group M0.15: 0.15 mg/kg morphine; and (iii) group M0.2: 0.2 mg/kg morphine. In all groups, levobupivacaine was added to achieve a total volume of 0.33 mL/kg. During the procedures, the following parameters were controlled: heart rate and rhythm, systolic blood pressure, rectal temperature and blood lactate. The data were analyzed by means of statistical methods of analysis of variance, such as Kruskal-Wallis, Fisher and Tukey tests. Epidural morphine did not cause significant electrocardiographic or blood pressure changes in the tested doses, which makes the use of this drug a viable alternative for epidural anesthesia.

Abstract P084: Neighborhood Characteristics and Changes in Systolic Blood Pressure Over Time: The Multi-Ethnic Study of Atherosclerosis

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Paulina Kaiser ◽  
Lynda Lisabeth ◽  
Philippa Clarke ◽  
Sara Adar ◽  
Mahasin Mujahid ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Standard Deviation ◽  
Systolic Blood Pressure ◽  
Social Environment ◽  
Social Environments ◽  
Lower Baseline ◽  
Neighborhood Environments ◽  
Physical Activity Environments ◽  
Over Time

Introduction: Research on the association between neighborhood environments and systolic blood pressure (SBP) is limited, predominantly cross-sectional, and has produced mixed results. Investigating specific aspects of neighborhood environments in relation to changes in SBP may help to identify the most important interventions for reducing the population burden of hypertension. Hypothesis: Better neighborhood food, physical activity, and social environments will be associated with lower baseline levels of SBP and smaller increases in SBP over time. Methods: The Multi-Ethnic Study of Atherosclerosis recruited participants from six sites in the U.S., aged 45-84 (mean 59) and free of clinical cardiovascular disease at baseline. Those with non-missing data for key variables were included (N=5,997); the analytic sample was 52.5% female, 39.1% White, 27.3% Hispanic, 11.9% Black, and 21.7% Chinese, with median follow-up time of 9.2 years (IQR 4.5) and SBP measured at three or more exams for 91.3% of participants. SBP in subjects taking anti-hypertensive medication were replaced with multiply imputed estimates of unmedicated SBP, imputed at each exam. Summary measures of neighborhood food and physical activity environments incorporated survey-based scales (healthy food availability and walking environment) and GIS-based measures (density of favorable food stores and recreational resources). The summary measure of the social environment combined survey-based measures of social cohesion and safety. Neighborhoods were defined by a one-mile buffer around each participant’s home address. Linear mixed models were used to model associations of time-varying cumulative average neighborhood environmental summary measures with SBP over time, adjusting for individual-level covariates (demographics, individual- and neighborhood-level SES); models with and without adjustment for baseline SBP were used to evaluate associations of neighborhood environments with SBP trajectories. Results: In models mutually adjusted for all three neighborhood domains and covariates, living in a better physical activity environment was associated with lower SBP at baseline (-1.34 mmHg [95% CI: -2.24, -0.45] per standard deviation higher cumulative average physical activity summary score), while living in a better social environment was associated with higher SBP at baseline (1.00 mmHg [0.39, 1.63] per standard deviation higher); food environment scores were not associated with baseline SBP. After adjustment for baseline SBP, there was no association between any neighborhood environments and trajectories of SBP. Conclusions: Better food and physical activity environments were associated with lower baseline SBP, while better social environments were associated with higher baseline SBP. Neighborhood environments appear to have minimal direct effect on SBP trajectories.

Abstract P011: Cardiovascular Risk Factors and Longevity

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Michelle C Odden ◽  
Andreea Rawlings ◽  
Alice Arnold ◽  
Mary Cushman ◽  
Mary Lou Biggs ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Old Age ◽  
Repeated Measures ◽  
Ldl Cholesterol ◽  
Low Cardiovascular Risk

Introduction: Cardiovascular disease is the leading cause of mortality in old age, yet there is limited research on the patterns of cardiovascular risk factors that predict survival to 90 years. Hypothesis: The patterns of cardiovascular risk factors that portend longevity will differ from those that confer low cardiovascular risk. Methods: We examined repeated measures of blood pressure, LDL-cholesterol, and BMI from age 67 and survival to 90 years in the Cardiovascular Health Study (CHS). CHS is a prospective study of 5,888 black and white adults in two waves (1989-90 and 1992-93) from Medicare eligibility lists in four counties in the U.S. We restricted to participants aged 67 to 75 years at baseline to control for birth cohort effects and examined repeated measures of cardiovascular risk factors throughout the late-life course. We fit logistic regression models to predict survival to age 90 using generalized estimating equations, and modeled the risk factors as linear, a linear spline, and clinically relevant categories. Models were adjusted for demographics and medication use, and we also examined whether the association of each risk factor with longevity varied by the age of risk factor measurement. Best fit models are presented. Results: Among 3,645 participants in the birth cohort, 1,160 (31.8%) survived to 90 by June 16 th , 2015. Higher systolic blood pressure in early old age was associated with reduced odds for longevity, but there was an interaction with age such that the association crossed the null at 80 years. (Table) Among those with LDL-cholesterol <130 mg/dL, higher LDL-cholesterol was associated with greater longevity; at levels above 130 mg/dL there was no association between LDL-cholesterol and longevity. BMI had a u-shaped association with longevity. Conclusions: In summary, the patterns of risk factors that predict longevity differ from that considered to predict low cardiovascular risk. The risk of high systolic blood pressure appears to depend on the age of blood pressure measurement.

scholarly journals DOES GENDER INFLUENCE RISK FOR ORTHOSTATIC HYPOTENSION IN OLDER ADULTS WITH SARCOPENIA?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S682-S682
Author(s):  
Melissa J Benton ◽  
Amy L Silva-Smith ◽  
Jefferson M Spicher
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Systolic Blood Pressure ◽  
Orthostatic Hypotension ◽  
Lean Mass ◽  
Bioelectrical Impedance ◽  
Early Morning ◽  
Postural Changes ◽  
Before And After ◽  
Pressure Changes

Abstract Older adults with sarcopenia may be at risk for unstable postural blood pressure due to diminished lean mass that plays a role in maintaining fluid volume. Males have greater lean mass, so risk may be mediated by gender. We compared postural blood pressure changes in older men (77.1 ± 2.0 years; n = 15) and women (79.6 ± 2.0 years; n = 13) with sarcopenia before and after an overnight fast. Sarcopenia was defined using the Lean Mass Index (males ≤ 19.0 kg/m2; females ≤ 15.0 kg/m2). Body composition was measured using multi-frequency bioelectrical impedance, and blood pressure was measured lying, sitting, and standing. On Day 1 (normally hydrated) there were significant drops in systolic blood pressure, with an overall decrease of -9.1 ± 2.2 mmHg (p &lt; 0.001) between lying and standing. On Day 2 (overnight fast), postural changes were more profound, with an overall decrease of -14.1 ± 2.8 mmHg (p &lt; 0.001). However, when compared by gender, postural changes between lying and standing remained significant but did not differ between men and women (Day 1: men -8.9 ± 2.5 vs. women -9.3 ± 2.5 mmHg; Day 2: men -14.6 ± 4.6 vs. women -13.6 ± 3.1 mmHg). On both days diastolic blood pressure remained stable. In this group of older adults, significant decreases in postural systolic blood pressure were observed in the early morning fasted condition, increasing the risk for orthostatic hypotension (drop in systolic blood pressure -20.0 mmHg). Interestingly, gender did not influence risk.

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.

Sign in / Sign up

Export Citation Format

Share Document