Age, Blood Pressure, and Vessel Diameter as Factors Influencing the Arterial Retinal Flicker Response

Abstract Objective A comprehensive understanding of the factors contributing to perinatal blood pressure is vital to ensure optimal postnatal hemodynamic support. The objective of this study was to review existing literature on maternal and perinatal factors influencing blood pressure in neonates up to 3 months corrected age. Methods A systematic search of published literature in OVID Medline, OVID Embase and the COCHRANE library identified publications relating to maternal factors affecting blood pressure of neonates up to corrected age of 3 months. Summary data were extracted and compared (PROSPERO CRD42018092886). Results Of the 3683 non-duplicate publications identified, 44 were eligible for inclusion in this review. Topics elicited were sociodemographic factors, maternal health status, medications, smoking during pregnancy, and cord management at birth. Limited data were available for each factor. Results regarding the impact of these factors on neonatal blood pressure were inconsistent across studies. Conclusions There is insufficient evidence to draw definitive conclusions regarding the impact of various maternal and perinatal factors on neonatal blood pressure. Future investigations of neonatal cardiovascular therapies should account for these factors in their study design. Similarly, studies on maternal diseases and perinatal interventions should include neonatal blood pressure as part of their primary or secondary analyses.

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Factors influencing the accuracy of oscillometric blood pressure measurement in critically ill patients

Critical Care Medicine ◽

10.1097/01.ccm.0000053650.12025.1a ◽

2003 ◽

Vol 31 (3) ◽

pp. 793-799 ◽

Cited By ~ 74

Author(s):

Andreas Bur ◽

Harald Herkner ◽

Marianne Vlcek ◽

Christian Woisetschläger ◽

Ulla Derhaschnig ◽

...

Keyword(s):

Blood Pressure ◽

Critically Ill ◽

Critically Ill Patients ◽

Pressure Measurement ◽

Blood Pressure Measurement ◽

Factors Influencing ◽

Oscillometric Blood Pressure Measurement

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The factors influencing on blood pressure during exercise.

SANGYO EISEIGAKU ZASSHI ◽

10.1539/sangyoeisei.kj00001990413 ◽

1998 ◽

Vol 40 (Special) ◽

pp. 592

Author(s):

J. Goji

Keyword(s):

Blood Pressure ◽

Factors Influencing

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Blood Pressure and Orthostatic Hypotension: Faints, Near-Faints, and Lightheadedness

Dementia with Lewy Body and Parkinson's Disease Patients ◽

10.1093/oso/9780199977567.003.0022 ◽

2013 ◽

Author(s):

J. Eric Ahlskog

Keyword(s):

Blood Pressure ◽

Nervous System ◽

Autonomic Nervous System ◽

Orthostatic Hypotension ◽

Vessel Diameter ◽

Upright Position ◽

Grocery Store ◽

The Body ◽

Autonomic Nervous ◽

Neurodegenerative Process

Case example: Mrs. H. feels lightheaded intermittently during the day. This happens exclusively when she is up and about. Sometimes she notes graying of vision with these episodes. The feeling is not spinning (i.e., not vertigo). She has fainted twice when standing in line at the grocery store. If she sits, she feels much better. It is worse in the morning but may recur any time of the day. She feels fine while lying in bed at night. Older adults often worry about high blood pressure (BP), yet the opposite problem, low BP, is common among those with DLB or PDD. This is because the Lewy neurodegenerative process impairs the autonomic nervous system. The specific condition that may afflict those with DLB or PDD is orthostatic hypotension. The term orthostatic implies the upright position (i.e., standing); hypotension translates into low BP. Thus, the low BP occurring in these Lewy disorders develops in the upright position; conversely, it is normal or even high when lying down. When standing or walking, the BP may drop so low that fainting occurs. Among people with orthostatic hypotension, the BP is normal when sitting, although in severe cases, even the sitting BP is low. Whereas most people with DLB or PDD do not experience symptoms of orthostatic hypotension, it is sufficiently frequent to deserve attention. It often goes undiagnosed, even when fainting occurs. Unrecognized orthostatic hypotension may limit activities and impair the person’s quality of life. The first half of this chapter provides further background, with focus on BP measurement and recognition of orthostatic hypotension. The last half addresses treatment. The normal autonomic nervous system senses the position of our body with respect to the pull of gravity. It is able to reflexively counter gravity’s downward pull on the blood volume when standing (gravity tends to draw blood toward our feet when standing). An important mechanism for countering gravity’s pull is the constriction of blood vessel diameter in the lower half of the body. These vessels reflexively constrict during standing, in effect forcing blood up to the brain. The autonomic nervous system mediates these and other reflexive changes to stabilize BP.

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Associations of Retinal Microvascular Diameters and Tortuosity With Blood Pressure and Arterial Stiffness

Hypertension ◽

10.1161/hypertensionaha.119.13752 ◽

2019 ◽

Vol 74 (6) ◽

pp. 1383-1390 ◽

Cited By ~ 6

Author(s):

Robyn J. Tapp ◽

Christopher G. Owen ◽

Sarah A. Barman ◽

Roshan A. Welikala ◽

Paul J. Foster ◽

...

Keyword(s):

Blood Pressure ◽

United Kingdom ◽

Mean Arterial Pressure ◽

Arterial Stiffness ◽

Arterial Pressure ◽

Retinal Vessel ◽

Vessel Diameter ◽

Automated Image Analysis ◽

Stiffness Index ◽

Arterial Stiffness Index

To examine the baseline associations of retinal vessel morphometry with blood pressure (BP) and arterial stiffness in United Kingdom Biobank. The United Kingdom Biobank included 68 550 participants aged 40 to 69 years who underwent nonmydriatic retinal imaging, BP, and arterial stiffness index assessment. A fully automated image analysis program (QUARTZ [Quantitative Analysis of Retinal Vessel Topology and Size]) provided measures of retinal vessel diameter and tortuosity. The associations between retinal vessel morphology and cardiovascular disease risk factors/outcomes were examined using multilevel linear regression to provide absolute differences in vessel diameter and percentage differences in tortuosity (allowing within person clustering), adjusted for age, sex, ethnicity, clinic, body mass index, smoking, and deprivation index. Greater arteriolar tortuosity was associated with higher systolic BP (relative increase, 1.2%; 95% CI, 0.9; 1.4% per 10 mmHg), higher mean arterial pressure, 1.3%; 0.9, 1.7% per 10 mmHg, and higher pulse pressure (PP, 1.8%; 1.4; 2.2% per 10 mmHg). Narrower arterioles were associated with higher systolic BP (−0.9 µm; −0.94, −0.87 µm per 10 mmHg), mean arterial pressure (−1.5 µm; −1.5, −1.5 µm per 10 mmHg), PP (−0.7 µm; −0.8, −0.7 µm per 10 mmHg), and arterial stiffness index (−0.12 µm; −0.14, −0.09 µm per ms/m 2 ). Associations were in the same direction but marginally weaker for venular tortuosity and diameter. This study assessing the retinal microvasculature at scale has shown clear associations between retinal vessel morphometry, BP, and arterial stiffness index. These observations further our understanding of the preclinical disease processes and interplay between microvascular and macrovascular disease.

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