Rapid Systolic Blood Pressure Changes After Standing Up Associate With Impaired Physical Performance in Geriatric Outpatients

Background: Orthostatic hypotension (OH) and impaired OH recovery derived from beat-to-beat blood pressure (BP) measurements are associated with detrimental clinical outcome, but the clinical relevance of OH recovery assessed using the widely available sphygmomanometer is still unclear. Method: 635 geriatric outpatients underwent comprehensive geriatric assessment, including orthostatic BP measurements using a sphygmomanometer, during supine rest and 1 and 3 min after standing up and assessment of physical performance (i.e., the timed up and go test and the Short Physical Performance Battery) and the number of falls in the past year. The association between BP recovery, defined as BP at 3 min minus BP at 1 min after standing up, with physical performance and falls was assessed using regression analyses, adjusting for age and sex, both in the entire cohort and after stratifying for the presence of OH at 1 min after standing up. Results: BP recovery was not associated with physical performance or number of falls, neither in the entire cohort, nor in subpopulations with or without OH. Conclusion: The clinical relevance of BP recovery between 1 and 3 min after standing up could not be demonstrated. The results suggest that sphygmomanometer measurements have an inadequate time resolution to record the clinically relevant dynamics of orthostatic BP recovery.

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Association between ibrutinib treatment and hypertension

Heart ◽

10.1136/heartjnl-2021-319110 ◽

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.

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

Clínica Veterinária ◽

10.46958/rcv.2017.xxii.n.130.p.60-70 ◽

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.

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

Innovation in Aging ◽

10.1093/geroni/igz038.2519 ◽

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 < 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 < 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.

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

Journal of Applied Physiology ◽

10.1152/jappl.1997.83.2.371 ◽

1997 ◽

Vol 83 (2) ◽

pp. 371-375 ◽

Cited By ~ 6

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.

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Relationship Between Orthostatic Blood Pressure Changes and Postural Sway When Standing up from a Chair in Older Adult Females

International Journal of Gerontology ◽

10.1016/j.ijge.2012.01.011 ◽

2012 ◽

Vol 6 (3) ◽

pp. 182-186 ◽

Cited By ~ 7

Author(s):

Jun Murata ◽

Shin Murata ◽

Jun Horie ◽

Hiroshi Ohtao ◽

Junya Miyazaki

Keyword(s):

Blood Pressure ◽

Older Adult ◽

Postural Sway ◽

Adult Females ◽

Orthostatic Blood Pressure ◽

Standing Up ◽

Pressure Changes

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Relationship between blood pressure and physical performance

HIGHER SCHOOL’S PULSE ◽

10.5604/01.3001.0003.3173 ◽

2014 ◽

Vol 8 (4) ◽

pp. 9-13 ◽

Cited By ~ 1

Author(s):

Karol Pilis ◽

Anna Pilis ◽

Krzysztof Stec ◽

Wiesław Pilis ◽

Michał Zych ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Physical Performance ◽

Body Height ◽

Circulatory System ◽

Soccer Players ◽

Rate Pressure Product ◽

Exercise Time ◽

Higher Power ◽

The Mean

Background: Changes in blood pressure during subjects’ exercise are individually different. The reasons of these differences are unknown. Aim of the study: The aim of this paper is to investigate the rate of changes in cardiovascular system at rest and at physical load which enhance systolic blood pressure (SBP) = 200 mmHg in people with different physical performance. Material and methods: The studies included 18 soccer players and 14 students who do not practice any sport, whose age, body mass, body height and BMI have been similar, and who at baseline were measured systolic blood pressure (SBPr), diastolic blood pressure (DBPr) and heart rate (HRr). Then, the subjects performed exercise on a cycloergometer with increasing intensity in which at the level of the systolic blood pressure = 200 mm Hg (SBP200) were measured DBP200 and HR200. In terms of resting and exercise time the size of the mean arterial pressure (MAPr, MAP200), pulse pressure (PPr, PP200) and rate-pressure product (DPr, DP200) were calculated. Moreover the power achieved in PWC170 test (W and W/kg) and maximal oxygen uptake (VO2max) (ml/min and ml/min/kg) were also calculated. Results: Soccer players have reached a higher power in PWC170 and higher VO2max and lower HR200 and DP200 (p<0,001), as well as lower values of HRr (p<0,01) than students however SBP, DBP, MAP and PP registered during rest and during exercise did not differ between the groups. Among the players power reached at PWC170 (W) correlate negatively with DP200 – (p<0,05) and VO2max (ml/min; ml/min/kg) also correlated negatively with HRr (p<0,05, p<0,01). Among students power reached at PWC170 (W, W/kg) and VO2max (ml/min, ml/min/kg) correlate negatively with HR200 and DP200. Moreover VO2max (ml/min/kg) correlate negatively with HRr. Conclusions: Studies have shown that, despite differences in physical performance of both groups, there were no significant changes in blood pressure at rest or modified during exercise. However, at extremely high increase in SBP improved economization in function of the heart and circulatory system independent of the size of physical performance of the subjects were observed.

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