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Sample records for blood pressure variability

  1. [Hypertensive urgency or high blood pressure variability?

    PubMed

    Rodionov, A V

    2017-01-01

    Hypertensive urgency (HU) is a common reason particularly for elderly patients to seek medical advice. Severe asymptomatic hypertension and situational high blood pressure (BP) in patients with its high variability is frequently taken as HU. The use of short-acting antihypertensive drugs is not only indicated in these situations, but it may also increase the risk of cardiovascular events (CVE). Over the past decade, increased BP variability is an independent predictor for a higher risk of CVE. Among the major groups of antihypertensive drugs, there are calcium antagonists, mainly amlodipine, which has the greatest potential to reduce BP variability. Thus, calcium antagonists can be considered as first-line drugs for patients with high BP variability.

  2. Dysglycemia induces abnormal circadian blood pressure variability

    PubMed Central

    2011-01-01

    Background Prediabetes (PreDM) in asymptomatic adults is associated with abnormal circadian blood pressure variability (abnormal CBPV). Hypothesis Systemic inflammation and glycemia influence circadian blood pressure variability. Methods Dahl salt-sensitive (S) rats (n = 19) after weaning were fed either an American (AD) or a standard (SD) diet. The AD (high-glycemic-index, high-fat) simulated customary human diet, provided daily overabundant calories which over time lead to body weight gain. The SD (low-glycemic-index, low-fat) mirrored desirable balanced human diet for maintaining body weight. Body weight and serum concentrations for fasting glucose (FG), adipokines (leptin and adiponectin), and proinflammatory cytokines [monocyte chemoattractant protein-1 (MCP-1) and tumor necrosis factor-α (TNF-α)] were measured. Rats were surgically implanted with C40 transmitters and blood pressure (BP-both systolic; SBP and diastolic; DBP) and heart rate (HR) were recorded by telemetry every 5 minutes during both sleep (day) and active (night) periods. Pulse pressure (PP) was calculated (PP = SBP-DBP). Results [mean(SEM)]: The AD fed group displayed significant increase in body weight (after 90 days; p < 0.01). Fasting glucose, adipokine (leptin and adiponectin) concentrations significantly increased (at 90 and 172 days; all p < 0.05), along with a trend for increased concentrations of systemic pro-inflammatory cytokines (MCP-1 and TNF-α) on day 90. The AD fed group, with significantly higher FG, also exhibited significantly elevated circadian (24-hour) overall mean SBP, DBP, PP and HR (all p < 0.05). Conclusion These data validate our stated hypothesis that systemic inflammation and glycemia influence circadian blood pressure variability. This study, for the first time, demonstrates a cause and effect relationship between caloric excess, enhanced systemic inflammation, dysglycemia, loss of blood pressure control and abnormal CBPV. Our results provide the fundamental

  3. [Measurement of blood pressure variability and the clinical value].

    PubMed

    Kékes, Ede; Kiss, István

    2014-10-19

    Authors have collected and analyzed literature data on blood pressure variability. They present the methods of blood pressure variability measurement, clinical value and relationships with target organ damages and risk of presence of cardiovascular events. They collect data about the prognostic value of blood pressure variability and the effects of different antihypertensive drugs on blood pressure variability. They underline that in addition to reduction of blood pressure to target value, it is essential to influence blood pressure fluctuation and decrease blood pressure variability, because blood pressure fluctuation presents a major threat for the hypertensive subjects. Data from national studies are also presented. They welcome that measurement of blood pressure variability has been included in international guidelines.

  4. [Blood pressure variability: clinical interest or simple curiosity?].

    PubMed

    Ciaroni, Stefano

    2007-03-14

    Blood pressure variability is a physiological phenomenon influenced by many internal and external factors. This variability could be also influenced by pathological conditions such as arterial hypertension. Two forms must be mainly distinguished: the blood pressure variability at long and short-term. The latter could only be studied by continuous recordings. In this article will be analysed the interest of measuring blood pressure variability, its cardiovascular prognosis and the therapeutic tools when it is increased.

  5. [Clinical significance of nocturnal blood pressure and blood pressure variability: analysis of 522 cases].

    PubMed

    Palatini, P; Mormino, P; Martina, S; Businaro, R; Penzo, M; Racioppa, A; Guzzardi, G; Anaclerio, M; Pessina, A C

    1990-03-01

    Purpose of the study was to investigate whether and to what extent blood pressure variability and average night-time blood pressure are related to cardiovascular complications in hypertension. To this aim 60 normotensive and 462 hypertensive subjects were studied by means of non-invasive 24 hour blood pressure monitoring, using either the Avionics, or the ICR Spacelabs, or the Takeda system. Each subject was attributed a target organ damage score on the basis of 12-lead electrocardiogram, chest X-ray and fundoscopy, starting from 0 (no damage) up to 5 (maximum degree of damage). The 522 subjects were subsequently subdivided into 5 classes of increasing average daytime diastolic blood pressure. In each class a higher degree of cardiovascular complications was present in the subjects with the higher blood pressure variability and the higher average night-time blood pressure. From these results it may be inferred that both blood pressure variability and night-time blood pressure are related to the degree of target organ damage in hypertension. This stresses the importance of recording blood pressure throughout the 24 hours.

  6. Asymmetric features of short-term blood pressure variability.

    PubMed

    Guzik, Przemyslaw; Piskorski, Jaroslaw; Krauze, Tomasz; Narkiewicz, Krzysztof; Wykretowicz, Andrzej; Wysocki, Henryk

    2010-11-01

    Prolongations of cardiac cycles have a significantly larger contribution to short-term heart rate variability than shortenings--this is called heart rate asymmetry. Our aim is to establish the existence of blood pressure asymmetry phenomenon, which has not been done so far. We used 30-min resting continuous recordings of finger pressure waveforms from 227 healthy young volunteers (19-31 years old; 97 female), and performed Poincaré plot analysis of systolic blood pressure (SBP) to quantify the effect. Median contribution of SBP increases (C(i)) to short-term blood pressure variability was 52.8% (inter-quartile range: 50.9-55.1%) and median number of SBP increases (N(i)) was 48.8% (inter-quartile range: 47.2-50.1%). The C(i)>50% was found in 82% (P<0.0001; binomial test) and N(i)<50% in 75% (P<0.0001) of the subjects. Although SBP increases are significantly less abundant than reductions, their contribution to short-term blood pressure variability is significantly larger, which means that short-term blood pressure variability is asymmetric. SBP increases and reductions have unequal contribution to short-term blood pressure variability at supine rest in young healthy people. As this asymmetric behavior of blood pressure variability is present in most of the healthy studied people at rest, it can be concluded that blood pressure asymmetry is a physiological phenomenon.

  7. Ambulatory blood pressure monitoring-derived short-term blood pressure variability in primary hyperparathyroidism.

    PubMed

    Concistrè, A; Grillo, A; La Torre, G; Carretta, R; Fabris, B; Petramala, L; Marinelli, C; Rebellato, A; Fallo, F; Letizia, C

    2017-07-12

    Primary hyperparathyroidism is associated with a cluster of cardiovascular manifestations, including hypertension, leading to increased cardiovascular risk. The aim of our study was to investigate the ambulatory blood pressure monitoring-derived short-term blood pressure variability in patients with primary hyperparathyroidism, in comparison with patients with essential hypertension and normotensive controls. Twenty-five patients with primary hyperparathyroidism (7 normotensive,18 hypertensive) underwent ambulatory blood pressure monitoring at diagnosis, and fifteen out of them were re-evaluated after parathyroidectomy. Short-term-blood pressure variability was derived from ambulatory blood pressure monitoring and calculated as the following: 1) Standard Deviation of 24-h, day-time and night-time-BP; 2) the average of day-time and night-time-Standard Deviation, weighted for the duration of the day and night periods (24-h "weighted" Standard Deviation of BP); 3) average real variability, i.e., the average of the absolute differences between all consecutive BP measurements. Baseline data of normotensive and essential hypertension patients were matched for age, sex, BMI and 24-h ambulatory blood pressure monitoring values with normotensive and hypertensive-primary hyperparathyroidism patients, respectively. Normotensive-primary hyperparathyroidism patients showed a 24-h weighted Standard Deviation (P < 0.01) and average real variability (P < 0.05) of systolic blood pressure higher than that of 12 normotensive controls. 24-h average real variability of systolic BP, as well as serum calcium and parathyroid hormone levels, were reduced in operated patients (P < 0.001). A positive correlation of serum calcium and parathyroid hormone with 24-h-average real variability of systolic BP was observed in the entire primary hyperparathyroidism patients group (P = 0.04, P  = 0.02; respectively). Systolic blood pressure variability is increased in normotensive

  8. High-normal blood pressure is associated with visit-to-visit blood pressure variability in the US adults.

    PubMed

    Faramawi, Mohammed F; Delongchamp, Robert; Said, Qayyim; Balamurugan, Appathurai; Hassan, Alaa; Abouelenien, Saly; Ismaeil, Mohamed

    2017-02-01

    High-normal blood pressure and visit-to-visit blood pressure variability are common in clinical settings. They are associated with cardiovascular outcomes. No population based studies have assessed the association between these two phenomena. Our objective was to test the relationship of high-normal blood pressure with visit-to-visit blood pressure variability. A cross-sectional study. We used data from the cross-sectional Third National Health and Nutrition Examination Survey to test the relationship between high-normal blood pressure and visit-to-visit blood pressure variability; we conducted multivariable regression analyses to evaluate the relationship between these two variables. The analysis included 6,071 participants. The participants' mean age was 37.16 years. The means of visit-to-visit systolic and diastolic blood pressure variability were 5.84 mmHg and 5.26 mmHg. High-normal blood pressure was significantly associated with systolic and diastolic blood pressure variability (p values <0.05). High-normal blood pressure is associated with visit-to-visit blood pressure variability. Additional research is required to replicate the reported results in prospective studies and evaluate approaches to reduce blood pressure variability observed in clinical settings among patients with high-normal blood pressure to reduce the subsequent complications of blood pressure variability.

  9. Blood Pressure Variability and Stress Management Training for Essential Hypertension

    ERIC Educational Resources Information Center

    Garcia-Vera, Maria Paz; Sanz, Jesus; Labrador, Francisco J.

    2004-01-01

    The purpose of this study was to determine whether stress management training reduces blood pressure (BP) variability in hypertensive patients. Previous literature suggests that cardiovascular risk is not only a function of BP levels, but also of BP variability, and this partially depends on changes induced by the stress of everyday life. The…

  10. Blood Pressure Variability and Stress Management Training for Essential Hypertension

    ERIC Educational Resources Information Center

    Garcia-Vera, Maria Paz; Sanz, Jesus; Labrador, Francisco J.

    2004-01-01

    The purpose of this study was to determine whether stress management training reduces blood pressure (BP) variability in hypertensive patients. Previous literature suggests that cardiovascular risk is not only a function of BP levels, but also of BP variability, and this partially depends on changes induced by the stress of everyday life. The…

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

    PubMed

    Sharma, Ajay P; Mohammed, Javed; Thomas, Benson; Lansdell, Nathan; Norozi, Kambiz; Filler, Guido

    2013-08-01

    Nighttime blood pressure (BP) and systolic BP variability on ambulatory blood pressure monitoring (ABPM) have been strongly associated with target-organ damage in hypertensive adults. The clinical relevance of these variables in children with hypertension remains under-studied. The study group included children aged 5-18 years old referred to the outpatient nephrology clinic for an elevated casual BP who underwent an ABPM and echocardiography (ECHO) study and did not have secondary hypertension. The interpretation of ABPM parameters and left ventricular mass index (LVMI) was based on normative references. Seventy-two children fulfilled the inclusion criteria. The association of various potential predictors including age, BMI z-score, casual BP z-score and ABPM parameters (BP z-score, BP load, nocturnal dipping and BP variability- within-subject standard deviation (SD) of BP) with LVMI was analyzed. On adjusted regression analysis, nighttime systolic BP load [standardized regression coefficient (β) 0.23; p < 0.05] and daytime systolic BP variability (β 0.37; p < 0.05) had significant association with LVMI. In children with primary hypertension, nighttime systolic BP load and daytime systolic BP variability had a stronger association with LVMI than casual BP and other ABPM parameters. Future longitudinal studies are needed to establish the causality among these variables.

  12. [Usefulness for detection of inappropriate blood pressure variability using 'wearable blood pressure sensor'].

    PubMed

    Iijima, Katsuya

    2015-11-01

    In the clinical settings, it has frequently seen that the elderly have rapid blood pressure (BP) elevation and decline, leading to such as orthostatic disorders and post-urination syncope. Excessive blood pressure variability (BPV) according to aging leads to aggravation of hypertensive target organ damage due to both disturbed baroreflex function and arterial stiffening. We developed continuous BP monitoring sensor using newly developing device 'wearable BP sensor', as our advantageous approach of without a cuff-stress. The new mobile device could reflect continuous beat-to-beat systolic BP, heart rate(HR), these very close changes and double product(sBPX HR) as a major indicator of cardiac lead, in consistent with cuff-based BP value. Our new challenge using this device might approach to the potential to achieve the quality-up of treatment strategy with consideration for very short-term BPV.

  13. Blood pressure variability, prehypertension, and hypertension in adolescents

    PubMed Central

    Batisky, Donald L

    2012-01-01

    Medical conditions diagnosed during adolescence may have long term impacts on the health of an individual. As a result, identifying cardiovascular risk factors earlier in life such as prehypertension (pre-HTN) and hypertension (HTN) can have significant benefits across an individual’s lifespan. Diagnosing elevated blood pressure (BP) during adolescence can be difficult, partially due to the natural variability that occurs during this period of life. Levels of BP that define adolescent prehypertension/hypertension are provided as well as an abridged review of BP variability across research groups. Strategies for BP management of adolescents are considered, with the primary focus on nonpharmacologic interventions. PMID:24600286

  14. Blood Pressure Variability and Cognitive Function Among Older African Americans: Introducing a New Blood Pressure Variability Measure.

    PubMed

    Tsang, Siny; Sperling, Scott A; Park, Moon Ho; Helenius, Ira M; Williams, Ishan C; Manning, Carol

    2017-09-01

    Although blood pressure (BP) variability has been reported to be associated with cognitive impairment, whether this relationship affects African Americans has been unclear. We sought correlations between systolic and diastolic BP variability and cognitive function in community-dwelling older African Americans, and introduced a new BP variability measure that can be applied to BP data collected in clinical practice. We assessed cognitive function in 94 cognitively normal older African Americans using the Mini-Mental State Examination (MMSE) and the Computer Assessment of Mild Cognitive Impairment (CAMCI). We used BP measurements taken at the patients' three most recent primary care clinic visits to generate three traditional BP variability indices, range, standard deviation, and coefficient of variation, plus a new index, random slope, which accounts for unequal BP measurement intervals within and across patients. MMSE scores did not correlate with any of the BP variability indices. Patients with greater diastolic BP variability were less accurate on the CAMCI verbal memory and incidental memory tasks. Results were similar across the four BP variability indices. In a sample of cognitively intact older African American adults, BP variability did not correlate with global cognitive function, as measured by the MMSE. However, higher diastolic BP variability correlated with poorer verbal and incidental memory. By accounting for differences in BP measurement intervals, our new BP variability index may help alert primary care physicians to patients at particular risk for cognitive decline.

  15. Higher Blood Pressure Variability in White Coat Hypertension; from the Korean Ambulatory Blood Pressure Monitoring Registry

    PubMed Central

    Kang, In Sook; Shin, Jinho; Ihm, Sang-Hyun; Kim, Ju Han; Park, Sungha; Kim, Kwang-Il; Kim, Woo-Shik; Kim, Soon Gil; Shin, Gil Ja

    2016-01-01

    Background and Objectives Blood pressure variability (BPV) was recently shown to be a risk factor of stroke. White coat hypertension (WCH) used to be regarded as innocuous, but one long-term follow-up study reported that WCH increased stroke rate compared to normotension (NT). In this study, we aimed to evaluate the relationship between WCH and BPV. Subjects and Methods We analyzed 1398 subjects from the Korean Ambulatory Blood Pressure Registry, who were divided into NT (n=364), masked hypertension (n=122), white coat hypertension (n=254), and sustained hypertension (n=658) groups. Results Baseline characteristics were similar among groups. The average real variability (ARV), a highly sensitive BPV parameter, was highest in the WCH group, followed by the sustained hypertension, masked hypertension, and NT groups. The results persisted after being adjusted for covariates. The WCH vs. sustained hypertension results (adjusted mean±standard error) were as follows: 24-h systolic ARV, 22.9±0.8 vs. 19.4±0.6; 24-h diastolic ARV, 16.8±0.6 vs. 14.3±0.5; daytime systolic ARV, 21.8±0.8 vs. 16.8±0.6; and daytime diastolic ARV, 16.2±0.6 vs. 13.4±0.5 (p<0.001 for all comparisons). Conclusion From the registry data, we found that subjects with WCH or masked hypertension had higher BPV than NT. However, long-term follow-up data assessing the clinical influences of WCH on stroke are needed. PMID:27275173

  16. Understanding Blood Pressure Variation and Variability: Biological Importance and Clinical Significance.

    PubMed

    James, Gary D

    2017-01-01

    Variability is a normative property of blood pressure necessary for survival which likely contributes to morbidity and mortality through allostatic load. Because of its allostatic and adaptive properties blood pressure responses to peculiar situations like the visit to the clinic can lead to the misdiagnosis of hypertension. Cuff methods of blood pressure measurement can also create blood pressure variation when there really is none. There are also physiological differences between populations related to their evolutionary history that likely further affect the extent of population differences in 24-h blood pressure variability. Quantifying the sources and extent of blood pressure variability can be done using natural experimental models and through the evaluation of ecological momentary data. It is very likely that the results of population studies of blood pressure variability and morbidity and mortality risk are inconclusive because the parameters used to assess blood pressure variability do not reflect the actual nature of blood pressure allostasis.

  17. Blood Pressure and Visit-to-Visit Blood Pressure Variability Among Individuals With Primary Proteinuric Glomerulopathies.

    PubMed

    Sethna, Christine B; Meyers, Kevin E C; Mariani, Laura H; Psoter, Kevin J; Gadegbeku, Crystal A; Gibson, Keisha L; Srivastava, Tarak; Kretzler, Matthias; Brady, Tammy M

    2017-08-01

    Hypertension and blood pressure variability (BPV; SD and average real variability) in primary proteinuric glomerulopathies are not well described. Data were from 433 participants in the NEPTUNE (Nephrotic Syndrome Study Network). Hypertensive BP status was defined as previous history of hypertension or BP ≥140/90 mm Hg for adults/≥95th percentile for children at baseline. BPV was measured in participants with ≥3 visits in the first year. Two-hundred ninety-six adults (43 years [interquartile range, 32-57.8 years], 61.5% male) and 147 children (11 years [interquartile range, 5-14 years], 57.8% male) were evaluated. At baseline, 64.8% of adults and 46.9% of children were hypertensive. Histological diagnosis was associated with hypertensive status in adults (P=0.036). In adults, hypertensive status was associated with lower hazard of complete remission (hazard ratio, 0.36; 95% confidence interval, 0.19-0.68) and greater hazard of achieving the composite end point (end-stage renal disease or estimated glomerular filtration rate decline >40%; hazard ratio, 4.1; 95% confidence interval, 1.4-12). Greater systolic and diastolic SD and average real variability were also associated with greater hazard of reaching the composite end point in adults (all P<0.01). In children, greater BPV was an independent predictor of composite end point (determined by systolic SD and average real variability) and complete remission (determined by systolic and diastolic average real variability; all P<0.05). Hypertensive status was common among adults and children enrolled in NEPTUNE. Differences in hypertensive status prevalence, BPV, and treatment were found by age and histological diagnosis. In addition, hypertensive status and greater BPV were associated with poorer clinical outcomes. © 2017 American Heart Association, Inc.

  18. Agreement between ambulatory, home, and office blood pressure variability.

    PubMed

    Juhanoja, Eeva P; Niiranen, Teemu J; Johansson, Jouni K; Puukka, Pauli J; Jula, Antti M

    2016-01-01

    Ambulatory, home, and office blood pressure (BP) variability are often treated as a single entity. Our aim was to assess the agreement between these three methods for measuring BP variability. Twenty-four-hour ambulatory BP monitoring, 28 home BP measurements, and eight office BP measurements were performed on 461 population-based or hypertensive participants. Five variability indices were calculated for all measurement methods: SD, coefficient of variation, maximum-minimum difference, variability independent of the mean, and average real variability. Pearson's correlation coefficients were calculated for indices measured with different methods. The agreement between different measurement methods on the diagnoses of extreme BP variability (participants in the highest decile of variability) was assessed with kappa (κ) coefficients. SBP/DBP variability was greater in daytime (coefficient of variation: 9.8 ± 2.9/11.9 ± 3.6) and night-time ambulatory measurements (coefficient of variation: 8.6 ± 3.4/12.1 ± 4.5) than in home (coefficient of variation: 4.4 ± 1.8/4.7 ± 1.9) and office (coefficient of variation: 4.6 ± 2.4/5.2 ± 2.6) measurements (P < 0.001/0.001 for all). Pearson's correlation coefficients for systolic/diastolic daytime or night-time ambulatory-home, ambulatory-office, and home-office variability indices ranged between 0.07-0.25/0.12-0.23, 0.13-0.26/0.03-0.22 and 0.13-0.24/0.10-0.19, respectively, indicating, at most, a weak positive (r < 0.3) relationship. The agreement between measurement methods on diagnoses of extreme SBP/DBP variability was only slight (κ < 0.2), with the κ coefficients for daytime and night-time ambulatory-home, ambulatory-office, and home-office agreement varying between-0.014-0.20/0.061-0.15, 0.037-0.18/0.082-0.15, and 0.082-0.13/0.045-0.15, respectively. Shorter-term and longer-term BP variability assessed by different methods of BP measurement seem to correlate only weakly

  19. Blood Pressure Variability and Its Management in Hypertensive Patients

    PubMed Central

    2012-01-01

    Optimizing treatment for hypertension has focused on reducing cardiovascular risk through reduction of mean blood pressure (BP) under the basic assumption that lower is better, as long as diastolic BP is sufficient to maintain coronary perfusion. However, antihypertensive therapy as currently practiced does not eliminate all hazards associated with BP elevation. Blood pressure variability (BPV) correlates closely with target-organ damage independent of mean BP and transient increases in BP are also triggers of vascular events. So far, there is no definitive outcome data relating specific reduction in BPV to decline cardiovascular events or death. Thus, the decision whether BPV should be considered a new therapeutic target is left to the clinical judgment of physicians and individualized for each patient. However, new evidence suggests that taking an antihypertensive medication at bedtime significantly affects BPV and lowers the risk of cardiovascular events and death. This strategy may provide a means of individualizing treatment of hypertension according to the circadian BPV of each patient and may be a new option to optimize BP control and reduce risk. PMID:23267418

  20. Association of heart rate with blood pressure variability: implications for blood pressure measurement.

    PubMed

    Cahan, Amos; Ben-Dov, Iddo Z; Bursztyn, Michael

    2012-03-01

    Antihypertensive β-blocker use is associated with greater intervisit blood pressure variability (BPV) and with less favorable outcomes compared to other antihypertensive agents. A theoretical model demonstrated that accuracy and precision of BP measurement are affected by heart rate (HR) at a constant cuff deflation rate. We aimed to examine the empirical relationship between HR and BPV in a clinical setting. Intratracing variability in ambulatory BP monitoring (ABPM) were analyzed in search of a link between BPV and HR. BPV was expressed as standard deviation (s.d.), coefficient of variation (CV), and variability independent of the mean (VIM). In a dataset of 4,693 subjects, HR was inversely associated with BPV and independently explained 1.3% of between-subject variation in s.d. of awake systolic BP (1.5% of CV and VIM). Linear regression suggested 0.5 mm Hg increase in s.d. of systolic BP per 10 beats per minute (bpm) decrease in HR. In a subset of 1,019 patients with available data on medications, HR was independently and inversely related with awake systolic BPV (P < 0.0001), more so in diuretic (P < 0.050) and renin-angiotensin system antagonists-treated (P < 0.050) patients. Associations of β-blockade with increased BPV were abolished by model-adjustment for HR. In another subset of patients who were monitored twice (n = 635), HR had a mild (0.6%) but significant (P < 0.05) inverse contribution to the change in awake systolic BPV between repeated monitoring. Ambulatory BPV is inversely related to HR and is not increased in referred patients treated with β-blockers after correction for HR. © 2012 American Journal of Hypertension, Ltd.

  1. Blood pressure

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    Normal blood pressure is important for proper blood flow to the body's organs and tissues. The force of the blood on the walls of the arteries is called blood pressure. Blood pressure is measured both as the heart ...

  2. Bias and variability in blood pressure measurement with ambulatory recorders.

    PubMed

    Pannarale, G; Bebb, G; Clark, S; Sullivan, A; Foster, C; Coats, A J

    1993-10-01

    This study sought to determine whether patient characteristics such as age, sex, blood pressure, and pulse pressure differently affect the accuracy of an oscillometric (SpaceLabs 90207) and a microphonic (TM2420 version 7) blood pressure monitor. Blood pressure recorded by two oscillometric and two microphonic ambulatory monitors was compared with simultaneous readings by two pairs of trained, blinded observers using random-zero sphygmomanometry. One hundred and eighteen subjects (53 men and 65 women, aged 17 to 94 years; systolic pressure, 89 to 211 mm Hg; diastolic, 44 to 116 mm Hg) were studied. There were no significant differences within each observer pair or between the two observer pairs as well as no correlation between interobserver differences and patient characteristics. The differences between the monitor and trained observers' readings were 2.8 +/- 9.9 mm Hg systolic and 3.9 +/- 6.8 mm Hg diastolic for the SpaceLabs and 5.0 +/- 5.2 mm Hg systolic and 3.4 +/- 6.1 mm Hg diastolic for the TM2420. Patient characteristics that predicted measurement error were defined by multiple regression. For oscillometry, systolic measurement error was highly correlated with systolic pressure, pulse pressure, and subject age. The diastolic error was significantly correlated with pulse pressure, diastolic pressure, and subject sex. For the oscillometric monitor, patient characteristics accounted for 36.6% of the variation of the systolic error and 34.7% of the variation of the diastolic error. For the microphonic monitor, only age correlated with diastolic error, and no significant correlations were seen with systolic error. Patient characteristics accounted for only 1.2% of the systolic and 8.9% of the diastolic error.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Low correlation between visit-to-visit variability and 24-hour variability of blood pressure

    PubMed Central

    Muntner, Paul; Shimbo, Daichi; Diaz, Keith M.; Newman, Jonathan; Sloan, Richard P.; Schwartz, Joseph E.

    2013-01-01

    Visit-to-visit variability (VVV) of clinic systolic blood pressure (SBP) has been associated with cardiovascular disease risk. Given the need for obtaining blood pressure (BP) at multiple visits to calculate VVV, substituting BP variability from ambulatory blood pressure monitoring (ABPM) may be a practical alternative. We assessed the correlation between VVV of BP and BP variability from ABPM using data from 146 untreated, mostly normotensive participants (mean age 47.9 years) in a substudy of the ongoing Masked Hypertension Study. VVV of SBP and diastolic blood pressure (DBP) was estimated by the standard deviation (SDvvv) and average real variability (ARVvvv) from 6 study visits over a median of 216 days. ABPM data were used to calculate the day-night SD (SDdn) and the ARV of SBP and DBP over 24 hours (ARV24). For SBP, the mean SDvvv and SDdn were 6.3 (SD=2.5) and 8.8 (SD=1.8) mmHg, respectively, and mean ARVvvv and ARV24 were 7.2 (SD=3.2) and 8.4 (SD=2.1) mmHg, respectively. The Spearman correlation coefficient between SDvvv and SDdn of SBP was rs=0.25 and between ARVvvv and ARV24 was rs=0.17. Participants in the highest quartile of SDdn of SBP were 1.66 (95% CI: 0.93 – 2.75) times more likely to be in the highest quartile of SDvvv of SBP. The observed-to-expected ratio between the highest quartiles of ARVvvv and ARV24 of SBP was 0.89 (95% CI: 0.41 – 1.69). The correlations for SDvvv and SDdn and ARVvvv and ARV24 of DBP were minimal. These data suggest VVV and 24-hour variability are weakly correlated and not interchangeable. PMID:23784506

  4. Blood pressure variability and outcomes in chronic kidney disease.

    PubMed

    Di Iorio, Biagio; Pota, Andrea; Sirico, Maria Luisa; Torraca, Serena; Di Micco, Lucia; Rubino, Roberto; Guastaferro, Pasquale; Bellasi, Antonio

    2012-12-01

    We investigated the effects of visit-to-visit systolic blood pressure variability (SBPV) on both mortality and dialysis inception in a cohort of chronic kidney disease (CKD) patients not requiring dialysis therapy. Furthermore, we also explored the carry-over effect of visit-to-visit SBPV on mortality after dialysis initiation. We conducted a longitudinal retrospective, observational, multi-centre study in three tertiary care nephrology outpatient clinics. All the ambulatory CKD patients admitted to the outpatient clinics from 1 January 2004 to 31 December 2005 were screened for study eligibility. We selected all consecutive patients older than 18 years of age with a mean estimated glomerular filtration rate of <60 mL/min/m(2), free from cardiovascular disease. SBPV was defined as the ratio of the SD to the mean SBP of five values recorded during a run-in phase of 4-5 months. Data on dialysis inception and mortality were recorded through 31 December 2010. Overall, we selected a cohort of 374 elderly (median age: 79 years) subjects. A total of 232 (62%) and 103 (29%) patients were male and had diabetes, respectively. A significant association between SBPV and the risk of death but not of CKD progression to dialysis was noted at univariate and after multivariable adjustments (hazard ratio for all-cause mortality per 1% increase in SBPV: 1.05; 95% confidence interval: 1.02-1.09; P = 0.001). Notably, no lethal event was recorded after dialysis initiation. Current findings suggest that SBPV may be of use for risk stratification in CKD patients.

  5. Healthy Lifestyle and Blood Pressure Variability in Young Adults.

    PubMed

    Maseli, Anna; Aeschbacher, Stefanie; Schoen, Tobias; Fischer, Andreas; Jung, Manuel; Risch, Martin; Risch, Lorenz; Conen, David

    2017-07-01

    The aim of this study was to assess the relationships between healthy lifestyle metrics and blood pressure variability (BPV) in young and healthy adults. A population-based sample of 1,999 individuals aged 25-41 years was investigated. A lifestyle-score from 0 (most unhealthy) to 7 (most healthy) was calculated by giving one point for each of the following components: never smoking cigarettes, adhering to a healthy diet, performing moderate or intense physical activity, having a body mass index <25 kg/m2, a total cholesterol <200 mg/dl, a glycated hemoglobin <5.7%, or a conventional BP <120/80 mm Hg. Standardized ambulatory 24-hour BP measurements were obtained in all individuals. BPV was defined as the SD of all individual ambulatory BP recordings. We constructed multivariable linear regression models to assess the relationships between the lifestyle-score and BPV. None of the results were adjusted for multiple testing. Median age was 37 years and 46.8% were men. With increasing lifestyle-score, systolic and diastolic BPV is decreasing linearly (P for trend <0.0001), even after multivariable adjustment. Per 1-point increase in lifestyle-score, the β-coefficient (95% confidence interval) for systolic and diastolic 24-hour BPV was -0.03 (-0.03; -0.02) and -0.04 (-0.05; -0.03), respectively, both P for trend <0.0001. These relationships were attenuated but remained statistically significant after additional adjustment for mean individual BP. In this study of young and healthy adults, adopting a healthy lifestyle was associated with a lower BPV. These associations were independent of mean BP levels.

  6. Gender differences in the relationship between resting heart rate variability and 24-hour blood pressure variability.

    PubMed

    Thayer, Julian F; Sollers, John J; Friedman, Bruce H; Koenig, Julian

    2016-01-01

    The study explored the relationship between time- and frequency-domain indices of cardiac autonomic control and 24 h blood pressure variability (BPV) in a sample of healthy men and women. Vagally mediated cardiac control was inversely related to 24 h BPV, and measures of cardiac autonomic control were better predictors of systolic BPV in men and better predictors of diastolic BPV in women. These findings may help researchers to understand the disparity in cardiovascular disease morbidity and mortality between men and women.

  7. Home Blood Pressure Variability as Cardiovascular Risk Factor in the Population of Ohasama

    PubMed Central

    Asayama, Kei; Kikuya, Masahiro; Schutte, Rudolph; Thijs, Lutgarde; Hosaka, Miki; Satoh, Michihiro; Hara, Azusa; Obara, Taku; Inoue, Ryusuke; Metoki, Hirohito; Hirose, Takuo; Ohkubo, Takayoshi; Staessen, Jan A.; Imai, Yutaka

    2013-01-01

    Blood pressure variability based on office measurement predicts outcome in selected patients. We explored whether novel indices of blood pressure variability derived from the self-measured home blood pressure predicted outcome in a general population. We monitored mortality and stroke in 2421 Ohasama residents (Iwate Prefecture, Japan). At enrollment (1988–1995), participants (mean age, 58.6 years; 60.9% women; 27.1% treated) measured their blood pressure at home, using an oscillometric device. In multivariable-adjusted Cox models, we assessed the independent predictive value of the within-subject mean systolic blood pressure (SBP) and corresponding variability as estimated by variability independent of the mean, difference between maximum and minimum blood pressure, and average real variability. Over 12.0 years (median), 412 participants died, 139 of cardiovascular causes, and 223 had a stroke. In models including morning SBP, variability independent of the mean and average real variability (median, 26 readings) predicted total and cardiovascular mortality in all of the participants (P≤0.044); variability independent of the mean predicted cardiovascular mortality in treated (P=0.014) but not in untreated (P=0.23) participants; and morning maximum and minimum blood pressure did not predict any end point (P≥0.085). In models already including evening SBP, only variability independent of the mean predicted cardiovascular mortality in all and in untreated participants (P≤0.046). The R2 statistics, a measure for the incremental risk explained by adding blood pressure variability to models already including SBP and covariables, ranged from <0.01% to 0.88%. In a general population, new indices of blood pressure variability derived from home blood pressure did not incrementally predict outcome over and beyond mean SBP. PMID:23172933

  8. Low correlation between visit-to-visit variability and 24-h variability of blood pressure.

    PubMed

    Muntner, Paul; Shimbo, Daichi; Diaz, Keith M; Newman, Jonathan; Sloan, Richard P; Schwartz, Joseph E

    2013-11-01

    visit-to-visit variability (VVV) of clinic systolic blood pressure (SBP) has been associated with cardiovascular disease risk. Given the need for obtaining blood pressure (BP) at multiple visits to calculate VVV, substituting BP variability from ambulatory blood pressure monitoring (ABPM) may be a practical alternative. We assessed the correlation between VVV of BP and BP variability from ABPM using data from 146 untreated, mostly normotensive participants (mean age 47.9 years), in a substudy of the ongoing Masked Hypertension Study. VVV of SBP and diastolic blood pressure (DBP) was estimated by the standard deviation (s.d.vvv) and average real variability (ARVvvv) from six study visits over a median of 216 days. ABPM data were used to calculate the day-night s.d. (s.d.dn), and the ARV of SBP and DBP over 24 h (ARV24). For SBP, the mean s.d.vvv and s.d.dn were 6.3 (s.d.=2.5) and 8.8 mm Hg (s.d.=1.8), respectively, and mean ARVvvv and ARV24 were 7.2 (s.d.=3.2) and 8.4 mm Hg (s.d.=2.1), respectively. Spearman's correlation coefficient between s.d.vvv and s.d.dn of SBP was rs=0.25, and between ARVvvv and ARV24 was rs=0.17. Participants in the highest quartile of s.d.dn of SBP were 1.66 (95% CI: 0.93-2.75) times more likely to be in the highest quartile of s.d.vvv of SBP. The observed-to-expected ratio between the highest quartiles of ARVvvv and ARV24 of SBP was 0.89 (95% CI: 0.41-1.69). The correlations for s.d.vvv and s.d.dn, and ARVvvv and ARV24 of DBP were minimal. These data suggest VVV and 24-h variability are weakly correlated and not interchangeable.

  9. Relationships between blood pressure and health and fitness-related variables in obese women

    PubMed Central

    Shin, Jeong Yeop; Ha, Chang Ho

    2016-01-01

    [Purpose] The present study aimed to separately compare systolic blood pressure and diastolic blood pressure with health and fitness-related variables among Asian obese and normal weight middle-aged women. [Subjects and Methods] The study included 1,201 women aged 30–59 years. The participants were classified into obese and normal weight groups. The blood pressure and health and fitness-related variables of all participants were assessed. [Results] Significant interaction effects were observed for most blood pressure and health and fitness-related variables between the groups. However, significant interaction effects were not observed for standard weight, basal metabolic rate, and heart rate. Blood pressure showed significant positive correlations with weight, body fat, fat weight, core fat, body mass index, and basal metabolic rate in both groups. Systolic blood pressure was significantly correlated with muscular endurance, power, and agility in the obese group and with VO2max and flexibility in the normal weight group. Diastolic blood pressure was significantly correlated with muscular endurance and power in the obese group and with VO2max in the normal weight group. [Conclusion] The relationships between systolic blood pressure and heart rate, muscle endurance, power, and agility are stronger than the relationships between diastolic blood pressure and these variables. PMID:27821965

  10. Methodology and technology for peripheral and central blood pressure and blood pressure variability measurement: current status and future directions - Position statement of the European Society of Hypertension Working Group on blood pressure monitoring and cardiovascular variability.

    PubMed

    Stergiou, George S; Parati, Gianfranco; Vlachopoulos, Charalambos; Achimastos, Apostolos; Andreadis, Emanouel; Asmar, Roland; Avolio, Alberto; Benetos, Athanase; Bilo, Grzegorz; Boubouchairopoulou, Nadia; Boutouyrie, Pierre; Castiglioni, Paolo; de la Sierra, Alejandro; Dolan, Eamon; Head, Geoffrey; Imai, Yutaka; Kario, Kazuomi; Kollias, Anastasios; Kotsis, Vasilis; Manios, Efstathios; McManus, Richard; Mengden, Thomas; Mihailidou, Anastasia; Myers, Martin; Niiranen, Teemu; Ochoa, Juan Eugenio; Ohkubo, Takayoshi; Omboni, Stefano; Padfield, Paul; Palatini, Paolo; Papaioannou, Theodore; Protogerou, Athanasios; Redon, Josep; Verdecchia, Paolo; Wang, Jiguang; Zanchetti, Alberto; Mancia, Giuseppe; O'Brien, Eoin

    2016-09-01

    Office blood pressure measurement has been the basis for hypertension evaluation for almost a century. However, the evaluation of blood pressure out of the office using ambulatory or self-home monitoring is now strongly recommended for the accurate diagnosis in many, if not all, cases with suspected hypertension. Moreover, there is evidence that the variability of blood pressure might offer prognostic information that is independent of the average blood pressure level. Recently, advancement in technology has provided noninvasive evaluation of central (aortic) blood pressure, which might have attributes that are additive to the conventional brachial blood pressure measurement. This position statement, developed by international experts, deals with key research and practical issues in regard to peripheral blood pressure measurement (office, home, and ambulatory), blood pressure variability, and central blood pressure measurement. The objective is to present current achievements, identify gaps in knowledge and issues concerning clinical application, and present relevant research questions and directions to investigators and manufacturers for future research and development (primary goal).

  11. Variability of blood pressure in dialysis patients: a new marker of cardiovascular risk.

    PubMed

    Di Iorio, Biagio; Di Micco, Lucia; Torraca, Serena; Sirico, Maria Luisa; Guastaferro, Pasquale; Chiuchiolo, Luigi; Nigro, Filippo; De Blasio, Antonietta; Romano, Paolo; Pota, Andrea; Rubino, Roberto; Morrone, Luigi; Lopez, Teodoro; Casino, Francesco Gaetano

    2013-01-01

    Hemodialysis patients have a high cardiovascular mortality, and hypertension is the most prevalent treatable risk factor. We aimed to assess the predictive significance of dialysis-to-dialysis variability in blood pressure in hemodialysis patients. We performed a historical cohort study in 1,088 prevalent hemodialysis patients, followed up for 5 years. The risk of cardiovascular death was determined in relation to dialysis-to-dialysis variability in blood pressure, maximum blood pressure and pulse pressure. Variability in blood pressure was a predictor of cardiovascular death (hazard ratio [HR] = 1.242; 95% confidence interval [95% CI], 1.004-1.537; p=0.046). Also age (HR=1.021; 95% CI, 1.011-1.048; p=0.049), diabetes (HR=1.134; 95% CI, 1.128-1.451; p=0.035), creatinine (HR=0.837; 95% CI, 0.717-0.977; p=0.024) and albumin (HR=0.901; 95% CI, 0.821-0.924; p=0.022) influenced mortality. Maximum blood pressure and pulse pressure did not show any effect on cardiovascular death. Dialysis-to-dialysis variability in blood pressure is a predictor of cardiovascular mortality in hemodialysis patients, and blood pressure variability may be used in managing hypertension and predicting outcomes in dialysis patients.

  12. Biological correlates of blood pressure variability in elderly at high risk of cardiovascular disease.

    PubMed

    Poortvliet, Rosalinde K E; Lloyd, Suzanne M; Ford, Ian; Sattar, Naveed; de Craen, Anton J M; Wijsman, Liselotte W; Mooijaart, Simon P; Westendorp, Rudi G J; Jukema, J Wouter; de Ruijter, Wouter; Gussekloo, Jacobijn; Stott, David J

    2015-04-01

    Visit-to-visit variability in blood pressure is an independent predictor of cardiovascular disease. This study investigates biological correlates of intra-individual variability in blood pressure in older persons. Nested observational study within the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) among 3,794 male and female participants (range 70-82 years) with a history of, or risk factors for cardiovascular disease. Individual visit-to-visit variability in systolic and diastolic blood pressure and pulse pressure (expressed as 1 SD in mm Hg) was assessed using nine measurements over 2 years. Correlates of higher visit-to-visit variability were examined at baseline, including markers of inflammation, endothelial function, renal function and glucose homeostasis. Over the first 2 years, the mean intra-individual variability (1 SD) was 14.4mm Hg for systolic blood pressure, 7.7mm Hg for diastolic blood pressure, and 12.6mm Hg for pulse pressure. After multivariate adjustment a higher level of interleukin-6 at baseline was consistently associated with higher intra-individual variability of blood pressure, including systolic, diastolic, and pulse pressure. Markers of endothelial function (Von Willebrand factor, tissue plasminogen activator), renal function (glomerular filtration rate) and glucose homeostasis (blood glucose, homeostatic model assessment index) were not or to a minor extent associated with blood pressure variability. In an elderly population at risk of cardiovascular disease, inflammation (as evidenced by higher levels of interleukin-6) is associated with higher intra-individual variability in systolic, diastolic, and pulse pressure. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. [Short-term variability of blood pressure: physiology and pharmacology].

    PubMed

    Elghozi, J-L

    2008-06-01

    Non invasive continuous measurement of blood pressure (BP) is currently performed at the finger level. The various oscillations of BP are distinguished using spectral analysis based on the fast Fourier transform. The first order oscillation of BP is synchronous with the heart beat and generates pulsaltile changes in BP. Second order oscillations are generated by respiration and depend on intrathoracic pressure changes. They do not exceed few millimeters of mercury. Heart rate also oscillates with respiration. This respiratory sinus arrhythmia depends on vagal activity. A slower third order oscillation also called 10-s period rhythm or Mayer waves depend on vascular tone changes. These waves may reach 20 mmHg. Mayer waves reflect oscillations in resistance vessels and depend on sympathetic discharges. Sympathetic nerves determine oscillations in resistance vessels and cardiac rhythm at the same 0.1 Hz frequency. A better understanding of these oscillations helps in understanding BP regulatory mechanisms and in treating BP disorders. Prognosis of arterial hypertension also depends on these BP fluctuations. Recent time and frequency domain developments in the analysis of the reflex relationship between BP and heart rate allow the calculations of indexes of spontaneous baroreflex sensitivity. Baroreflex sensitivity is a new indicator of cardiovascular risk.

  14. Heterogeneity of Prognostic Studies of 24-Hour Blood Pressure Variability: Systematic Review and Meta-Analysis

    PubMed Central

    Taylor, Kathryn S.; Heneghan, Carl J.; Stevens, Richard J.; Adams, Emily C.; Nunan, David; Ward, Alison

    2015-01-01

    In addition to mean blood pressure, blood pressure variability is hypothesized to have important prognostic value in evaluating cardiovascular risk. We aimed to assess the prognostic value of blood pressure variability within 24 hours. Using MEDLINE, EMBASE and Cochrane Library to April 2013, we conducted a systematic review of prospective studies of adults, with at least one year follow-up and any day, night or 24-hour blood pressure variability measure as a predictor of one or more of the following outcomes: all-cause mortality, cardiovascular mortality, all cardiovascular events, stroke and coronary heart disease. We examined how blood pressure variability is defined and how its prognostic use is reported. We analysed relative risks adjusted for covariates including the appropriate mean blood pressure and considered the potential for meta-analysis. Our analysis of methods included 24 studies and analysis of predictions included 16 studies. There were 36 different measures of blood pressure variability and 13 definitions of night- and day-time periods. Median follow-up was 5.5 years (interquartile range 4.2–7.0). Comparing measures of dispersion, coefficient of variation was less well researched than standard deviation. Night dipping based on percentage change was the most researched measure and the only measure for which data could be meaningfully pooled. Night dipping or lower night-time blood pressure was associated with lower risk of cardiovascular events. The interpretation and use in clinical practice of 24-hour blood pressure variability, as an important prognostic indicator of cardiovascular events, is hampered by insufficient evidence and divergent methodologies. We recommend greater standardisation of methods. PMID:25984791

  15. Heterogeneity of prognostic studies of 24-hour blood pressure variability: systematic review and meta-analysis.

    PubMed

    Taylor, Kathryn S; Heneghan, Carl J; Stevens, Richard J; Adams, Emily C; Nunan, David; Ward, Alison

    2015-01-01

    In addition to mean blood pressure, blood pressure variability is hypothesized to have important prognostic value in evaluating cardiovascular risk. We aimed to assess the prognostic value of blood pressure variability within 24 hours. Using MEDLINE, EMBASE and Cochrane Library to April 2013, we conducted a systematic review of prospective studies of adults, with at least one year follow-up and any day, night or 24-hour blood pressure variability measure as a predictor of one or more of the following outcomes: all-cause mortality, cardiovascular mortality, all cardiovascular events, stroke and coronary heart disease. We examined how blood pressure variability is defined and how its prognostic use is reported. We analysed relative risks adjusted for covariates including the appropriate mean blood pressure and considered the potential for meta-analysis. Our analysis of methods included 24 studies and analysis of predictions included 16 studies. There were 36 different measures of blood pressure variability and 13 definitions of night- and day-time periods. Median follow-up was 5.5 years (interquartile range 4.2-7.0). Comparing measures of dispersion, coefficient of variation was less well researched than standard deviation. Night dipping based on percentage change was the most researched measure and the only measure for which data could be meaningfully pooled. Night dipping or lower night-time blood pressure was associated with lower risk of cardiovascular events. The interpretation and use in clinical practice of 24-hour blood pressure variability, as an important prognostic indicator of cardiovascular events, is hampered by insufficient evidence and divergent methodologies. We recommend greater standardisation of methods.

  16. Quantification of peripheral and central blood pressure variability using a time-frequency method.

    PubMed

    Kouchaki, Z; Butlin, M; Qasem, A; Avolio, A P; Kouchaki, Z; Butlin, M; Qasem, A; Avolio, A P; Kouchaki, Z; Avolio, A P; Butlin, M; Qasem, A

    2016-08-01

    Systolic blood pressure variability (BPV) is associated with cardiovascular events. As the beat-to-beat variation of blood pressure is due to interaction of several cardiovascular control systems operating with different response times, assessment of BPV by spectral analysis using the continuous measurement of arterial pressure in the finger is used to differentiate the contribution of these systems in regulating blood pressure. However, as baroreceptors are centrally located, this study considered applying a continuous aortic pressure signal estimated noninvasively from finger pressure for assessment of systolic BPV by a time-frequency method using Short Time Fourier Transform (STFT). The average ratio of low frequency and high frequency power band (LFPB/HFPB) was computed by time-frequency decomposition of peripheral systolic pressure (pSBP) and derived central aortic systolic blood pressure (cSBP) in 30 healthy subjects (25-62 years) as a marker of balance between cardiovascular control systems contributing in low and high frequency blood pressure variability. The results showed that the BPV assessed from finger pressure (pBPV) overestimated the BPV values compared to that assessed from central aortic pressure (cBPV) for identical cardiac cycles (P<;0.001), with the overestimation being greater at higher power.

  17. Genome wide analysis of blood pressure variability and ischemic stroke

    PubMed Central

    Khan, Muhammad S; Nalls, Michael A; Bevan, Steve; Cheng, Yu-Ching; Chen, Wei-Min; Malik, Rainer; McCarthy, Nina S; Holliday, Elizabeth G; Speed, Douglas; Hasan, Nazeeha; Pucek, Mateusz; Rinne, Paul E.; Sever, Peter; Stanton, Alice; Shields, Denis C; Maguire, Jane M; McEvoy, Mark; Scott, Rodney J; Ferrucci, Luigi; Macleod, Mary J; Attia, John; Markus, Hugh S; Sale, Michele M; Worrall, Bradford B; Mitchell, Braxton D; Dichgans, Martin; Sudlow, Cathy; Meschia, James F; Rothwell, Peter M

    2013-01-01

    Background and Purpose Visit-to-visit variability in BP is associated with ischemic stroke. We sought to determine whether such variability has a genetic aetiology and whether genetic variants associated with BP variability are also associated with ischemic stroke. Methods A GWAS for loci influencing BP variability was undertaken in 3,802 individuals from the Anglo-Scandinavian Cardiac Outcome Trial (ASCOT) study where long-term visit-to-visit and within visit BP measures were available. Since BP variability is strongly associated with ischemic stroke, we genotyped the sentinel SNP in an independent ischemic stroke population comprising of 8,624 cases and 12,722 controls and in 3,900 additional (Scandinavian) participants from the ASCOT study in order to replicate our findings. Results The ASCOT discovery GWAS identified a cluster of 17 correlated SNPs within the NLGN1 gene (3q26.31) associated with BP variability. The strongest association was with rs976683 (p=1.4×10−8). Conditional analysis on rs976683 provided no evidence of additional independent associations at the locus. Analysis of rs976683 in ischemic stroke patients found no association for overall stroke (OR 1.02; 95% CI 0.97-1.07; p=0.52) or its sub-types: CE (OR 1.07; 95% CI 0.97-1.16; p=0.17), LVD (OR 0.98; 95% 0.89-1.07; p=0.60) and SVD (OR 1.07; 95% CI 0.97-1.17; p=0.19). No evidence for association was found between rs976683 and BP variability in the additional (Scandinavian) ASCOT participants (p=0.18). Conclusions We identified a cluster of SNPs at the NLGN1 locus showing significant association with BP variability. Follow up analyses did not support an association with risk of ischemic stroke and its subtypes. PMID:23929743

  18. MEASUREMENT-TO-MEASUREMENT BLOOD PRESSURE VARIABILITY IS RELATED TO COGNITIVE PERFORMANCE: THE MAINE-SYRACUSE STUDY

    PubMed Central

    Crichton, Georgina E.; Elias, Merrill F.; Dore, Gregory A.; Torres, Rachael V.; Robbins, Michael A.

    2014-01-01

    The objective was to investigate the association between variability in blood pressure and cognitive function for sitting, standing and reclining blood pressure values, and variability derived from all 15 measures. In previous studies only sitting blood pressure values have been examined, and only a few cognitive measures have been employed. A secondary objective was to examine associations between blood pressure variability and cognitive performance in hypertensive individuals stratified by treatment success. Cross-sectional analyses were performed on 972 participants of the Maine Syracuse Study for whom 15 serial blood pressure clinic measures (5 sitting, 5 recumbant and 5 standing) were obtained, prior to testing of cognitive performance. Using all 15 measures, higher variability in systolic and diastolic blood pressure was associated with poorer performance on multiple measures of cognitive performance, independent of demographic factors, cardiovascular risk factors, and pulse pressure. When sitting, reclining and standing systolic blood pressure values were compared, only variability in standing blood pressure was related to measures of cognitive performance. However, for diastolic blood pressure, variability in all three positions was related to cognitive performance. Mean blood pressure values were weaker predictors of cognition. Furthermore, higher overall variability in both systolic and diastolic blood pressure was associated with poorer cognitive performance in unsuccessfully treated hypertensive individuals (with blood pressure ≥140/90 mmHg), but these associations were not evident in those with controlled hypertension. PMID:25156168

  19. Beat-to-beat heart rate and blood pressure variability and hypertensive disease in pregnancy.

    PubMed

    Flood, Pamela; McKinley, Paula; Monk, Catherine; Muntner, Paul; Colantonio, Lisandro D; Goetzl, Laura; Hatch, Maureen; Sloan, Richard P

    2015-09-01

    The aim of this study is to determine the relationship between heart rate and/or blood pressure variability, measured at 28 weeks' gestation, and the incidence of pregnancy-induced hypertension or preeclampsia. Secondary analysis of data from a prospectively enrolled cohort of 385 active military women in whom spectral analysis of continuous heart rate and variability was measured at 28 weeks' gestation. The primary outcome was the predictive value of spectral analysis of heart rate and blood pressure for hypertensive diseases of pregnancy. High-frequency heart rate variability was reduced and low-frequency variability of systolic and diastolic blood pressure increased in women who would develop pregnancy-induced hypertension but not preeclampsia. Low-frequency variability of diastolic blood pressure remained a significant predictor of pregnancy-induced hypertension but not preeclampsia after adjustment for age, weight, and blood pressure in a multivariate model. Early identification of pregnancy-induced hypertension can facilitate treatment to avoid maternal morbidity. Understanding the physiological underpinnings of the two very different diseases may lead to improved treatment and prevention. If proven effective in a broader population, the ability to differentiate pregnancy-induced hypertension from preeclampsia may reduce unnecessary iatrogenic interventions or inappropriate preterm delivery. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  20. Relationship of office, home, and ambulatory blood pressure to blood glucose and lipid variables in the PAMELA population.

    PubMed

    Mancia, Giuseppe; Facchetti, Rita; Bombelli, Michele; Polo Friz, Hernan; Grassi, Guido; Giannattasio, Cristina; Sega, Roberto

    2005-06-01

    Alterations in blood glucose and cholesterol are more frequently detectable in hypertensive than in normotensive conditions. However, no information exists as to whether this phenomenon involves only office or also home and 24-hour ambulatory blood pressure (ie, when values are representative of daily life). In 2045 subjects enrolled in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study, we measured home, 24-hour, and office blood pressure. Measurements also included fasting blood glucose and serum total and HDL cholesterol values. Prevalence of diabetes (> or =126 mg/dL or use of antidiabetic drugs), impaired fasting blood glucose (> or =110 to <126 mg/dL), and hypercholesterolemia (serum total cholesterol > or =240 mg/dL or 200 mg/dL) increased progressively from "optimal" to "normal," "high-normal," and "elevated" office systolic or diastolic blood pressure. Fasting blood glucose and total serum cholesterol also increased progressively from the first to the fourth group, with HDL cholesterol values showing a concomitant progressive decrease. This was also the case for quartiles of office, home, and 24-hour blood pressure. In the whole population, there was a positive correlation between serum cholesterol or blood glucose and all blood pressure values (P always <0.0001), with a much smaller and less consistent relationship with heart rate. In a multivariate analysis that included gender, body mass index, age, and antihypertensive treatment, all blood pressure values remained highly significantly related to values of either metabolic variables. Thus, in the PAMELA population, glucose and lipid values are independently related to blood pressure. This is also the case when daily life blood pressure values are considered.

  1. Ambulatory blood pressure monitoring-derived short-term blood pressure variability is increased in Cushing's syndrome.

    PubMed

    Rebellato, Andrea; Grillo, Andrea; Dassie, Francesca; Sonino, Nicoletta; Maffei, Pietro; Martini, Chiara; Paoletta, Agostino; Fabris, Bruno; Carretta, Renzo; Fallo, Francesco

    2014-11-01

    Cushing's syndrome is associated with high cardiovascular morbility and mortality. Blood pressure (BP) variability within a 24-h period is increasingly recognized as an independent predictor of cardiovascular risk. The aim of our study was to investigate the short-term BP variability indices in Cushing's syndrome. Twenty-five patients with Cushing's syndrome (mean age 49 ± 13 years, 4 males; 21 Cushing's disease and 4 adrenal adenoma patients) underwent 24-h ambulatory BP monitoring (ABPM) and evaluation of cardiovascular risk factors. Cushing patients were divided into 8 normotensive (NOR-CUSH) and 17 hypertensive (HYP-CUSH) patients and were compared with 20 normotensive (NOR-CTR) and 20 hypertensive (HYP-CTR) age-, sex-, and BMI-matched control subjects. Short-term BP variability was derived from ABPM and calculated as the following: (1) standard deviation (SD) of 24-h, daytime, and nighttime BP; (2) 24-h weighted SD of BP; and (3) average real variability (ARV), i.e., the average of the absolute differences between consecutive BP measurements over 24 h. In comparison with controls, patients with Cushing's syndrome, either normotensive or hypertensive, had higher 24-h and daytime SD of BP, as well as higher 24-h weighted SD and ARV of BP (P = 0.03 to P < 0.0001). No difference in metabolic parameters was observed between NOR-CTR and NOR-CUSH or between HYP-CTR and HYP-CUSH subgroups. ABPM-derived short-term BP variability is increased in Cushing's syndrome, independent of BP elevation. It may represent an additional cardiovascular risk factor in this disease. The role of excess cortisol in BP variability has to be further clarified.

  2. Heart rate variability, blood pressure variability, and baroreflex sensitivity in overtrained athletes.

    PubMed

    Baumert, Mathias; Brechtel, Lars; Lock, Jürgen; Hermsdorf, Mario; Wolff, Roland; Baier, Vico; Voss, Andreas

    2006-09-01

    To assess the effects of abruptly intensified physical training on cardiovascular control. Retrospective longitudinal study. Research laboratory. Ten healthy athletes (5 men and 5 women) from track and field as well as triathlon. A 2-week training camp, including daily stepwise increasing cycling tests, running of 40 minutes, and additional cycling of 60 minutes. Time and frequency domain parameters of resting heart rate and blood pressure variability (HRV and BPV) and baroreflex sensitivity (BRS), before, during, and after the training camp. We found significantly reduced HRV during the training camp (mean beat-to-beat interval: 1042 [937 to 1194] ms vs. 933 [832 to 1103] ms vs. 1055 [947 to 1183] ms, P < 0.01; root-mean-square of beat-to-beat interval differences: 68 [52 to 95] ms vs. 52 [38 to 71] ms vs. 61 [48 to 78] ms, P < 0.05). Further, BRS was significantly reduced: 25.2 (20.4 to 40.4) ms/mmHg vs. 17.0 (12.9 to 25.7) ms/mmHg vs. 25.7 (18.8 to 29.1) ms/mmHg, P < 0.05. These effects disappeared at a large degree after 3 to 4 days of recovery. Abruptly intensified physical training results in an altered autonomic cardiovascular activity towards parasympathetic inhibition and sympathetic activation that can be monitored by means of HRV and BRS analyses and might provide useful markers to avoid the overtraining syndrome.

  3. Blood Pressure and Heart Rate Variability to Detect Vascular Dysregulation in Glaucoma

    PubMed Central

    Koch, Eva Charlotte; Staab, Johanna; Fuest, Matthias; Witt, Katharina; Voss, Andreas; Plange, Niklas

    2015-01-01

    Purpose. To investigate blood pressure and heart rate variability in patients with primary open-angle glaucoma (POAG) to detect disturbed blood pressure regulation. Methods. Thirty-one patients with POAG (mean age 68 ± 10 years) and 48 control subjects (mean age 66 ± 10 years) were included in a prospective study. Continuous blood pressure and heart rate were simultaneously and noninvasively recorded over 30 min (Glaucoscreen, aviant GmbH, Jena, Germany). Data were analyzed calculating univariate linear (time domain and frequency domain), nonlinear (Symbolic Dynamics, SD) and bivariate (Joint Symbolic Dynamics, JSD) indices. Results. Using nonlinear methods, glaucoma patients were separated with more parameters compared to linear methods. In POAG, nonlinear univariate indices (pW113 and pW120_Sys) were increased while the indices pTH10_Sys and pTH11_Sys reflect a reduction of dominant patterns. Bivariate indices (JSDdia29, JSDdia50, and JSDdia52; coupling between heart rate and diastolic blood pressure) were increased in POAG. The optimum set consisting of six parameters (JSDdia29, JSDdia58, pTH9_Sys, pW231, pW110_Sys and pW120_Sys) revealed a sensitivity of 83.3% and specificity of 80.6%. Conclusions. Nonlinear uni- and bivariate indices of continuous recordings of blood pressure and heart rate are altered in glaucoma. Abnormal blood pressure variability suggests disturbed autonomic regulation in patients with glaucoma. PMID:26495136

  4. Blood Pressure and Heart Rate Variability to Detect Vascular Dysregulation in Glaucoma.

    PubMed

    Koch, Eva Charlotte; Staab, Johanna; Fuest, Matthias; Witt, Katharina; Voss, Andreas; Plange, Niklas

    2015-01-01

    Purpose. To investigate blood pressure and heart rate variability in patients with primary open-angle glaucoma (POAG) to detect disturbed blood pressure regulation. Methods. Thirty-one patients with POAG (mean age 68 ± 10 years) and 48 control subjects (mean age 66 ± 10 years) were included in a prospective study. Continuous blood pressure and heart rate were simultaneously and noninvasively recorded over 30 min (Glaucoscreen, aviant GmbH, Jena, Germany). Data were analyzed calculating univariate linear (time domain and frequency domain), nonlinear (Symbolic Dynamics, SD) and bivariate (Joint Symbolic Dynamics, JSD) indices. Results. Using nonlinear methods, glaucoma patients were separated with more parameters compared to linear methods. In POAG, nonlinear univariate indices (pW113 and pW120_Sys) were increased while the indices pTH10_Sys and pTH11_Sys reflect a reduction of dominant patterns. Bivariate indices (JSDdia29, JSDdia50, and JSDdia52; coupling between heart rate and diastolic blood pressure) were increased in POAG. The optimum set consisting of six parameters (JSDdia29, JSDdia58, pTH9_Sys, pW231, pW110_Sys and pW120_Sys) revealed a sensitivity of 83.3% and specificity of 80.6%. Conclusions. Nonlinear uni- and bivariate indices of continuous recordings of blood pressure and heart rate are altered in glaucoma. Abnormal blood pressure variability suggests disturbed autonomic regulation in patients with glaucoma.

  5. Inhibitory effects of losartan and azelnidipine on augmentation of blood pressure variability induced by angiotensin II in rats.

    PubMed

    Jiang, Danfeng; Kawagoe, Yukiko; Kuwasako, Kenji; Kitamura, Kazuo; Kato, Johji

    2017-07-05

    Increased blood pressure variability has been shown to be associated with cardiovascular morbidity and mortality. Recently we reported that continuous infusion of angiotensin II not only elevated blood pressure level, but also increased blood pressure variability in a manner assumed to be independent of blood pressure elevation in rats. In the present study, the effects of the angiotensin type I receptor blocker losartan and the calcium channel blocker azelnidipine on angiotensin II-induced blood pressure variability were examined and compared with that of the vasodilator hydralazine in rats. Nine-week-old male Wistar rats were subcutaneously infused with 240 pmol/kg/min angiotensin II for two weeks without or with oral administration of losartan, azelnidipine, or hydralazine. Blood pressure variability was evaluated using a coefficient of variation of blood pressure recorded every 15min under an unrestrained condition via an abdominal aortic catheter by a radiotelemetry system. Treatment with losartan suppressed both blood pressure elevation and augmentation of systolic blood pressure variability in rats infused with angiotensin II at 7 and 14 days. Azelnidipine also inhibited angiotensin II-induced blood pressure elevation and augmentation of blood pressure variability; meanwhile, hydralazine attenuated the pressor effect of angiotensin II, but had no effect on blood pressure variability. In conclusion, angiotensin II augmented blood pressure variability in an angiotensin type 1 receptor-dependent manner, and azelnidipine suppressed angiotensin II-induced augmentation of blood pressure variability, an effect mediated by the mechanism independent of the blood pressure-lowering action. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. On the origin of low-frequency blood pressure variability in the conscious dog.

    PubMed Central

    Just, A; Wagner, C D; Ehmke, H; Kirchheim, H R; Persson, P B

    1995-01-01

    1. Baroreceptor denervation increases blood pressure variability below 0.1 Hz. This study was undertaken to determine to what extent these fluctuations originate from the central nervous system or from cardiovascular sources. 2. Blood pressure was recorded at a rate of 10 Hz for approximately 3.5 h in conscious, resting dogs. Power density spectra were calculated from all 2(17) points of each recording session and integrated between 0.0002 and 0.1 Hz. 3. Blockade of the afferent limb of the baroreceptor reflex by surgical denervation of sinoaortic and cardiopulmonary afferents (Den; n = 6) significantly increased integrated power more than sixfold compared with a control group (n = 11). 4. Impairment of the efferent limb in non-deafferented dogs by either alpha 1-adrenergic blockade with prazosin (Praz; n = 7) or ganglionic blockade with hexamethonium (Hex; n = 6) failed to raise variability. 5. Both prazosin (n = 6) and hexamethonium (n = 3) reduced the increased variability in denervated dogs. 6. In non-deafferented dogs receiving hexamethonium, elevation of mean blood pressure to the hypertensive level of the Den group, by a continuous infusion of noradrenaline (n = 4), did not change the variability. 7. It is concluded that in the absence of changes in posture, most of the increased blood pressure variability after baroreceptor denervation is derived from the central nervous system. 8. Direct comparison of power spectra of the Den (total variability) and Hex groups (variability derived from the cardiovascular system only) suggests that the central nervous system is also the prevalent source of low-frequency blood pressure variability in intact animals. PMID:8583405

  7. Is It Daily, Monthly, or Yearly Blood Pressure Variability that Enhances Cardiovascular Risk?

    PubMed

    Dolan, Eamon; O'Brien, Eoin

    2015-11-01

    Variability is a phenomenon common to most biological processes that we can measure and is a particular feature of blood pressure (BP). Variability causes concern for many physicians regarding its clinical meaning and potential impact on cardiovascular risk. In this review, we assess the role of different time periods of blood pressure variability (BPV) in cardiovascular risk stratification. We review the indices of BPV derived from ambulatory blood pressure measurement (ABPM), home blood pressure measurement (HBPM), or at the clinic setting with the intention of providing a clear message for clinical practice. BPV, either derived from ABPM or HBPM, does not consistently augment cardiovascular risk prediction over and beyond that of average BP, particularly in low-risk individuals. That said, it would seem that certain medications such as calcium channel blockers may have a beneficial effect on visit-to-visit BPV and perhaps reduce the associated cardiovascular risk. This highlights the benefits in using combination therapy which might couple a number of therapeutic benefits such as the reductions of mean blood pressure and BPV. Overall, we should remain aware that the average BP level remains the main modifiable risk factor derived from BP measurements and continue to improve the control of hypertension and adverse health outcomes.

  8. Telmisartan exerts sustained blood pressure control and reduces blood pressure variability in metabolic syndrome by inhibiting sympathetic activity.

    PubMed

    Sueta, Daisuke; Koibuchi, Nobutaka; Hasegawa, Yu; Toyama, Kensuke; Uekawa, Ken; Katayama, Tetsuji; Ma, MingJie; Nakagawa, Takashi; Ogawa, Hisao; Kim-Mitsuyama, Shokei

    2014-12-01

    Accumulating evidence on blood pressure (BP) reduction with various angiotensin II receptor blockers (ARBs) show that the magnitudes and durations of BP control differ across ARBs. However, the mechanism of ARBs is unknown. This work was undertaken to compare telmisartan and valsartan in duration of BP control, BP variability, and effects on the autonomic nervous system. Using radiotelemetry combined with spectral analysis with a fast Fourier transformation algorithm, we compared the effects of various doses of telmisartan and valsartan on BP and its variability during dark (active phase) and light (inactive phase) periods over 5 weeks in SHR/NDmcr-cp(+/+)(SHRcp) rats, a model of metabolic syndrome. We also compared the effects of these ARBs on autonomic nervous system, central oxidative stress, and inflammation in SHRcp rats. Telmisartan exerted a longer-lasting BP-lowering effect and greater attenuation of BP variability in SHRcp than valsartan. Telmisartan decreased low frequency power of systolic BP and increased spontaneous baroreflex gain in SHRcp during both the dark and light periods more than valsartan. Telmisartan reduced 24-hour urinary norepinephrine excretion more than valsartan. Furthermore, telmisartan attenuated oxidative stress and the numbers of gp91(phox)-positive cells and activated microglia and astrocytes in the rostral ventrolateral medulla of SHRcp rats more than valsartan. The superiority of telmisartan over valsartan in sustained BP control and reduction of BP variability was attributed to more suppression of sympathetic activity and more improvement of baroreceptor reflex. The greater suppression of sympathetic activity by telmisartan appeared to be partially mediated by a stronger amelioration of central oxidative stress. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Excess Weight, Anthropometric Variables and Blood Pressure in Schoolchildren aged 10 to 18 years

    PubMed Central

    Schommer, Vânia Ames; Barbiero, Sandra Mari; Cesa, Cláudia Ciceri; Oliveira, Rosemary; Silva, Anelise Damiani; Pellanda, Lucia Campos

    2014-01-01

    Background The prevalence of hypertension among children and adolescents is estimated to range between 1% and 13%. Excess weight and central obesity are related to blood pressure levels in adults, and may be important in the early pathogenesis of SH when present in childhood. Objectives To study the association between anthropometric variables and blood pressure levels in schoolchildren from the 5th and 8th grades, and to identify which parameter was more strongly correlated with blood pressure levels. Methods Contemporary cross-sectional study with probabilistic population-based cluster sampling of schoolchildren enrolled from the 5th to the 8th grades in public elementary schools of Porto Alegre. Data on familial risk factors and anthropometry were collected. Statistical analysis included correlations and cluster-adjusted confidence intervals. Results The mean age of participants was 12.57 (± 1.64) years, and 55.2% of them were females. Abnormal blood pressure levels were found in 11.3% of the sample and borderline values, in 16.2%. Among the anthropometric variables analyzed, hip circumference was the one with the strongest correlation with increased blood pressure (r = 0.462, p < 0.001), followed by waist circumference (r = 0.404, p < 0.001) and abdominal skinfold (r = 0.291, p < 0.001). Conclusion We observed an association of waist circumference and skinfolds with increased blood pressure levels in the schoolchildren of the sample. Therefore, it is of the utmost importance that early measurements of blood pressure, and waist and hip circumferences become a routine in health services in order to prevent this condition. PMID:24676224

  10. Can Ambulatory Blood Pressure Variability Contribute to Individual Cardiovascular Risk Stratification?

    PubMed

    Magdás, Annamária; Szilágyi, László; Incze, Alexandru

    2016-01-01

    Objective. The aim of this study is to define the normal range for average real variability (ARV) and to establish whether it can be considered as an additional cardiovascular risk factor. Methods. In this observational study, 110 treated hypertensive patients were included and admitted for antihypertensive treatment adjustment. Circadian blood pressure was recorded with validated devices. Blood pressure variability (BPV) was assessed according to the ARV definition. Based on their variability, patients were classified into low, medium, and high variability groups using the fuzzy c-means algorithm. To assess cardiovascular risk, blood samples were collected. Characteristics of the groups were compared by ANOVA tests. Results. Low variability was defined as ARV below 9.8 mmHg (32 patients), medium as 9.8-12.8 mmHg (48 patients), and high variability above 12.8 mmHg (30 patients). Mean systolic blood pressure was 131.2 ± 16.7, 135.0 ± 12.1, and 141.5 ± 11.4 mmHg in the low, medium, and high variability groups, respectively (p = 0.0113). Glomerular filtration rate was 78.6 ± 29.3, 74.8 ± 26.4, and 62.7 ± 23.2 mL/min/1.73 m(2) in the low, medium, and high variability groups, respectively (p = 0.0261). Conclusion. Increased values of average real variability represent an additional cardiovascular risk factor. Therefore, reducing BP variability might be as important as achieving optimal BP levels, but there is need for further studies to define a widely acceptable threshold value.

  11. Blood pressure variability in relation to autonomic nervous system dysregulation: the X-CELLENT study.

    PubMed

    Zhang, Yi; Agnoletti, Davide; Blacher, Jacques; Safar, Michel E

    2012-04-01

    The purpose of this study was to investigate the association of autonomic nervous system dysregulation with blood pressure variability. Among the 2370 participants in the X-CELLENT study, 577 patients (59.0±10.2 years) were randomly selected to participate in an ancillary ambulatory blood-pressure monitoring study. We proposed a novel autonomic nervous system regulation index termed dSBP/dHR, which was defined as the steepness of the slope of the relationship between the 24-h systolic blood pressure (SBP) and the heart rate (HR) for each participant. Within-subjects s.d. of SBP, weighted for the time interval between consecutive validated readings from 24-h ambulatory blood pressure monitoring, was used to evaluate blood pressure variability. When dSBP/dHR was divided into tertiles, we observed a progressive increase from tertile 1 to tertile 3 in the daytime SBP, a progressive decrease in nighttime SBP, and consequently a progressive increase in the day-night SBP gradient (P<0.001). The s.d. of both daytime and nighttime SBPs were consistently and significantly increased from tertile 1 to tertile 3 (P<0.01). Both before and after adjustment for age, gender and 24-h mean blood pressure, all of these increasing and decreasing trends reached statistical significance (P<0.01). Furthermore, in our sensitivity analysis, when men and women were considered separately, the findings remained unaltered. In summary, autonomic nervous system dysfunction was associated with a heightened day-night SBP gradient and more variable SBP over 24 h in patients with essential hypertension.

  12. CXCL5 polymorphisms are associated with variable blood pressure in cardiovascular disease-free adults

    PubMed Central

    2012-01-01

    Objective Leukocyte count has been associated with blood pressure, hypertension, and hypertensive complications. We hypothesized that polymorphisms in the CXCL5 gene, which encodes the neutrophilic chemokine ENA-78, are associated with blood pressure in cardiovascular disease (CVD)-free adults and that these polymorphisms are functional. Methods and results A total of 192 community-dwelling participants without CVD or risk equivalents were enrolled. Two CXCL5 polymorphisms (−156 G > C (rs352046) and 398 G > A (rs425535)) were tested for associations with blood pressure. Allele-specific mRNA expression in leukocytes was also measured to determine whether heterozygosity was associated with allelic expression imbalance. In −156 C variant carriers, systolic blood pressure (SBP) was 7 mmHg higher than in −156 G/G wild-type homozygotes (131 ± 17 vs. 124 ± 14 mmHg; P = 0.008). Similarly, diastolic blood pressure (DBP) was 4 mmHg higher in −156 C variant carriers (78 ± 11 vs. 74 ± 11 mmHg; P = 0.013). In multivariate analysis of SBP, age, sex, body mass index, and the −156 G > C polymorphism were identified as significant variables. Age, sex, and the −156 G > C SNP were further associated with DBP, along with white blood cells. Allelic expression imbalance and significantly higher circulating ENA-78 concentrations were noted for variant carriers. Conclusion CXCL5 gene polymorphisms are functional and associated with variable blood pressure in CVD-free individuals. The role of CXCL5 as a hypertension- and CVD-susceptibility gene should be further explored. PMID:23245743

  13. CXCL5 polymorphisms are associated with variable blood pressure in cardiovascular disease-free adults.

    PubMed

    Beitelshees, Amber L; Aquilante, Christina L; Allayee, Hooman; Langaee, Taimour Y; Welder, Gregory J; Schofield, Richard S; Zineh, Issam

    2012-08-02

    Leukocyte count has been associated with blood pressure, hypertension, and hypertensive complications. We hypothesized that polymorphisms in the CXCL5 gene, which encodes the neutrophilic chemokine ENA-78, are associated with blood pressure in cardiovascular disease (CVD)-free adults and that these polymorphisms are functional. A total of 192 community-dwelling participants without CVD or risk equivalents were enrolled. Two CXCL5 polymorphisms (-156 G > C (rs352046) and 398 G > A (rs425535)) were tested for associations with blood pressure. Allele-specific mRNA expression in leukocytes was also measured to determine whether heterozygosity was associated with allelic expression imbalance. In -156 C variant carriers, systolic blood pressure (SBP) was 7 mmHg higher than in -156 G/G wild-type homozygotes (131 ± 17 vs. 124 ± 14 mmHg; P = 0.008). Similarly, diastolic blood pressure (DBP) was 4 mmHg higher in -156 C variant carriers (78 ± 11 vs. 74 ± 11 mmHg; P = 0.013). In multivariate analysis of SBP, age, sex, body mass index, and the -156 G > C polymorphism were identified as significant variables. Age, sex, and the -156 G > C SNP were further associated with DBP, along with white blood cells. Allelic expression imbalance and significantly higher circulating ENA-78 concentrations were noted for variant carriers. CXCL5 gene polymorphisms are functional and associated with variable blood pressure in CVD-free individuals. The role of CXCL5 as a hypertension- and CVD-susceptibility gene should be further explored.

  14. Short term Heart Rate Variability to predict blood pressure drops due to standing: a pilot study.

    PubMed

    Sannino, G; Melillo, P; Stranges, S; De Pietro, G; Pecchia, L

    2015-01-01

    Standing from a bed or chair may cause a significant lowering of blood pressure (ΔBP), which may have severe consequences such as, for example, falls in older subjects. The goal of this study was to develop a mathematical model to predict the ΔBP due to standing in healthy subjects, based on their Heart Rate Variability, recorded in the 5 minutes before standing. Heart Rate Variability was extracted from an electrocardiogram, recorded from 10 healthy subjects during the 5 minutes before standing. The blood pressure value was measured before and after rising. A mathematical model aiming to predict ΔBP based on Heart Rate Variability measurements was developed using a robust multi-linear regression and was validated with the leave-one-subject-out cross-validation technique. The model predicted correctly the ΔBP in 80% of experiments, with an error below the measurement error of sphygmomanometer digital devices (± 4.5 mmHg), a false negative rate of 7.5% and a false positive rate of 10%. The magnitude of the ΔBP was associated with a depressed and less chaotic Heart Rate Variability pattern. The present study showes that blood pressure lowering due to standing can be predicted by monitoring the Heart Rate Variability in the 5 minutes before standing.

  15. Short term Heart Rate Variability to predict blood pressure drops due to standing: a pilot study

    PubMed Central

    2015-01-01

    Background Standing from a bed or chair may cause a significant lowering of blood pressure (ΔBP), which may have severe consequences such as, for example, falls in older subjects. The goal of this study was to develop a mathematical model to predict the ΔBP due to standing in healthy subjects, based on their Heart Rate Variability, recorded in the 5 minutes before standing. Methods Heart Rate Variability was extracted from an electrocardiogram, recorded from 10 healthy subjects during the 5 minutes before standing. The blood pressure value was measured before and after rising. A mathematical model aiming to predict ΔBP based on Heart Rate Variability measurements was developed using a robust multi-linear regression and was validated with the leave-one-subject-out cross-validation technique. Results The model predicted correctly the ΔBP in 80% of experiments, with an error below the measurement error of sphygmomanometer digital devices (±4.5 mmHg), a false negative rate of 7.5% and a false positive rate of 10%. The magnitude of the ΔBP was associated with a depressed and less chaotic Heart Rate Variability pattern. Conclusions The present study showes that blood pressure lowering due to standing can be predicted by monitoring the Heart Rate Variability in the 5 minutes before standing. PMID:26391336

  16. Increased Blood Pressure Variability Is Associated with Worse Neurologic Outcome in Acute Anterior Circulation Ischemic Stroke

    PubMed Central

    Bennett, Alicia; Stoddard, Gregory J.; Smith, Gordon; Wang, Haimei; Wold, Jana; Chung, Lee; Tirschwell, David L.; Majersik, Jennifer J.

    2016-01-01

    Background. Although research suggests that blood pressure variability (BPV) is detrimental in the weeks to months after acute ischemic stroke, it has not been adequately studied in the acute setting. Methods. We reviewed acute ischemic stroke patients from 2007 to 2014 with anterior circulation stroke. Mean blood pressure and three BPV indices (standard deviation, coefficient of variation, and successive variation) for the intervals 0–24, 0–72, and 0–120 hours after admission were correlated with follow-up modified Rankin Scale (mRS) in ordinal logistic regression models. The correlation between BPV and mRS was further analyzed by terciles of clinically informative stratifications. Results. Two hundred and fifteen patients met inclusion criteria. At all time intervals, increased systolic BPV was associated with higher mRS, but the relationship was not significant for diastolic BPV or mean blood pressure. This association was strongest in patients with proximal stroke parent artery vessel occlusion and lower mean blood pressure. Conclusion. Increased early systolic BPV is associated with worse neurologic outcome after ischemic stroke. This association is strongest in patients with lower mean blood pressure and proximal vessel occlusion, often despite endovascular or thrombolytic therapy. This hypothesis-generating dataset suggests potential benefit for interventions aimed at reducing BPV in this patient population. PMID:27974991

  17. Reciprocal Interaction of 24-Hour Blood Pressure Variability and Systolic Blood Pressure on Outcome in Stroke Thrombolysis.

    PubMed

    Kellert, Lars; Hametner, Christian; Ahmed, Niaz; Rauch, Geraldine; MacLeod, Mary J; Perini, Francesco; Lees, Kennedy R; Ringleb, Peter A

    2017-07-01

    Significance and management of blood pressure (BP) changes in acute stroke care are unclear. Here, we aimed to investigate the impact of 24-hour BP variability (BPV) on outcome in patients with acute ischemic stroke treated with intravenous thrombolysis. From the Safe Implementation of Treatment in Stroke International Stroke Thrombolysis registry, 28 976 patients with documented pre-treatment systolic BP at 2 and 24 hours were analyzed. The primary measure of BP variability was successive variability. Data were preprocessed using coarsened exact matching. We assessed early neurological improvement, symptomatic intracerebral hemorrhage (SICH), and long-term functional outcome (modified Rankin Scale [mRS] at 90 days) by binary and ordinal regression analyses. Attempts to explain successive variation for analysis of BPV with patients characteristics at admission found systolic BP (5.5% variance) to be most influential, yet 92% of BPV variance remained unexplained. Independently from systolic BP, successive variation for analysis of BPV was associated with poor functional outcome mRS score of 0 to 2 (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.90-0.98), disadvantage across the shift of mRS (OR, 1.04; 95% CI, 1.01-1.08), mortality (OR, 1.10; 95% CI, 1.01-1.08), SICHSITS (OR, 1.14; 95% CI, 1.06-1.23), and SICHECASS (OR, 1.24; 95% CI, 1.10-1.40; ECASS [European Cooperative Acute Stroke Study 2]). Analyzing successive variation for analysis of BPV as a function of pre-treatment, systolic BP significantly improved the prediction of functional outcome (mRS score of 0-1, mRS score of 0-2, neurological improvement, mRS-shift: all Pinteraction<0.01). Excluding patients with atrial fibrillation in a sensitivity analysis gave consistent results overall. This study suggests the need for a more individual BP management accounting for pre-treatment BP and the acute BP course (ie, BPV) to achieve best possible outcome for the patient. © 2017 American Heart Association

  18. INTRACRANIAL AND BLOOD PRESSURE VARIABILITY AND LONG-TERM OUTCOME AFTER ANEURYSMAL SUBARACHNOID HEMORRHAGE

    PubMed Central

    Kirkness, Catherine J.; Burr, Robert L.; Mitchell, Pamela H.

    2009-01-01

    Background Care of individuals in the intensive care unit (ICU) with brain injury traditionally focuses on maintaining ABP and ICP within prescribed ranges. However research suggests that the dynamic variability of these pressure signals provides additional information about physiologic functioning and may reflect adaptive capacity. Objectives The purpose of this study was to examine the ability to predict long-term outcome from arterial blood pressure (ABP) and intracranial pressure (ICP) variability in patients with aneurysmal subarachnoid hemorrhage (SAH). Methods ABP and ICP were monitored continuously for four days in 90 patients (74% female; mean age 53 years) in an ICU following SAH. Variability of ABP and ICP signals was calculated at four time scales (24-hour, hourly, 5-minute, and difference of sequential 5second averages). Long-term functional outcome was assessed 6 months post-SAH using the Extended Glasgow Outcome Scale. Results Pressure (ABP, ICP) variability indices were better predictors of 6-month functional outcome than mean pressure levels. Indices reflecting faster variability (particularly 5-second) were positively associated with better long-term outcome (typical p<0.001), while greater 24-hour variability was related to poorer outcomes (typical p <0.001), controlling for initial neurologic condition. Conclusions Beyond the measurement of ABP and ICP levels in acutely ill patients with SAH, simple measures of variability of these signals provide prognostic information regarding long-term functional outcome. The relationship between outcome and ICP and ABP variability in SAH 2 variability was dependent on the time scale at which the variability was measured. Given its positive association with better outcome, greater faster variability may reflect better physiologic adaptive capacity. PMID:19411584

  19. Blood pressure and heart rate variability and baroreflex sensitivity before and after brain death

    PubMed Central

    Conci, F; Di, R; Castiglioni, P

    2001-01-01

    OBJECTIVES—To evaluate spontaneous blood pressure and heart rate variability and spontaneous baroreflex sensitivity before and after brain death.
METHODS—Spontaneous variability of arterial blood pressure and heart rate—estimated by power spectra of systolic (SBP) and diastolic blood pressure (DBP) and pulse interval (PI)—and spontaneous baroreflex sensitivity (BRS)—estimated by the alpha index and the sequence technique—were evaluated in 11 patients twice: shortly before and 1 hour after the onset of brain death.
RESULTS—Significant spectral changes occurred after brain death: a general power reduction in PI spectra; a shift of SBP, DBP and PI powers toward the lower frequencies, resulting in a greater slope of the "1/f" spectral trends; and a marked reduction of SBP and DBP powers (-93%) and of SBP-PI coherence (−63%) at 0.1Hz. The estimated average BRS was relatively high before brain death (around 11 ms/mm Hg), and fell close to 0 or even was not detectable at all after brain death.
CONCLUSIONS—Parameters describing spontaneous blood pressure and heart rate variability and indexes reflecting the baroreflex function, which were relatively normal up to a few hours before brain death, underwent marked changes with the onset of brain death. All the changes found are likely to reflect the cessation of activity of the cardiovascular brain stem centres. These findings indicate that techniques of blood pressure and heart rate spectral analysis and of dynamic assessment of baroreflex sensitivity may be useful to complement the diagnosis of brain stem death.

 PMID:11606674

  20. Environmental lead exposure is associated with visit-to-visit systolic blood pressure variability in the US adults.

    PubMed

    Faramawi, Mohammed F; Delongchamp, Robert; Lin, Yu-Sheng; Liu, Youcheng; Abouelenien, Saly; Fischbach, Lori; Jadhav, Supriya

    2015-04-01

    The association between environmental lead exposure and blood pressure variability, an important risk factor for cardiovascular disease, is unexplored and unknown. The objective of the study was to test the hypothesis that lead exposure is associated with blood pressure variability. American participants 17 years of age or older from National Health and Nutrition Examination Survey III were included in the analysis. Participants' blood lead concentrations expressed as micrograms per deciliter were determined. The standard deviations of visit-to-visit systolic and diastolic blood pressure were calculated to determine blood pressure variability. Multivariable regression analyses adjusted for age, gender, race, smoking and socioeconomic status were employed. The participants' mean age and mean blood lead concentration were 42.72 years and 3.44 mcg/dl, respectively. Systolic blood pressure variability was significantly associated with environmental lead exposure after adjusting for the effect of the confounders. The unadjusted and adjusted means of visit-to-visit systolic blood pressure variability and the β coefficient of lead exposure were 3.44, 3.33 mcg/dl, β coefficient = 0.07, P < 0.01. This study documents a positive linear relationship between environmental lead exposure and systolic blood pressure variability. Screening adults with fluctuating blood pressure for lead exposure could be warranted.

  1. Application of cardiovascular models in comparative physiology and blood pressure variability.

    PubMed

    Avolio, Alberto P; Xu, Ke; Butlin, Mark

    2013-01-01

    The usefulness of cardiovascular models is determined by their intended function with respect to elucidating underlying hemodynamic concepts and to enable simulations that will assist in understanding the effects of specific parameters. Models can take different forms, including mock circulatory constructs with physical components, mathematical representations of parameter space relations employing constitutive equations, or closed form representations of electrical circuit analogs described in the time or frequency domain. This investigation describes the use of cardiovascular models based on electrical analogs of mechanical hydrodynamic systems to elucidate two different physiologic concepts: (i) the use of distributed vascular impedance to investigate comparative physiology of optimal design and features related to body size across a broad range of animal species; (ii) use of lumped parameter models to assess the role of arterial stiffness in blood pressure variability. The impedance model shows that an allometric relationship between body weight and aortic effective length can be determined by using the frequency of minimum input impedance and aortic pulse wave velocity. This concept provides a background for optimal matching of body size and hemodynamic load on the heart. The lumped parameter model indicates that arterial stiffness, simulated by the total arterial compliance term, has a significant impact on variability of arterial pressure when changes are due to dynamic alterations of peripheral resistance. In addition, the known pressure dependency of arterial stiffness results in a curvilinear relationship between blood pressure variability and mean pressure. This has implications in hypertensive treatment where there are marked changes in arterial stiffness, as occurs with aging.

  2. Heart Rate and Blood Pressure Variability under Moon, Mars and Zero Gravity Conditions During Parabolic Flights

    NASA Astrophysics Data System (ADS)

    Aerts, Wouter; Joosen, Pieter; Widjaja, Devy; Varon, Carolina; Vandeput, Steven; Van Huffel, Sabine; Aubert, Andre E.

    2013-02-01

    Gravity changes during partial-G parabolic flights (0g -0.16g - 0.38g) lead to changes in modulation of the autonomic nervous system (ANS), studied via the heart rate variability (HRV) and blood pressure variability (BPV). HRV and BPV were assessed via classical time and frequency domain measures. Mean systolic and diastolic blood pressure show both increasing trends towards higher gravity levels. The parasympathetic and sympathetic modulation show both an increasing trend with decreasing gravity, although the modulation is sympathetic predominant during reduced gravity. For the mean heart rate, a non-monotonic relation was found, which can be explained by the increased influence of stress on the heart rate. This study shows that there is a relation between changes in gravity and modulations in the ANS. With this in mind, countermeasures can be developed to reduce postflight orthostatic intolerance.

  3. Suppressor effects in the relations of psychological variables to resting blood pressure.

    PubMed

    Goldstein, H S; Edelberg, R; Meier, C F; Davis, L

    1991-08-01

    The role of suppressor effects in obscuring the relation of psychological variables and blood pressure was studied. Forty-five nonmedicated patients in a family practice rated themselves relative to their peers on a series of characteristics. Two of these, trapped and lonely, exhibited marked suppressor effects in their relationship with each other and resting blood pressure. Self-ratings of lonely exhibited a moderately strong positive association with ratings of trapped (r = .63) while only ratings of lonely showed a significant correlation with resting systolic blood pressure (r = .31). Yet when the suppressor effects of the ratings on feeling lonely were removed in the regression analyses, the ratings on feeling trapped showed a significant positive association with resting systolic pressure (r = .42). Similarly, while neither ratings on feeling lonely or on feeling trapped showed separately a significant association with resting diastolic pressure, when suppressor effects were removed in the regression analyses, the ratings of trapped were significantly associated with diastolic pressure in a positive direction (r = .34) and ratings of lonely were significantly associated in a negative direction (r = .33). The significance of this specific suppressor effect and the implications of suppression for psychosomatic research are discussed.

  4. ICU Blood Pressure Variability May Predict Nadir of Respiratory Depression After Coronary Artery Bypass Surgery

    PubMed Central

    Costa, Anne S. M.; Costa, Paulo H. M.; de Lima, Carlos E. B.; Pádua, Luiz E. M.; Campos, Luciana A.; Baltatu, Ovidiu C.

    2016-01-01

    Objectives: Surgical stress induces alterations on sympathovagal balance that can be determined through assessment of blood pressure variability. Coronary artery bypass graft surgery (CABG) is associated with postoperative respiratory depression. In this study we aimed at investigating ICU blood pressure variability and other perioperative parameters that could predict the nadir of postoperative respiratory function impairment. Methods: This prospective observational study evaluated 44 coronary artery disease patients subjected to coronary artery bypass surgery (CABG) with cardiopulmonary bypass (CPB). At the ICU, mean arterial pressure (MAP) was monitored every 30 min for 3 days. MAP variability was evaluated through: standard deviation (SD), coefficient of variation (CV), variation independent of mean (VIM), and average successive variability (ASV). Respiratory function was assessed through maximal inspiratory (MIP) and expiratory (MEP) pressures and peak expiratory flow (PEF) determined 1 day before surgery and on the postoperative days 3rd to 7th. Intraoperative parameters (volume of cardioplegia, CPB duration, aortic cross-clamp time, number of grafts) were also monitored. Results: Since, we aimed at studying patients without confounding effects of postoperative complications on respiratory function, we had enrolled a cohort of low risk EuroSCORE (European System for Cardiac Operative Risk Evaluation) with < 2. Respiratory parameters MIP, MEP, and PEF were significantly depressed for 4–5 days postoperatively. Of all MAP variability parameters, the ASV had a significant good positive Spearman correlation (rho coefficients ranging from 0.45 to 0.65, p < 0.01) with the 3-day nadir of PEF after cardiac surgery. Also, CV and VIM of MAP were significantly associated with nadir days of MEP and PEF. None of the intraoperative parameters had any correlation with the postoperative respiratory depression. Conclusions: Variability parameters ASV, CV, and VIM of the MAP

  5. Blood Pressure Variability: Can Nonlinear Dynamics Enhance Risk Assessment During Cardiovascular Surgery? A Feasibility Study

    PubMed Central

    Subramaniam, Balachundhar; Khabbaz, Kamal R.; Heldt, Thomas; Lerner, Adam B.; Mittleman, Murray A.; Davis, Roger B.; Goldberger, Ary L.; Costa, Madalena D.

    2014-01-01

    Brief Summary We propose that complex (nonlinear) fluctuations of hemodynamic variables (including systemic blood pressure parameters) during cardiovascular surgery contain information relevant to risk assessment and intraoperative management. Preliminary analysis of a pilot study supports the feasibility and potential merits of performing a larger, prospective study to assess the clinical utility of such new dynamical measures and to evaluate their potential role in enhancing contemporary approaches to risk assessment of major adverse events. PMID:24508020

  6. Estimation of blood pressure variability using independent component analysis of photoplethysmographic signal.

    PubMed

    Abe, Makoto; Yoshizawa, Makoto; Sugita, Norihiro; Tanaka, Akira; Chiba, Shigeru; Yambe, Tomoyuki; Nitta, Shin-ichi

    2009-01-01

    The maximum cross-correlation coefficient rho(max) between blood pressure variability and heart rate variability, whose frequency components are limited to the Mayer wave-related band, is a useful index to evaluate the state of the autonomic nervous function related to baroreflex. However, measurement of continuous blood pressure with an expensive and bulky measuring device is required to calculate rho(max). The present study has proposed an easier method for obtaining rho(max) with measurement of finger photoplethysmography (PPG). In the proposed method, independent components are extracted from feature variables specified by the PPG signal by using the independent component analysis (ICA), and then the most appropriate component is chosen out of them so that the rho(max) based on the component can fit its true value. The results from the experiment with a postural change performed in 17 healthy subjects suggested that the proposed method is available for estimating rho(max) by using the ICA to extract blood pressure information from the PPG signal.

  7. Genetic and environmental influences on blood pressure variability: a study in twins.

    PubMed

    Xu, Xiaojing; Ding, Xiuhua; Zhang, Xinyan; Su, Shaoyong; Treiber, Frank A; Vlietinck, Robert; Fagard, Robert; Derom, Catherine; Gielen, Marij; Loos, Ruth J F; Snieder, Harold; Wang, Xiaoling

    2013-04-01

    Blood pressure variability (BPV) and its reduction in response to antihypertensive treatment are predictors of clinical outcomes; however, little is known about its heritability. In this study, we examined the relative influence of genetic and environmental sources of variance of BPV and the extent to which it may depend on race or sex in young twins. Twins were enrolled from two studies. One study included 703 white twins (308 pairs and 87 singletons) aged 18-34 years, whereas another study included 242 white twins (108 pairs and 26 singletons) and 188 black twins (79 pairs and 30 singletons) aged 12-30 years. BPV was calculated from 24-h ambulatory blood pressure recording. Twin modeling showed similar results in the separate analysis in both twin studies and in the meta-analysis. Familial aggregation was identified for SBP variability (SBPV) and DBP variability (DBPV) with genetic factors and common environmental factors together accounting for 18-40% and 23-31% of the total variance of SBPV and DBPV, respectively. Unique environmental factors were the largest contributor explaining up to 82-77% of the total variance of SBPV and DBPV. No sex or race difference in BPV variance components was observed. The results remained the same after adjustment for 24-h blood pressure levels. The variance in BPV is predominantly determined by unique environment in youth and young adults, although familial aggregation due to additive genetic and/or common environment influences was also identified explaining about 25% of the variance in BPV.

  8. Visit-to-visit variability of blood pressure and renal function decline in patients with diabetic chronic kidney disease.

    PubMed

    Yokota, Kei; Fukuda, Masamichi; Matsui, Yoshio; Kario, Kazuomi; Kimura, Kenjiro

    2014-05-01

    The authors previously reported that the visit-to-visit variability of blood pressure is correlated with renal function decline in nondiabetic chronic kidney disease. Little is known about the association between visit-to-visit variability and renal function decline in patients with diabetic chronic kidney disease. The authors retrospectively studied 69 patients with diabetic chronic kidney disease stage 3a, 3b, or 4. The standard deviation and coefficient of variation of blood pressure in 12 consecutive visits were defined as visit-to-visit variability of blood pressure. The median observation period was 32 months. In univariate correlation, the standard deviation and coefficient of variation of blood pressure were not significantly associated with the slope of estimated glomerular filtration rate. There was no significant association between the visit-to-visit variability of blood pressure and renal function decline in patients with diabetic chronic kidney disease, in contrast with our previous study of nondiabetic patients with chronic kidney disease.

  9. Mechanism of blood pressure and R-R variability: insights from ganglion blockade in humans

    NASA Technical Reports Server (NTRS)

    Zhang, Rong; Iwasaki, Kenichi; Zuckerman, Julie H.; Behbehani, Khosrow; Crandall, Craig G.; Levine, Benjamin D.; Blomqvist, C. G. (Principal Investigator)

    2002-01-01

    Spontaneous blood pressure (BP) and R-R variability are used frequently as 'windows' into cardiovascular control mechanisms. However, the origin of these rhythmic fluctuations is not completely understood. In this study, with ganglion blockade, we evaluated the role of autonomic neural activity versus other 'non-neural' factors in the origin of BP and R-R variability in humans. Beat-to-beat BP, R-R interval and respiratory excursions were recorded in ten healthy subjects (aged 30 +/- 6 years) before and after ganglion blockade with trimethaphan. The spectral power of these variables was calculated in the very low (0.0078-0.05 Hz), low (0.05-0.15 Hz) and high (0.15-0.35 Hz) frequency ranges. The relationship between systolic BP and R-R variability was examined by cross-spectral analysis. After blockade, R-R variability was virtually abolished at all frequencies; however, respiration and high frequency BP variability remained unchanged. Very low and low frequency BP variability was reduced substantially by 84 and 69 %, respectively, but still persisted. Transfer function gain between systolic BP and R-R interval variability decreased by 92 and 88 % at low and high frequencies, respectively, while the phase changed from negative to positive values at the high frequencies. These data suggest that under supine resting conditions with spontaneous breathing: (1) R-R variability at all measured frequencies is predominantly controlled by autonomic neural activity; (2) BP variability at high frequencies (> 0.15 Hz) is mediated largely, if not exclusively, by mechanical effects of respiration on intrathoracic pressure and/or cardiac filling; (3) BP variability at very low and low frequencies (< 0.15 Hz) is probably mediated by both sympathetic nerve activity and intrinsic vasomotor rhythmicity; and (4) the dynamic relationship between BP and R-R variability as quantified by transfer function analysis is determined predominantly by autonomic neural activity rather than other

  10. Mechanism of blood pressure and R-R variability: insights from ganglion blockade in humans

    NASA Technical Reports Server (NTRS)

    Zhang, Rong; Iwasaki, Kenichi; Zuckerman, Julie H.; Behbehani, Khosrow; Crandall, Craig G.; Levine, Benjamin D.; Blomqvist, C. G. (Principal Investigator)

    2002-01-01

    Spontaneous blood pressure (BP) and R-R variability are used frequently as 'windows' into cardiovascular control mechanisms. However, the origin of these rhythmic fluctuations is not completely understood. In this study, with ganglion blockade, we evaluated the role of autonomic neural activity versus other 'non-neural' factors in the origin of BP and R-R variability in humans. Beat-to-beat BP, R-R interval and respiratory excursions were recorded in ten healthy subjects (aged 30 +/- 6 years) before and after ganglion blockade with trimethaphan. The spectral power of these variables was calculated in the very low (0.0078-0.05 Hz), low (0.05-0.15 Hz) and high (0.15-0.35 Hz) frequency ranges. The relationship between systolic BP and R-R variability was examined by cross-spectral analysis. After blockade, R-R variability was virtually abolished at all frequencies; however, respiration and high frequency BP variability remained unchanged. Very low and low frequency BP variability was reduced substantially by 84 and 69 %, respectively, but still persisted. Transfer function gain between systolic BP and R-R interval variability decreased by 92 and 88 % at low and high frequencies, respectively, while the phase changed from negative to positive values at the high frequencies. These data suggest that under supine resting conditions with spontaneous breathing: (1) R-R variability at all measured frequencies is predominantly controlled by autonomic neural activity; (2) BP variability at high frequencies (> 0.15 Hz) is mediated largely, if not exclusively, by mechanical effects of respiration on intrathoracic pressure and/or cardiac filling; (3) BP variability at very low and low frequencies (< 0.15 Hz) is probably mediated by both sympathetic nerve activity and intrinsic vasomotor rhythmicity; and (4) the dynamic relationship between BP and R-R variability as quantified by transfer function analysis is determined predominantly by autonomic neural activity rather than other

  11. Measurement-to-measurement blood pressure variability is related to cognitive performance: the Maine Syracuse study.

    PubMed

    Crichton, Georgina E; Elias, Merrill F; Dore, Gregory A; Torres, Rachael V; Robbins, Michael A

    2014-11-01

    The objective was to investigate the association between variability in blood pressure (BP) and cognitive function for sitting, standing, and reclining BP values and variability derived from all 15 measures. In previous studies, only sitting BP values have been examined, and only a few cognitive measures have been used. A secondary objective was to examine associations between BP variability and cognitive performance in hypertensive individuals stratified by treatment success. Cross-sectional analyses were performed on 972 participants of the Maine Syracuse Study for whom 15 serial BP clinic measures (5 sitting, 5 recumbent, and 5 standing) were obtained before testing of cognitive performance. Using all 15 measures, higher variability in systolic and diastolic BP was associated with poorer performance on multiple measures of cognitive performance, independent of demographic factors, cardiovascular risk factors, and pulse pressure. When sitting, reclining, and standing systolic BP values were compared, only variability in standing BP was related to measures of cognitive performance. However, for diastolic BP, variability in all 3 positions was related to cognitive performance. Mean BP values were weaker predictors of cognition. Furthermore, higher overall variability in both systolic and diastolic BP was associated with poorer cognitive performance in unsuccessfully treated hypertensive individuals (with BP ≥140/90 mm Hg), but these associations were not evident in those with controlled hypertension.

  12. The relationship between ambulatory blood pressure variability and enlarged perivascular spaces: a cross-sectional study.

    PubMed

    Yang, Shuna; Qin, Wei; Yang, Lei; Fan, Huimin; Li, Yue; Yin, Jiangmei; Hu, Wenli

    2017-08-21

    Recent studies reported that 24-hour ambulatory blood pressure variability (ABPV) was associated with lacunar infarction and white matter hyperintensities (WMH). However, the relationship between ABPV and enlarged perivascular spaces (EPVS) has not been investigated. Thus, our study aimed to investigate whether ABPV is associated with EPVS by 24-hour ambulatory blood pressure monitoring (ABPM). We conducted this study as a cross-sectional study. The study was based on patients who presented for physical examinations in our hospital from May 2013 to June 2016. Patients with both brain MRI scans and 24-hour ABPM were included and patients with acute stroke, a history of severe stroke and some other severe diseases were excluded. A total of 573 Chinese patients were prospectively enrolled in this study. EPVS in basal ganglia (BG) and white matter (WM) were identified on MRI and classified into three categories by the severity. WMH were scored by the Fazekas scale. Coefficient of variation (CV) and SD were considered as metrics of ABPV. Spearman correlation analysis and ordinal logistic regression analysis were used to assess the relationship between ABPV and EPVS. There were statistical differences among the subgroups stratified by the severity of EPVS in BG in the following ABPV metrics: SD and CV of systolic blood pressure (SBP), CV of diastolic blood pressure (DBP) in 24 hours, daytime and nighttime and SD of DBP in nighttime. The above ABPV metrics were positively associated with the degree of EPVS. The association was unchanged after adjusting for confounders. Spearman correlation analysis showed ABPV was not related to the degree of EPVS in the WM. ABPV was independently associated with EPVS in BG after controlling for blood pressure, but not in the WM. Pathogenesis of EPVS in BG and WM might be different. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted

  13. Identification of low and high frequency ranges for heart rate variability and blood pressure variability analyses using pharmacological autonomic blockade with atropine and propranolol in swine.

    USDA-ARS?s Scientific Manuscript database

    Understanding autonomic nervous system functioning, which mediates behavioral and physiological responses to stress, offers great potential for evaluation of farm animal stress and welfare. Evaluation of heart rate variability (HRV) and blood pressure variability (BPV), using time and frequency doma...

  14. Blood pressure and heart rate variability complexity analysis in pregnant women with hypertension.

    PubMed

    Tejera, Eduardo; Areias, Maria Jose; Rodrigues, Ana Isabel; Nieto-Villar, Jose Manuel; Rebelo, Irene

    2012-01-01

    In this work, we perform a comparative analysis of blood pressure and heart rate variability complexity during pregnancy between normal, hypertensive, and preeclamptic women. A total of 563 short electrocardiographic (10 min) records were obtained from 217 pregnant women (135 normal, 55 hypertensive, and 27 preeclamptic) during several gestational ages in sitting position. We used a mixed unbalanced model for the longitudinal statistical analysis and besides the conventional spectral analysis, we applied Lempel-Ziv complexity, sample entropy, approximated entropy, and detrended fluctuation analysis in the complexity measurement. The obtained results revealed significant differences between pathological and normal states with important considerations related to pregnancy adaptability and evolution as well as the relationship of complexity and blood pressure with factors such as maternal age, familial history of diabetes or hypertension, and parity.

  15. Pre-dialysis systolic blood pressure-variability is independently associated with all-cause mortality in incident haemodialysis patients.

    PubMed

    Selvarajah, Viknesh; Pasea, Laura; Ojha, Sanjay; Wilkinson, Ian B; Tomlinson, Laurie A

    2014-01-01

    Systolic blood pressure variability is an independent risk factor for mortality and cardiovascular events. Standard measures of blood pressure predict outcome poorly in haemodialysis patients. We investigated whether systolic blood pressure variability was associated with mortality in incident haemodialysis patients. We performed a longitudinal observational study of patients commencing haemodialysis between 2005 and 2011 in East Anglia, UK, excluding patients with cardiovascular events within 6 months of starting haemodialysis. The main exposure was variability independent of the mean (VIM) of systolic blood pressure from short-gap, pre-dialysis blood pressure readings between 3 and 6 months after commencing haemodialysis, and the outcome was all-cause mortality. Of 203 patients, 37 (18.2%) patients died during a mean follow-up of 2.0 (SD 1.3) years. The age and sex-adjusted hazard ratio (HR) for mortality was 1.09 (95% confidence interval (CI) 1.02-1.17) for a one-unit increase of VIM. This was not altered by adjustment for diabetes, prior cardiovascular disease and mean systolic blood pressure (HR 1.09, 95% CI 1.02-1.16). Patients with VIM of systolic blood pressure above the median were 2.4 (95% CI 1.17-4.74) times more likely to die during follow-up than those below the median. Results were similar for all measures of blood pressure variability and further adjustment for type of dialysis access, use of antihypertensives and absolute or variability of fluid intake did not alter these findings. Diastolic blood pressure variability showed no association with all cause mortality. Our study shows that variability of systolic blood pressure is a strong and independent predictor of all-cause mortality in incident haemodialysis patients. Further research is needed to understand the mechanism as this may form a therapeutic target or focus for management.

  16. Association between mortality and blood pressure variability in hypertensive and normotensive elders: A cohort study.

    PubMed

    Weiss, Avraham; Beloosesky, Yichayaou; Koren-Morag, Nira; Grossman, Alon

    2017-08-01

    To evaluate the association between blood pressure variability (BPV) and mortality in the elderly, all blood pressure measurements recorded in a cohort of individuals 65 years and older were collected and the association between BPV coefficient of variation (BPV divided by mean arterial pressure) was calculated. Mortality during a 10-year period was compared between BPV coefficient of variation quartiles. Overall, 39 502 individuals 65 years and older were included in the analysis, of which 31 737 (80.3%) were hypertensive; 12 817 (32.4%) individuals died during the study period. Mortality was lower in the second and third blood pressure quartiles compared with the first quartile in both the normotensive and hypertensive groups. In both normotensive and hypertensive individuals, mortality was higher in the fourth quartile, but it was more pronounced in normotensive individuals (odds ratio, 1.18; 95% confidence interval, 1.06-1.31 in hypertensive individuals vs odds ratio, 1.27; 95% confidence interval, 1.17-1.37 in normotensive individuals). High and low BPV are associated with mortality in both hypertensive and normotensive elders. ©2017 Wiley Periodicals, Inc.

  17. Antihypertensive drug classes have different effects on short-term blood pressure variability in essential hypertension.

    PubMed

    Levi-Marpillat, Natacha; Macquin-Mavier, Isabelle; Tropeano, Anne-Isabelle; Parati, Gianfranco; Maison, Patrick

    2014-06-01

    Increased blood pressure variability (BPV) contributes to end-organ damage, cardiovascular events and mortality associated with hypertension. In a cohort of 2780 hypertensive patients treated by either calcium channel blockers (CCBs), diuretics, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs) or β-blockers alone or in combination, we compared indices of short-term BPV according to the different treatments. Short-term BPV was calculated as the standard deviation (s.d.) of 24 h, daytime or nighttime systolic blood pressure and diastolic blood pressure (SBP and DBP). Short-term BPV was compared between patients treated with a given antihypertensive class of interest (alone or in combination) and those not treated with this class, after controlling for ambulatory average blood pressure, heart rate, age, gender, propensity scores and carotid-femoral pulse wave velocity. Patients treated with CCBs (n=1247) or diuretics (n=1486) alone, or in addition to other drugs had significant lower s.d. of 24-h SBP compared with those not treated with these classes (mean differences in s.d. -0.50±0.50 mm Hg, P=0.001 and -0.17±0.15 mm Hg, P=0.05, respectively). There was no significant difference regarding treatment with or without ARBs, ACEIs and β-blockers. The combinations of CCBs with diuretics or ARBs on top of other treatments resulted in a lower 24-h SBP variability (mean differences in s.d. -0.43±0.17 mm Hg, P=0.02 and -0.44±0.19 mm Hg, P=0.005 vs. other combination uses, respectively). Antihypertensive drug classes have differential effects on short-term BPV with a greater reduction in patients treated with CCBs and diuretics. The combinations of CCBs with diuretics may be the most efficient treatments in lowering BPV.

  18. Engineering analysis of biological variables: an example of blood pressure over 1 day.

    PubMed

    Huang, W; Shen, Z; Huang, N E; Fung, Y C

    1998-04-28

    Almost all variables in biology are nonstationarily stochastic. For these variables, the conventional tools leave us a feeling that some valuable information is thrown away and that a complex phenomenon is presented imprecisely. Here, we apply recent advances initially made in the study of ocean waves to study the blood pressure waves in the lung. We note first that, in a long wave train, the handling of the local mean is of predominant importance. It is shown that a signal can be described by a sum of a series of intrinsic mode functions, each of which has zero local mean at all times. The process of deriving this series is called the "empirical mode decomposition method." Conventionally, Fourier analysis represents the data by sine and cosine functions, but no instantaneous frequency can be defined. In the new way, the data are represented by intrinsic mode functions, to which Hilbert transform can be used. Titchmarsh [Titchmarsh, E. C. (1948) Introduction to the Theory of Fourier Integrals (Oxford Univ. Press, Oxford)] has shown that a signal and i times its Hilbert transform together define a complex variable. From that complex variable, the instantaneous frequency, instantaneous amplitude, Hilbert spectrum, and marginal Hilbert spectrum have been defined. In addition, the Gumbel extreme-value statistics are applied. We present all of these features of the blood pressure records here for the reader to see how they look. In the future, we have to learn how these features change with disease or interventions.

  19. Heart rate variability and blood pressure during dynamic and static exercise at similar heart rate levels.

    PubMed

    Weippert, Matthias; Behrens, Kristin; Rieger, Annika; Stoll, Regina; Kreuzfeld, Steffi

    2013-01-01

    Aim was to elucidate autonomic responses to dynamic and static (isometric) exercise of the lower limbs eliciting the same moderate heart rate (HR) response. 23 males performed two kinds of voluntary exercise in a supine position at similar heart rates: static exercise (SE) of the lower limbs (static leg press) and dynamic exercise (DE) of the lower limbs (cycling). Subjective effort, systolic (SBP) and diastolic blood pressure (DBP), mean arterial pressure (MAP), rate pressure product (RPP) and the time between consecutive heart beats (RR-intervals) were measured. Time-domain (SDNN, RMSSD), frequency-domain (power in the low and high frequency band (LFP, HFP)) and geometric measures (SD1, SD2) as well as non-linear measures of regularity (approximate entropy (ApEn), sample entropy (SampEn) and correlation dimension D2) were calculated. Although HR was similar during both exercise conditions (88±10 bpm), subjective effort, SBP, DBP, MAP and RPP were significantly enhanced during SE. HRV indicators representing overall variability (SDNN, SD 2) and vagal modulated variability (RMSSD, HFP, SD 1) were increased. LFP, thought to be modulated by both autonomic branches, tended to be higher during SE. ApEn and SampEn were decreased whereas D2 was enhanced during SE. It can be concluded that autonomic control processes during SE and DE were qualitatively different despite similar heart rate levels. The differences were reflected by blood pressure and HRV indices. HRV-measures indicated a stronger vagal cardiac activity during SE, while blood pressure response indicated a stronger sympathetic efferent activity to the vessels. The elevated vagal cardiac activity during SE might be a response mechanism, compensating a possible co-activation of sympathetic cardiac efferents, as HR and LF/HF was similar and LFP tended to be higher. However, this conclusion must be drawn cautiously as there is no HRV-marker reflecting "pure" sympathetic cardiac activity.

  20. Blood pressure variability and pedigree analysis of nocturnal SBP dipping in Kumbas from rural Chhattisgarh, India.

    PubMed

    Sultana, Razia; Pati, Atanu Kumar

    2014-05-01

    Family is the smallest unit of people to share most of the lifestyle, environmental and genetic factors. They are likely to have similarity in many physiological and behavioural aspects. Therefore, we designed a protocol to test the effect of large rural Indian families living together (Kumbas), on blood pressure variability. We also investigated the hypothesis that 'nocturnal dipping' in systolic blood pressure (SBP) is not heritable. Members of two families (1 and 2) consisting of 3-4 generations willingly participated in the study. Both families (natives of Chhattisgarh) belong to reasonably peaceful rural area and are financially stable. Farming is the main occupation of the members of both families. Few members of the families had jobs or small business. The null hypothesis regarding heritability of nocturnal dipping trait was accepted based on data emanating from either of the studied families. Hourly-averaged values depicted less variation in males and females of family 1 from midnight to early morning at around 06:00, as compared to that in males and females of family 2. The 24 h averages of BP in family 2 were significantly higher as compared to that in family 1. Further, in family 2 the peaks of SBP, diastolic blood pressure (DBP) and mean arterial pressure (MAP) occurred significantly earlier as compared to that in family 1. The peak spread of SBP, DBP, heart rate (HR), MAP and pulse pressure (PP) among the members of family 1 was narrower than that for the members of family 2. Arbitrary cut-off values for classification of dipping, small sample size, and age dependency of nocturnal dipping might have marred outcome of the pedigree analysis of nocturnal dipping trait in this study. We have a hunch that the family shares typical temporal ups and downs in 24 h BP and HR. The above hypothesis needs confirmation based on studies with large data set involving subjective and objective assessment of the effects of psychosocial factors on BP and HR variability.

  1. The relationships between visit-to-visit blood pressure variability and renal and endothelial function in chronic kidney disease.

    PubMed

    Nakano, Chikara; Morimoto, Satoshi; Nakahigashi, Mitsutaka; Kusabe, Makiko; Ueda, Hiroko; Someya, Kazunori; Ichihara, Atsuhiro; Iwasaka, Toshiji; Shiojima, Ichiro

    2015-03-01

    Visit-to-visit blood pressure variability has been shown to be an independent risk factor for cardiovascular diseases. High visit-to-visit blood pressure variability and endothelial dysfunction are observed in patients with chronic kidney disease. It is therefore assumed that high variability in visit-to-visit blood pressure measurements may be associated with endothelial dysfunction in these patients. The present study investigated the associations between visit-to-visit blood pressure variability and renal and endothelial function in patients with chronic kidney disease. We analyzed 150 consecutive patients with predialysis chronic kidney disease who visited our outpatient clinic from January 2006 to December 2010. The study examined the relationships between variability in visit-to-visit systolic blood pressure levels or mean systolic blood pressure (M SBP) and estimated glomerular filtration rate (eGFR) and flow-mediated dilation, an index of endothelial function. Variability in visit-to-visit systolic blood pressure showed a significant negative association with eGFR, independent of age, hemoglobin A1c, low-density lipoprotein (LDL) cholesterol and uric acid, whereas M SBP did not. Similarly, variability in SBP showed a significant negative association with flow-mediated dilation, independent of age, eGFR, HbA1c, LDL cholesterol and M SBP. These data indicate that variability in visit-to-visit blood pressure measurements is associated with impaired renal and endothelial function in patients with chronic kidney disease. This finding suggests that reducing blood pressure fluctuations might have beneficial effects in patients with chronic kidney disease, although this point needs to be addressed by future studies.

  2. Genetic and environmental influences on blood pressure variability: a study in twins

    PubMed Central

    Xu, Xiaojing; Ding, Xiuhua; Zhang, Xinyan; Su, Shaoyong; Treiber, Frank A.; Vlietinck, Robert; Fagard, Robert; Derom, Catherine; Gielen, Marij; Loos, Ruth J.F.; Snieder, Harold; Wang, Xiaoling

    2013-01-01

    Objectives Blood pressure variability (BPV) and its reduction in response to antihypertensive treatment are predictors of clinical outcomes; however, little is known about its heritability. In this study, we examined the relative influence of genetic and environmental sources of variance of BPV and the extent to which it may depend on race or sex in young twins. Methods Twins were enrolled from two studies. One study included 703 white twins (308 pairs and 87 singletons) aged 18–34 years, whereas another study included 242 white twins (108 pairs and 26 singletons) and 188 black twins (79 pairs and 30 singletons) aged 12–30 years. BPV was calculated from 24-h ambulatory blood pressure recording. Results Twin modeling showed similar results in the separate analysis in both twin studies and in the meta-analysis. Familial aggregation was identified for SBP variability (SBPV) and DBP variability (DBPV) with genetic factors and common environmental factors together accounting for 18–40% and 23–31% of the total variance of SBPV and DBPV, respectively. Unique environmental factors were the largest contributor explaining up to 82–77% of the total variance of SBPV and DBPV. No sex or race difference in BPV variance components was observed. The results remained the same after adjustment for 24-h blood pressure levels. Conclusions The variance in BPV is predominantly determined by unique environment in youth and young adults, although familial aggregation due to additive genetic and/or common environment influences was also identified explaining about 25% of the variance in BPV. PMID:23470779

  3. Does the control of negative emotions influence blood pressure control and its variability?

    PubMed

    Symonides, Bartosz; Holas, Paweł; Schram, Małgorzata; Śleszycka, Justyna; Bogaczewicz, Anna; Gaciong, Zbigniew

    2014-12-01

    The aim was to assess the control of negative emotions in treated patients with hypertension in comparison with normotensive individuals and to evaluate the association between suppression of negative emotions, control of blood pressure (BP) on ambulatory blood pressure monitoring (ABPM) and blood pressure variability (BPV). We studied 195 patients (women/men: 89/106); mean age 45.4 ± 15.9 years. All patients had ABPM and completed the Courtauld Emotional Control Scale (CECS). The total CECS score and scores for subscales for anger, depression and anxiety were analyzed together with mean BP values from ABPM, and their SD and coefficient of variation as BPV measures. The mean CECS score was 54 ± 12 in all subjects; highest in uncontrolled hypertension 56 ± 11, intermediate 53 ± 12 in controlled hypertension and lowest 48 ± 12 in normotensive subjects. The reference value for the Polish population is 50 ± 11. Significant differences of mean CECS scores among groups were observed (p = 0.0165) also in multivariate analysis. The difference between uncontrolled hypertension and normotension was significant (p = 0.0262). Few significant, weak correlations were observed between CECS score or its subscales and ABPM derivates in all subjects. Conclusion. Suppression of negative emotions may adversely affect BP control in treated hypertensive patients and it should be considered a cause of uncontrolled hypertension.

  4. Determination of Correlation Among Heart Rate Variability, Left Atrium Global Strain, and Nighttime Blood Pressure Among Patients with Tinnitus

    PubMed Central

    Değirmenci, Hüsnü; Bakırcı, Eftal Murat; Salcan, İsmail; Demirelli, Selami; Duman, Hakan; Ceyhun, Gökhan; Küçüksu, Zafer

    2014-01-01

    Background We aimed to examine the correlation among nighttime blood pressure, heart rate variability, and left atrium peak systolic global longitudinal strain among patients with subjective tinnitus. Material/Methods Eighty patients with tinnitus were assigned to Group 1 and 80 healthy individuals were assigned to Group 2. Clinical blood pressure measurements, ambulatory blood pressure monitoring, and Holter electrocardiography monitoring were performed. All of the cases included in the study were examined with conventional echocardiography and 2-dimensional speckle tracking echocardiography. Results Mean nighttime systolic blood pressure (130.3±5.4) and mean nighttime diastolic blood pressure (82.8±3.9) in Group 1 were higher than in Group 2 (125.1±5.4 and 80.7±4.7, respectively) (p<0.05). Mean heart rate in Group 1 was significantly lower than in Group 2 but there was no statistically significant difference between the groups in terms of heart rate variability parameters and left atrium peak systolic global longitudinal strain values (p>0.05). Conclusions Nighttime systolic blood pressure and nighttime diastolic blood pressure were higher among the patients with tinnitus. In light of these results, we can conclude that both clinical blood pressure measurement and ambulatory blood pressure monitoring are important for patients with tinnitus. PMID:25249354

  5. Determination of correlation among heart rate variability, left atrium global strain, and nighttime blood pressure among patients with tinnitus.

    PubMed

    Değirmenci, Hüsnü; Bakırcı, Eftal Murat; Salcan, İsmail; Demirelli, Selami; Duman, Hakan; Ceyhun, Gökhan; Küçüksu, Zafer

    2014-09-24

    We aimed to examine the correlation among nighttime blood pressure, heart rate variability, and left atrium peak systolic global longitudinal strain among patients with subjective tinnitus. Eighty patients with tinnitus were assigned to Group 1 and 80 healthy individuals were assigned to Group 2. Clinical blood pressure measurements, ambulatory blood pressure monitoring, and Holter electrocardiography monitoring were performed. All of the cases included in the study were examined with conventional echocardiography and 2-dimensional speckle tracking echocardiography. Mean nighttime systolic blood pressure (130.3±5.4) and mean nighttime diastolic blood pressure (82.8±3.9) in Group 1 were higher than in Group 2 (125.1±5.4 and 80.7±4.7, respectively) (p<0.05). Mean heart rate in Group 1 was significantly lower than in Group 2 but there was no statistically significant difference between the groups in terms of heart rate variability parameters and left atrium peak systolic global longitudinal strain values (p>0.05). Nighttime systolic blood pressure and nighttime diastolic blood pressure were higher among the patients with tinnitus. In light of these results, we can conclude that both clinical blood pressure measurement and ambulatory blood pressure monitoring are important for patients with tinnitus.

  6. Systolic Blood Pressure Variability and Lower Extremity Amputation In a Non-Elderly Population with Diabetes

    PubMed Central

    Budiman-Mak, Elly; Epstein, Noam; Brennan, Meghan; Stuck, Rodney; Guihan, Marylou; Huo, Zhiping; Emanuele, Nicholas; Sohn, Min-Woong

    2016-01-01

    Objective Systolic blood pressure (SBP) variability is emerging as a new risk factor for cardiovascular diseases, diabetic nephropathy, and other atherosclerotic conditions. Our objective is to examine whether it has any prognostic value for lower-extremity amputations. Research Design and Methods This is a nested case-control study of a cohort of patients with diabetes aged < 60 years and treated in the US Department of Veterans Healthcare system in 2003. They were followed over five years for any above-ankle (major) amputations. For each case with a major amputation (event), we randomly selected up to five matched controls based on age, sex, race/ethnicity, and calendar time. SBP variability was computed using three or more blood pressure measures taken during the one-year period before the event. Patients were classified into quartiles according to their SBP variability. Results The study sample included 1038 cases and 2932 controls. Compared to Quartile 1 (lowest variability), Quartile 2 had 1.4 times (OR = 1.44, 95% CI = 1.00 – 2.07) and Quartiles 3 and 4 (highest) had 2.5 times (OR for Quartile 3 = 2.62, 95% CI = 1.85 – 3.72; OR for Quartile 4 = 2.50, 95% CI = 1.74 – 3.59) higher risk of major amputation (P for trend < 0.001). This gradient relationship held in both normotensive and hypertensive groups as well as for individuals without prior peripheral vascular disease. Conclusions This is the first study to show a significant graded relationship between SBP variability and risk of major amputation among non-elderly persons with diabetes. PMID:26809904

  7. VISIT-TO-VISIT VARIABILITY OF BLOOD PRESSURE AND DEATH, ESRD AND CARDIOVASCULAR EVENTS IN PATIENTS WITH CHRONIC KIDNEY DISEASE

    PubMed Central

    CHANG, Tara I.; TABADA, Grace H.; YANG, Jingrong; TAN, Thida X.; GO, Alan S.

    2016-01-01

    OBJECTIVES Visit-to-visit variability of blood pressure is an important independent risk factor for premature death and cardiovascular events, but relatively little is known about this phenomenon in patients with chronic kidney disease not yet on dialysis. METHODS We conducted a retrospective study in a community-based cohort of 114,900 adults with chronic kidney disease stages 3–4 (estimated glomerular filtration rate 15–59 mL/min per 1.73 m2). We hypothesized that visit-to-visit variability of blood pressure would be independently associated with higher risks of death, incident treated end-stage renal disease, and cardiovascular events. We defined systolic visit-to-visit variability of blood pressure using three metrics: (1) coefficient of variation (2) standard deviation of the mean systolic blood pressure, and (3) average real variability. RESULTS The highest versus the lowest quintile of the coefficient of variation was associated with higher adjusted rates of death (hazard ratio 1.22; 95% confidence interval 1.11–1.34) and hemorrhagic stroke (hazard ratio 1.91, confidence interval 1.36–2.68). Visit-to-visit variability of blood pressure was inconsistently associated with heart failure, and was not significantly associated with acute coronary syndrome and ischemic stroke. Results were similar when using the other two visit-to-visit variability of blood pressure. Visit-to-visit variability of blood pressure had inconsistent associations with end-stage renal disease, perhaps due to the relatively low incidences of this outcome. CONCLUSIONS Higher visit-to-visit variability of blood pressure is independently associated with higher rates of death and hemorrhagic stroke in patients with moderate to advanced chronic kidney disease not yet on dialysis. PMID:26599220

  8. Evaluation of heart rate variability and night-time blood pressure measurements in patients with idiopathic sudden sensorineural hearing loss.

    PubMed

    Demirelli, S; Degirmenci, H; Fırtına, S; Salcan, I; Ermis, E; Duman, H; Ipek, E; Hamur, H; Ceyhun, G

    2016-01-01

    The aim of this study is to investigate the role of the autonomic nervous system in the etiology of idiopathic sudden sensorineural hearing loss (ISSHL) by measuring heart rate variability (HRV) and night-time blood pressure levels. A total of 58 patients, 31 ISSHL patients (group 1) and 27 healthy volunteers (control group; group 2), were included in this study. Clinical and ambulatory blood pressure measurements and Holter electrocardiography were performed in both groups. After these evaluations, HRV parameters and night-time blood pressure values were determined. Mean systolic blood pressure (SBP) and mean diastolic blood pressure (DBP) measured at night-time were higher in group 1 compared to group 2 (p < 0.05). Heart rate variability parameters were lower in group 1 than in group 2. In patients with ISSHL, elevated blood pressure at night-time and reduced heart rate variability suggest that autonomic nervous system dysfunction might play a role in the etiopathogenesis of the disease. The measurements of ambulatory blood pressure and heart rate variability can reveal more enlightening data in the determination of the etiology of ISSHL and guiding the treatment.

  9. Heart Rate and Systolic Blood Pressure Variability on Recently Diagnosed Diabetics

    PubMed Central

    Michel-Chávez, Anaclara; Estañol, Bruno; Gien-López, José Antonio; Robles-Cabrera, Adriana; Huitrado-Duarte, María Elena; Moreno-Morales, René; Becerra-Luna, Brayans

    2015-01-01

    Background Diabetes affects approximately 250 million people in the world. Cardiovascular autonomic neuropathy is a common complication of diabetes that leads to severe postural hypotension, exercise intolerance, and increased incidence of silent myocardial infarction. Objective To determine the variability of heart rate (HR) and systolic blood pressure (SBP) in recently diagnosed diabetic patients. Methods The study included 30 patients with a diagnosis of type 2 diabetes of less than 2 years and 30 healthy controls. We used a Finapres® device to measure during five minutes beat-to-beat HR and blood pressure in three experimental conditions: supine position, standing position, and rhythmic breathing at 0.1 Hz. The results were analyzed in the time and frequency domains. Results In the HR analysis, statistically significant differences were found in the time domain, specifically on short-term values such as standard deviation of NN intervals (SDNN), root mean square of successive differences (RMSSD), and number of pairs of successive NNs that differ by more than 50 ms (pNN50). In the BP analysis, there were no significant differences, but there was a sympathetic dominance in all three conditions. The baroreflex sensitivity (BRS) decreased in patients with early diabetes compared with healthy subjects during the standing maneuver. Conclusions There is a decrease in HR variability in patients with early type 2 diabetes. No changes were observed in the BP analysis in the supine position, but there were changes in BRS with the standing maneuver, probably due to sympathetic hyperactivity. PMID:26176187

  10. Blood pressure variability in the elderly. Association between postprandial and sleeping periods.

    PubMed

    Garcia, Fernando Abrão; Fidale, Beatriz; Ferreira-Filho, Sebastião Rodrigues

    2017-04-27

    The variability of arterial blood pressure (BP) is considered an important cardiovascular risk factor. To verify the possible associations between the postprandial and the sleeping blood pressure variability. This study evaluated systolic, diastolic, mean, pulse pressures and heart variability in 69 elderly patients in preprandial, postprandial and sleeping periods. One 24 hours ambulatory blood pressure monitoring was used for measurements and the results were showed in the time-rate index. We observed a decrease in the systolic blood pressure values from preprandial to postprandial and to the sleeping periods (124.7 ± 14.6, 113.2 ± 15.3 and 108.5 ± 13.9mmHg, respectively; p = 0.003). Associations between BP variability of the postprandial and sleeping periods were obtained for systolic, diastolic and mean arterial pressure. The correlation between postprandial and sleeping BP variability has rarely been demonstrated in the literature. These correlations between BP changes after eating and during sleep might suggest that both events could coexist in other clinical situations. A variabilidade da Pressão Arterial Sistêmica (PAS) é considerada um importante fator de risco cardio vascular. Verificar as possíveis associações entre as variabilidades pressóricas nos períodos pós prandial e durante o sono. A variabilidade das pressões sistólica, diastólica, média, de pulso e frequência cardíaca foram avaliadas em 69 pacientes idosos nos períodos pós prandial e durante o sono. A Monitorização Ambulatorial da Pressão Arterial de 24 horas foi usada para o cálculo da variabilidade pressórica e os resultados apresentados no índice frequência tempo. Observamosuma redução nos níveis sistólicos pos prandiais em relação ao período pre prandial e durante o sono (124.7 ± 14.6, 113.2 ± 15.3 e 108.5 ± 13.9mmHg, respectivamente; p = 0.003). A associação das variabilidade das pressões sistólicas, diastólicas e média foram confirmadas (p < 0

  11. Familial aggregation of blood pressure with respect to anthropometric variables in a business community of Punjab, a north Indian state.

    PubMed

    Badaruddoza; Sawhney, Rashveen

    2009-12-01

    This study aimed to examine the familial aggregation of blood pressure with respect to anthropometric variables in an upper-middle class business community in Punjab, a northern state of India. The results were evaluated in a sample of 75 families, constituting 305 individual from three generations such as offspring, parental and grandparental. The data were analyzed through familial correlations, multiple regressions, percent of variance and univariate analysis. The data indicate a strong familial aggregation of blood pressure in this population especially in offspring generations and show that such a familial influence on blood pressure can be detected from the different anthropometric variables, genetic factors, shared household environment and age. These effects were strong in SBP and moderate in DBP. SBP and DBP have showed higher genetic correlation with many anthropometric characters in offspring generation as compared to other generations. These correlations are negligible in male grandparental generation. The results suggest that almost all measured variables are significant multivariate correlates with blood pressure.

  12. Beneficial Effects of Paeoniflorin Enriched Extract on Blood Pressure Variability and Target Organ Damage in Spontaneously Hypertensive Rats

    PubMed Central

    Yang, Zheng-Biao; Lei, Shan-Shan; Chen, Bo

    2017-01-01

    Blood pressure variability (BPV) is associated with the development and progression of severe target organ damage (TOD). This study aims to evaluate the protective effect of paeoniflorin enriched extract from Radix Paeoniae Alba (PG) on BPV and TOD in spontaneously hypertensive rats (SHR). All SHR were orally treated with distilled water, metoprolol (MP, 20 mg/kg), and PG (PG-H, 90 mg/kg or PG-L, 30 mg/kg) for a single time or daily for 7 weeks. The 24-hour dynamic blood pressure was monitored and then calculated BPV including long- and short-term systolic blood pressure variability (SBPV), diastolic blood pressure variability (DBPV), mean blood pressure variability (MBPV), and heart rate variability (HRV) as well as the 24-hour-SBP, 24-hour-DBP, and 24-hour-MBP. The protective effects of PG on TOD were observed by histopathologic and biochemical detection. The results indicated that long- and short-term SBPV, DBPV, MBPV, and HRV as well as 24-hour-SBP, 24-hour-DBP, and 24-hour-MBP showed no significant changes after single-dose administration of PG and significantly decreased after administration with PG for 7 weeks. PG could also markedly improve the damage of aorta, heart, kidney, and brain. This study suggested that PG could notably reduce BPV, stabilize blood pressure, and mitigate TOD in SHR. PMID:28243310

  13. Genome-wide analysis of blood pressure variability and ischemic stroke.

    PubMed

    Yadav, Sunaina; Cotlarciuc, Ioana; Munroe, Patricia B; Khan, Muhammad S; Nalls, Michael A; Bevan, Steve; Cheng, Yu-Ching; Chen, Wei-Min; Malik, Rainer; McCarthy, Nina S; Holliday, Elizabeth G; Speed, Douglas; Hasan, Nazeeha; Pucek, Mateusz; Rinne, Paul E; Sever, Peter; Stanton, Alice; Shields, Denis C; Maguire, Jane M; McEvoy, Mark; Scott, Rodney J; Ferrucci, Luigi; Macleod, Mary J; Attia, John; Markus, Hugh S; Sale, Michele M; Worrall, Bradford B; Mitchell, Braxton D; Dichgans, Martin; Sudlow, Cathy; Meschia, James F; Rothwell, Peter M; Caulfield, Mark; Sharma, Pankaj

    2013-10-01

    Visit-to-visit variability in blood pressure (vBP) is associated with ischemic stroke. We sought to determine whether such variability has genetic causes and whether genetic variants associated with BP variability are also associated with ischemic stroke. A Genome Wide Association Study (GWAS) for loci influencing BP variability was undertaken in 3802 individuals from the Anglo-Scandinavian Cardiac Outcome Trial (ASCOT) study, in which long-term visit-to-visit and within-visit BP measures were available. Because BP variability is strongly associated with ischemic stroke, we genotyped the sentinel single nucleotide polymorphism in an independent ischemic stroke population comprising 8624 cases and 12 722 controls and in 3900 additional (Scandinavian) participants from the ASCOT study to replicate our findings. The ASCOT discovery GWAS identified a cluster of 17 correlated single nucleotide polymorphisms within the NLGN1 gene (3q26.31) associated with BP variability. The strongest association was with rs976683 (P=1.4×10(-8)). Conditional analysis of rs976683 provided no evidence of additional independent associations at the locus. Analysis of rs976683 in patients with ischemic stroke found no association for overall stroke (odds ratio, 1.02; 95% CI, 0.97-1.07; P=0.52) or its subtypes: cardioembolic (odds ratio, 1.07; 95% CI, 0.97-1.16; P=0.17), large vessel disease (odds ratio, 0.98; 95% CI, 0.89-1.07; P=0.60), and small vessel disease (odds ratio, 1.07; 95% CI, 0.97-1.17; P=0.19). No evidence for association was found between rs976683 and BP variability in the additional (Scandinavian) ASCOT participants (P=0.18). We identified a cluster of single nucleotide polymorphisms at the NLGN1 locus showing significant association with BP variability. Follow-up analyses did not support an association with risk of ischemic stroke and its subtypes.

  14. Low Blood Pressure

    MedlinePlus

    ... a problem. Sometimes blood pressure that is too low can also cause problems. Blood pressure is the ... reading is 90/60 or lower, you have low blood pressure. Some people have low blood pressure ...

  15. Blood Pressure Test

    MedlinePlus

    ... blood pressure readings at home. Tracking your blood pressure readings It can be helpful in diagnosing or ... options might work best for you. Low blood pressure Low blood pressure that either doesn't cause ...

  16. Orthostatic stress causes immediately increased blood pressure variability in women with vasovagal syncope.

    PubMed

    Reulecke, S; Charleston-Villalobos, S; Voss, A; González-Camarena, R; González-Hermosillo, J; Gaitán-González, M J; Hernández-Pacheco, G; Schroeder, R; Aljama-Corrales, T

    2016-04-01

    The cardiovascular and respiratory autonomic nervous regulation has been studied mainly by hemodynamic responses during different physical stressors. In this study, dynamics of autonomic response to an orthostatic challenge was investigated by hemodynamic variables and by diverse linear and nonlinear indices calculated from time series of beat-to-beat intervals (BBI), respiratory cycle duration (RESP), systolic (SYS) and diastolic (DIA) blood pressure. This study included 16 young female patients (SYN) with vasovagal syncope and 12 age-matched female controls (CON). The subjects were enrolled in a head-up tilt (HUT) test, breathing normally, including 5min of baseline (BL, supine position) and 18min of 70° orthostatic phase (OP). To increase the time resolution of the analysis the time series were segmented in five-minute overlapping windows with a shift of 1min. Hemodynamic parameters did not show any statistical differences between SYN and CON. Time domain linear analysis revealed increased respiratory frequency and increased blood pressure variability (BPV) in patients during OP meaning increased sympathetic activity and vagal withdrawal. Frequency domain analysis confirmed a predominance of sympathetic tone by steadily increased values of low over high frequency power in BBI and of low frequency power in SYS and DIA in patients during OP. The nonlinear analysis by symbolic dynamics seemed to be highly suitable for differentiation of SYN and CON in the early beginning of OP, i.e., 5min after tilt-up. In particular the index SYS_plvar3 showed less patterns of low variability in patients reflecting a steadily increase in both BPV and sympathetic activity. The proposed dynamical analysis could lead to a better understanding of the temporal underlying mechanisms in healthy subjects and patients under orthostatic stress. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Familial aggregation of blood pressure with respect to anthropometric variables among the Lobana (nomadic origin) population in Punjab, India.

    PubMed

    Badaruddoza; Kaur, Punarjot

    2012-01-01

    Familial aggregation of blood pressure with respect to anthropometric characteristics was investigated among the Lobana (a tribal origin) population in Punjab, a North Indian state. A total of 505 individuals comprised the study sample, constituting 116 families of 3 generations. The study represents a multivariate model analysis, which includes family data with respect to blood pressure phenotypes and other metric measurements such as height, weight, body mass index, waist and hip circumferences, waist-to-hip ratio (WHR), and 4 skinfold measurements. A higher correlation for almost all sets of anthropometric variables with blood pressure was found among the offspring generation as compared with the parental and grandparental generations. The study confirmed that the familial aggregation of blood pressure with respect to anthropometric measurements is strong in the offspring generation. The findings suggest that sharing a household environment has a significant effect on familial aggregation especially for systolic blood pressure.

  18. VISIT-TO-VISIT VARIABILITY IN BLOOD PRESSURE IS RELATED TO LATE-LIFE COGNITIVE DECLINE

    PubMed Central

    Qin, Bo; Viera, Anthony J.; Muntner, Paul; Plassman, Brenda L.; Edwards, Lloyd J.; Adair, Linda S.; Popkin, Barry M.; Mendez, Michelle A.

    2016-01-01

    The association between visit-to-visit variability of blood pressure (BP) and cognitive decline over time remains incompletely understood in a general population of older adults. We assessed the hypothesis that higher visit-to-visit variability in BP, but not mean BP, would be associated with faster decline in cognitive function among community-dwelling older adults. This prospective cohort study comprised 976 adults who had 3 or 4 visits with BP measurements as part of the China Health and Nutrition Survey from 1991, up to their first cognitive tests, and completed cognitive screening tests at 2 or more visits in 1997, 2000 or 2004. Visit-to visit BP variability was expressed as the standard deviation (SD), coefficient of variation or as the variation independent of mean BP across visits conducted at a mean interval of 3.2y. Mean (SD) age at the first cognitive test was 64 (6)y. Using multivariable-adjusted linear mixed-effects models, we found higher visit-to-visit variability in systolic BP, but not mean systolic BP, was associated with a faster decline of cognitive function (adjusted mean difference [95% CI] for high vs. low tertile of SD variability: standardized composite scores −0.038 standardized units (SU)/y [−0.066, −0.009] and verbal memory −0.041 SU/y [−0.075 to −0.008]). Higher visit-to-visit variability in diastolic BP was associated with a faster decline of cognitive function, independent of mean diastolic BP, among adults 55–64y but not those ≥ 65y. Our results suggest that higher long-term BP visit-to-visit variability is associated with a faster rate of cognitive decline among older adults. PMID:27217401

  19. The relationship between blood pressure variability, obesity and left atrial phasic function in hypertensive population.

    PubMed

    Tadic, Marijana; Cuspidi, Cesare; Ilic, Irena; Suzic-Lazić, Jelena; Zivanovic, Vladimir; Jozika, Ljilja; Celic, Vera

    2016-04-01

    We sought to investigate the relationship between blood pressure (BP) variability and left atrial (LA) phasic function assessed by volumetric and speckle tracking method in normal-weight, overweight and obese hypertensive patients. This cross-sectional study included 164 untreated hypertensive subjects who underwent a 24-h ambulatory BP monitoring and complete two-dimensional echocardiographic examination (2DE). All the patients were separated into three groups according to their body mass index (BMI): normal-weight patients (BMI < 25 kg/m(2)), overweight patients (25 ≤ BMI < 30 kg/m(2)), and obese patients (BMI ≥ 30 kg/m(2)). Daytime, nighttime and 24 h BP variability indices were higher in obese hypertensive subjects than in lean patients. Maximum and minimum LA volumes and volume indexes gradually and significantly increased, whereas pre-A LAV decreased, from normal-weight to obese subjects. Total and passive LA emptying fractions, representing LA reservoir and conduit function, gradually reduced from lean to obese individuals. Active LA EF, the parameter of LA booster pump function, increased in the same direction. Similar results were obtained by 2DE strain analysis. BP variability parameters were associated with structural, functional and mechanical parameters of LA remodeling in the whole study population. The parameters of LA reservoir function were negatively related with BP variability indices, whereas the parameters of LA pump function were positively related with BP variability indices. Obesity significantly impacts BP variability and LA phasic function in untreated hypertensive subjects. BP variability is associated with LA remodeling independent of BP, left ventricular systolic and diastolic function.

  20. Blood pressure (BP) assessment-from BP level to BP variability.

    PubMed

    Feber, Janusz; Litwin, Mieczyslaw

    2016-07-01

    The assessment of blood pressure (BP) can be challenging in children, especially in very young individuals, due to their variable body size and lack of cooperation. In the absence of data relating BP with cardiovascular outcomes in children, there is a need to convert absolute BP values (in mmHg) into age-, gender- and height appropriate BP percentiles or Z-scores in order to compare a patient's BP with the BP of healthy children of the same age, but also of children of different ages. Traditionally, the interpretation of BP has been based mainly on the assessment of the BP level obtained by office, home or 24-h BP monitoring. Recent studies suggest that it is not only BP level (i.e. average BP) but also BP variability that is clinically important for the development of target organ damage, including the progression of chronic kidney disease. In this review we describe current methods to evaluate of BP level, outline available methods for BP variability assessment and discuss the clinical consequences of BP variability, including its potential role in the management of hypertension.

  1. Association between day-by-day and ambulatory blood pressure variability in type 2 diabetes patients.

    PubMed

    Iuchi, Hiroyuki; Sakamoto, Masaya; Matsutani, Daisuke; Suzuki, Hirofumi; Kayama, Yosuke; Takeda, Norihiko; Utsunomiya, Kazunori

    2017-09-18

    It remains unclear whether ambulatory blood pressure variability (BPV) contributes toward day-by-day BPV, despite the fact that not only day-by-day but also ambulatory BPV is reported to be a risk factor for type 2 diabetes patients. This study aimed to determine the association between day-by-day BPV and ambulatory BPV, which is especially distinguished between diurnal and nocturnal BPV, in type 2 diabetes patients. Day-by-day and ambulatory BPV were assessed in 30 type 2 diabetes patients (aged 54±15 years; 87% men; glycated hemoglobin: 9.1±1.9%) in inpatient settings. Day-by-day systolic BPV was correlated significantly with diurnal systolic BPV (r=0.426, P=0.019), but not nocturnal systolic BPV (r=0.175, P=0.354). Multiple regression analysis showed that diurnal systolic BPV and diurnal mean systolic blood pressure were associated independently with day-by-day systolic BPV. With respect to type 2 diabetes, these findings suggest that day-by-day BPV is reflected in diurnal BPV rather than nocturnal BPV.

  2. Diurnal blood pressure variability and physical activity measured electronically and by diary.

    PubMed

    Gretler, D D; Carlson, G F; Montano, A V; Murphy, M B

    1993-02-01

    In order for 24 h ambulatory blood pressure monitoring (ABPM) to be useful in clinical decision making, it is necessary to quantify ambient physical activity and to develop appropriate norms of ambulatory pressure for different levels of activity. The present study has compared the predictive value of physical activity determined by an electronic activity monitor or a written diary, for concomitantly recorded blood pressure during ABPM in healthy normotensive subjects. Each subject wore four activity monitors, on the right and left wrists, on the left ankle and at the waist, respectively. Linear regression analysis was performed for each subject to determine the correlation between ABPM data (systolic and diastolic blood pressure and heart rate) and activity data (obtained from diaries and the four monitors). Significant differences in the degree of correlation were found for both the location of the activity monitor and the time (1/2, 2, 5, 10, 15, and 30 min preceding blood pressure measurement) over which activity was averaged (P < .05 by two-way analysis of variance). The best correlation was obtained with the activity monitor worn on the dominant wrist, and when activity was averaged over 2 to 10 min preceding blood pressure determination, accounting for 18 to 69% (mean 36 +/- 5%) of systolic blood pressure variation. Diaries performed similarly in these well-motivated subjects. It is concluded that because of the significant interaction between activity and blood pressure, ABPM data should be interpreted only in the light of concomitant activity data.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Visit-to-visit systolic blood pressure variability predicts treatment-related adverse event of hyponatremia in SPRINT.

    PubMed

    Goyal, Abhinav; Mezue, Kenechukwu; Rangaswami, Janani

    2017-08-01

    Hypertension is a common condition and an important cardiovascular risk factor. SPRINT trial showed that the beneficial effects of targeting systolic blood pressure <120 mm Hg were accompanied by more adverse events. De-identified SPRINT database was used for this analysis. All subjects in each group that achieved their respective target blood pressure (<120, intensive; <140, standard) were included. Only readings after reaching target blood pressure for the first time were included. Subjects that never reached target or had <2 readings upon reaching target were excluded. Coefficient of Variation (CV) of systolic blood pressure was calculated for each subject to characterize variability. Cox proportional hazards regression was used in the overall cohort as well as the intensive and standard treatment subgroups separately, to identify the effect of CV of systolic blood pressure on occurrence of hyponatremia. P<.05 was considered statistically significant. A total of 8884 subjects met the inclusion criteria; 4323 in intensive and 4561 in standard group. Two hundred and sixty five hyponatremic events occurred in the overall cohort; 168 in intensive, and 127 in standard treatment group. CV of systolic blood pressure consistently and independently predicted a greater hazard of hyponatremia on overall (HR 1.08, P<.001), as well as separate regressions by treatment arms (each HR=1.08 and P<.05). In conclusion, visit-to-visit systolic blood pressure variability is independently associated with a small but significant risk of hyponatremia in the SPRINT trial. © 2017 John Wiley & Sons Ltd.

  4. Association between Heart Rate Variability, Blood Pressure and Autonomic Activity in Cyclic Alternating Pattern during Sleep

    PubMed Central

    Kondo, Hideaki; Ozone, Motohiro; Ohki, Noboru; Sagawa, Yohei; Yamamichi, Keiichirou; Fukuju, Mitsuki; Yoshida, Takeshi; Nishi, Chikako; Kawasaki, Akiko; Mori, Kaori; Kanbayashi, Takashi; Izumi, Motomori; Hishikawa, Yasuo; Nishino, Seiji; Shimizu, Tetsuo

    2014-01-01

    Study Objectives: Cyclic alternating pattern (CAP) is frequently followed by changes in heart rate (HR) and blood pressure (BP), but the sequential associations between CAP and autonomic nerve activity have not been studied. The study aimed to reveal the precise changes in heart rate variability (HRV) during phase A of the CAP cycle. Design: Polysomnography was recorded according to the CAP Atlas (Terzano, 2002), and BP and electrocardiogram were simultaneously recorded. The complex demodulation method was used for analysis of HRV and evaluation of autonomic nerve activity. Setting: Academic sleep laboratory. Participants: Ten healthy males. Measurements and Results: The increase in HR (median [first quartile – third quartile]) for each subtype was as follows: A1, 0.64 (-0.30 to 1.69), A2, 1.44 (0.02 to 3.79), and A3, 6.24 (2.53 to 10.76) bpm (A1 vs. A2 P < 0.001, A1 vs. A3 P < 0.001, A2 vs. A3 P < 0.001). The increase in BP for each subtype was as follows: A1, 1.23 (-2.04 to 5.75), A2, 1.76 (-1.46 to 9.32), and A3, 12.51 (4.75 to 19.94) mm Hg (A1 vs. A2 P = 0.249, A1 vs. A3 P < 0.001, A2 vs. A3 P < 0.001). In all of phase A, the peak values for HR and BP appeared at 4.2 (3.5 to 5.4) and 8.4 (7.0 to 10.3) seconds, respectively, after the onset of phase A. The area under the curve for low-frequency and high-frequency amplitude significantly increased after the onset of CAP phase A (P < 0.001) and was higher in the order of subtype A3, A2, and A1 (P < 0.001). Conclusions: All phase A subtypes were accompanied with increased heart rate variability, and the largest heart rate variability was seen in subtype A3, while a tendency for less heart rate variability was seen in subtype A1. Citation: Kondo H; Ozone M; Ohki N; Sagawa Y; Yamamichi K; Fukuju M; Yoshida T; Nishi C; Kawasaki; Mori; Kanbayashi T; Izumi M; Hishikawa Y; Nishino S; Shimizu T. Association between heart rate variability, blood pressure and autonomic activity in cyclic alternating pattern during sleep

  5. [Population characteristics and impact on heart rate variability, heart rate and blood pressure of passive smoking].

    PubMed

    Zhao, Jing; He, Fei; Hu, Da-yi; Ding, Rong-jing; Yu, Xiao-jun; Wang, Long; Zhang, Ping; Li, Xue-bin; Guo, Ji-hong; Liu, Wen-ling; Li, Cui-lan; Li, Lei; Gao, Chuan-yu; Zhao, Luo-sha; Chu, Ying-jie; Huang, Zhen-wen; Wei, Jing-han; Hua, Shao-hua; Liu, Rui-yun; Zhuang, Xiao-feng

    2013-05-01

    To investigate the basic characteristics of passive smoking population, and the impact of passive smoking on heart rate variability, heart rate and blood pressure. Eighty-six passive smokers [mean age: (52.4 ± 7.6) years] were recruited from patients and their relatives who visited cardiovascular outpatient department and excluded structural heart disease between June 2010 and June 2012, 80 normal subjects who were not exposed to smoking served as controls. Questionnaire survey, 24 hours ambulatory electrocardiogram examination and blood pressure measurement were performed in all recruited subjects. (1) Non-marriage rate [18.60% (16/86) vs. 3.75% (3/80), P < 0.01] was significantly higher while education level were significantly lower in passive smoking group than in control group. Passive smokers were more likely service industry workers [29.07% (25/86) vs. 15.00% (12/80), P < 0.05] and had longer daily working time [(7.56 ± 1.24) h vs. (6.02 ± 0.96) h, P < 0.01], and were less likely to be professional technology industry employers [20.93% (18/86) vs. 36.25% (29/80), P < 0.05] and managers [13.95% (12/86) vs. 38.75% (31/80), P < 0.01] compared to controls. The main place of passive smoking was workplace (67.44%, 58/86), entertainment venues (63.95%,55/86), restaurants (48.84%, 42/86). (2) Standard of the normal sinus RR intervals (SDNN), the normal consecutive sinus RR interval difference between the root-mean-square (rMSSD) and adjacent the difference between the RR interval>50 ms the number of share the percentage (PNN50) were significantly lower in passive smoking group than in the control group (all P < 0.05). Every 5 min average of the standard deviation of sinus RR cycle (SDNN index) and 24 h every 5 min sinus RR interval mean standard deviation (SDANN) were similar between the 2 groups (all P > 0.05). Ultra-low-frequency power (VLF), low frequency power (LF), high frequency power (HF) and LF/HF were significantly lower in passive smoking group than in

  6. The Impact of Resonance Frequency Breathing on Measures of Heart Rate Variability, Blood Pressure, and Mood.

    PubMed

    Steffen, Patrick R; Austin, Tara; DeBarros, Andrea; Brown, Tracy

    2017-01-01

    Heart rate variability biofeedback (HRVB) significantly improves heart rate variability (HRV). Breathing at resonance frequency (RF, approximately 6 breaths/min) constitutes a key part of HRVB training and is hypothesized to be a pathway through which biofeedback improves HRV. No studies to date, however, have experimentally examined whether RF breathing impacts measures of HRV. The present study addressed this question by comparing three groups: the RF group breathed at their determined RF for 15 min; the RF + 1 group breathed at 1 breath/min higher than their determined RF for 15 min; and the third group sat quietly for 15 min. After this 15-min period, all groups participated in the Paced Auditory Serial Addition Task (PASAT) for 8 min, and then sat quietly during a 10-min recovery period. HRV, blood pressure, and mood were measured throughout the experiment. Groups were not significantly different on any of the measures at baseline. After the breathing exercise, the RF group reported higher positive mood than the other two groups and a significantly higher LF/HF HRV ratio relative to the control group, a key goal in HRVB training (p < 0.05). Additionally, the RF group showed lower systolic blood pressure during the PASAT and during the recovery period relative to the control group, with the RF + 1 group not being significantly different from either group (p < 0.05). Overall, RF breathing appears to play an important role in the positive effect HRVB has on measures of HRV.

  7. The Impact of Resonance Frequency Breathing on Measures of Heart Rate Variability, Blood Pressure, and Mood

    PubMed Central

    Steffen, Patrick R.; Austin, Tara; DeBarros, Andrea; Brown, Tracy

    2017-01-01

    Heart rate variability biofeedback (HRVB) significantly improves heart rate variability (HRV). Breathing at resonance frequency (RF, approximately 6 breaths/min) constitutes a key part of HRVB training and is hypothesized to be a pathway through which biofeedback improves HRV. No studies to date, however, have experimentally examined whether RF breathing impacts measures of HRV. The present study addressed this question by comparing three groups: the RF group breathed at their determined RF for 15 min; the RF + 1 group breathed at 1 breath/min higher than their determined RF for 15 min; and the third group sat quietly for 15 min. After this 15-min period, all groups participated in the Paced Auditory Serial Addition Task (PASAT) for 8 min, and then sat quietly during a 10-min recovery period. HRV, blood pressure, and mood were measured throughout the experiment. Groups were not significantly different on any of the measures at baseline. After the breathing exercise, the RF group reported higher positive mood than the other two groups and a significantly higher LF/HF HRV ratio relative to the control group, a key goal in HRVB training (p < 0.05). Additionally, the RF group showed lower systolic blood pressure during the PASAT and during the recovery period relative to the control group, with the RF + 1 group not being significantly different from either group (p < 0.05). Overall, RF breathing appears to play an important role in the positive effect HRVB has on measures of HRV. PMID:28890890

  8. Determinants of the impact of blood pressure variability on neurological outcome after acute ischaemic stroke

    PubMed Central

    Bennett, Alicia; Stoddard, Gregory J; Smith, Gordon; Chung, Lee; O'Donnell, Steve; McNally, J Scott; Tirschwell, David; Majersik, Jennifer J

    2017-01-01

    Introduction Increased blood pressure variability (BPV) is detrimental after acute ischaemic stroke, but the interaction between BPV and neuroimaging factors that directly influence stroke outcome has not been explored. Methods We retrospectively reviewed inpatients from 2007 to 2014 with acute anterior circulation ischaemic stroke, CT perfusion and angiography at hospital admission, and a modified Rankin Scale (mRS) 30–365 days after stroke onset. BPV indices included SD, coefficient of variation and successive variation of the systolic blood pressure between 0 and 120 hours after admission. Ordinal logistic regression models were fitted to mRS with predictor variables of BPV indices. Models were further stratified by CT perfusion volumetric measurements, proximal vessel occlusion and collateral score. Results 110 patients met the inclusion criteria. The likelihood of a 1-point rise in the mRS increased with every 10 mm Hg increase in BPV (OR for the 3 BPV indices ranged from 2.27 to 5.54), which was more pronounced in patients with larger ischaemic core volumes (OR 8.37 to 18.0) and larger hypoperfused volumes (OR 6.02 to 15.4). This association also held true for patients with larger mismatch volume, proximal vessel occlusion and good collateral vessels. Conclusions These results indicate that increased BPV is associated with worse neurological outcome after stroke, particularly in patients with a large lesion core volume, concurrent viable ischaemic penumbra, proximal vessel occlusion and good collaterals. This subset of patients, who are often not candidates for or fail acute stroke therapies such as intravenous tissue plasminogen activator or endovascular thrombectomy, may benefit from interventions aimed at reducing BPV. PMID:28959484

  9. Blood pressure and heart rate variability analysis of orthostatic challenge in normal human pregnancies.

    PubMed

    Heiskanen, Nonna; Saarelainen, Heli; Valtonen, Pirjo; Lyyra-Laitinen, Tiina; Laitinen, Tomi; Vanninen, Esko; Heinonen, Seppo

    2008-11-01

    The aim of the present study was to evaluate pregnancy-related changes in autonomic regulatory functions in healthy subjects. We studied cardiovascular autonomic responses to head-up tilt (HUT) in 28 pregnant women during the third trimester of pregnancy and 3 months after parturition. The maternal ECG and non-invasive beat-to-beat blood pressure were recorded in the horizontal position (left-lateral position) and during HUT in the upright position. Stroke volume was assessed from blood pressure signal by using the arterial pulse contour method. Heart rate variability (HRV) was analysed in frequency domain, and baroreflex sensitivity by the cross-spectral and the sequence methods. In the horizontal position, all frequency components of HRV were lower during pregnancy than 3 months after parturition (P < 0.01 to <0.001), while pregnancy had no influence on normalized low frequency and high frequency powers. During pregnancy haemodynamics was well balanced with only minor changes in response to postural change while haemodynamic responses to HUT were more remarkable after parturition. In pregnant women HRV and especially its very low frequency component increased in response to HUT, whereas at 3 months after parturition the direction of these changes was opposite. Parasympathetic deactivation towards term is likely to contribute to increased heart rate and cardiac output at rest, whereas restored sympathetic modulation with modest responses may contribute stable peripheral resistance and sufficient placental blood supply under stimulated conditions. It is important to understand cardiovascular autonomic nervous system and haemodynamic control in normal pregnancy before being able to judge whether they are dysregulated in complicated pregnancies.

  10. Effects of moderate physical training on blood pressure variability and hemodynamic pattern in mildly hypertensive subjects.

    PubMed

    Izdebska, E; Cybulska, I; Izdebskir, J; Makowiecka-Ciesla, M; Trzebski, A

    2004-12-01

    The objective of our study was to compare the cardiovascular effects of moderate exercise training in healthy young (NTS, n=18, 22.9+/-0.44 years) and in hypertensive human subjects (HTS, n=30, 23+/-1.1). The VO(2max) did not significantly differ between groups. HTS of systolic blood pressure (SBP) 148+/-3.6 mmHg and diastolic blood pressure(DBP) 88+/-2.2 mmHg, and NTS of SBP: 128.8 +/- 4 mmHg and DBP: 72 +/- 2.9 mmHg were submitted to moderate dynamic exercise training, at about 50% VO(2max) 3 times per week for one hour, over 3 months. VO(2max) was measured by Astrand's test. Arterial blood pressure was measured with Finapres technique, the stroke volume, cardiac output and arm blood flow were assessed by impedance reography. Variability of SBP and pulse interval values (PI) were estimated by computing the variance and power spectra according to FFT algorithm. After training period significant improvements in VO(2max) were observed in NTS- by 1.92 +/-0.76 and in HTS by 3+/-0.68 ml/kg/min). In HTS significantly decreased: SBP by 19 +/-2.9 mmHg, in DBP by 10.7+/-2 mmHg total peripheral resistance (TPR) by 0.28 +/-0.05 TPR units. The pretraining value of low frequency component power spectra SBP (LF(SPB)) was significantly greater in HTS, compared to NTS. PI variance was lower in HTS, compared to NTS. After physical training, in HTS PI variance increased suggesting a decrease in frequency modulated sympathetic activity and increase in vagal modulation of heart rate in mild hypertension. A major finding of the study is the significant decrease of resting low frequency component SBP power spectrum after training in HTS. The value of LF(SPB) in trained hypertensive subjects normalized to the resting level of LF(SPB) in NTS. Our findings suggest that antihypertensive hemodynamic effects of moderate dynamic physical training are associated with readjustment of the autonomic cardiovascular control system.

  11. High blood pressure medicines

    MedlinePlus

    Hypertension - medicines ... blood vessel diseases. You may need to take medicines to lower your blood pressure if lifestyle changes ... blood pressure to the target level. WHEN ARE MEDICINES FOR HIGH BLOOD PRESSURE USED Most of the ...

  12. REPRODUCIBILITY OF BLOOD PRESSURE DIPPING: RELATION TO DAY-TO-DAY VARIABILITY IN SLEEP QUALITY

    PubMed Central

    Hinderliter, Alan L.; Routledge, Faye S.; Blumenthal, James A.; Koch, Gary; Hussey, Michael A.; Wohlgemuth, William K.; Sherwood, Andrew

    2013-01-01

    Background Previous studies of the reproducibility of blood pressure (BP) dipping have yielded inconsistent results. Few have examined factors that may influence dayto-day differences in dipping. Methods and Results Ambulatory BP monitoring was performed on three occasions, approximately one week apart, in 115 untreated adult subjects with elevated clinic BPs. The mean±SD BP dip was 18±7/15±5 mmHg (sleep/awake BP ratio = 0.87±0.05/0.82±0.06), with a median (interquartile range) day-to-day variation of 5.2 (3.1–8.1)/4.3(2.8–5.6) mmHg. There was no decrease in variability with successive measurements. The reproducibility coefficient (5.6 [95% CI 5.1, 6.1] mmHg) was greater and the intraclass correlation coefficient (0.53 [95% CI 0.42, 0.63]) was smaller for the systolic dip than for 24-hour or awake systolic BPs, suggesting greater day-today variability in dipping. Variability in systolic dipping was greater in subjects with higher awake BP, but was not related to age, gender, race, or body mass index. Within individuals, day-to-day variations in dipping were related to variations in the fragmentation index (p < 0.001), a measure of sleep quality. Conclusions Although mean 24-hour and awake BPs were relatively stable over repeated monitoring days, our study confirms substantial variability in BP dipping. Day-to-day differences in dipping are related to sleep quality. PMID:23850195

  13. Hypertension and blood pressure variability management practices among physicians in Singapore.

    PubMed

    Setia, Sajita; Subramaniam, Kannan; Tay, Jam Chin; Teo, Boon Wee

    2017-01-01

    There are limited data on blood pressure variability (BPV) in Singapore. The absence of updated local guidelines might contribute to variations in diagnosis, treatment and control of hypertension and BPV between physicians. This study evaluated BPV awareness, hypertension management and associated training needs in physicians from Singapore. Physicians from Singapore were surveyed between September 8, 2016, and October 5, 2016. Those included were in public or private practice for ≥3 years, cared directly for patients ≥70% of the time and treated ≥30 patients for hypertension each month. The questionnaire covered 6 main categories: general blood pressure (BP) management, BPV awareness/diagnosis, home BP monitoring (HBPM), ambulatory BP monitoring (ABPM), BPV management and associated training needs. Responses from 60 physicians (30 general practitioners [GPs], 20 cardiologists, 10 nephrologists) were analyzed (77% male, 85% aged 31-60 years, mean 22 years of practice). Approximately 63% of physicians considered white-coat hypertension as part of BPV. The most common diagnostic tool was HBPM (overall 77%, GPs 63%, cardiologists 65%, nephrologists 70%), but ABPM was rated as the tool most valued by physicians (80% overall), especially specialists (97%). Withdrawn Singapore guidelines were still being used by 73% of GPs. Approximately 48% of physicians surveyed did not adhere to the BP cutoff recommended by most guidelines for diagnosing hypertension using HBPM (>135/85 mmHg). Hypertension treatment practices also varied from available guideline recommendations, although physicians did tend to use a lower BP target for patients with diabetes or kidney disease. There were a number of challenges to estimating BPV, the most common of which was patient refusal of ABPM/HBPM. The majority of physicians (82%) had no training on BPV, but stated that this would be useful. There appear to be gaps in knowledge and guideline adherence relating to the assessment and

  14. Systolic Blood Pressure Variability is a Novel Risk Factor for Rebleeding in Acute Subarachnoid Hemorrhage

    PubMed Central

    Lin, Qing-Song; Ping-Chen; Lin, Yuan-Xiang; Lin, Zhang-Ya; Yu, Liang-Hong; Dai, Lin-Sun; Kang, De-Zhi

    2016-01-01

    Abstract Rebleeding of an aneurysm is a major cause of morbidity and mortality after subarachnoid hemorrhage (SAH). Whereas numerous studies have demonstrated predictors of rebleeding and effect of systolic blood pressure variability (SBPV) on stroke, few data on the association between SBPV and rebleeding. Here, we sought to identify the effect of SBPV on rebleeding in acute aneurysmal SAH. Case–control study. From January 2010 to June 2015, 612 patients with aneurysmal SAH were enrolled in our tertiary care medical center. Main outcome measures: Consecutive patients with acute (<3 days from ictus) aneurismal rebleeding or repair or death were retrospectively included. Antihypertensive therapy based on a predefined standardized protocol was prescribed to lower and maintain SBP between 120 and 160 mm Hg. SBP was measured hourly until a censoring event occurred. SBPV was determined as standard deviation (SD) and successive variation (SV). Binary logistic regression was used to assess the association between SBPV and rebleeding. Rebleeding occurred in 61 (10.0%) of the 612 patients. We identified 47 acute rebleeding as cases and 382 early repair or early death as controls. On binary logistic regression analysis, rebleeding was associated with the SD of SBP (odds ratio [OR], 1.254; 95% confidence interval [CI], 1.131–1.391; P < 0.001) and the SV of SBP (OR, 1.131; 95% CI, 1.039–1.231; P = 0.004). No significant difference was seen between rebleeding and mean systolic blood pressure (MSBP). SBPV is associated with increased rates of acute aneurysmal rebleeding. Further prospective research is warranted to confirm that SBP stability prevents acute aneurysm rebleeding. PMID:26986118

  15. Systemic Hemodynamic Atherothrombotic Syndrome and Resonance Hypothesis of Blood Pressure Variability: Triggering Cardiovascular Events

    PubMed Central

    2016-01-01

    Blood pressure (BP) exhibits different variabilities and surges with different time phases, from the shortest beat-by-beat to longest yearly changes. We hypothesized that the synergistic resonance of these BP variabilites generates an extraordinarily large dynamic surge in BP and triggers cardiovascular events (the resonance hypothesis). The power of pulses is transmitted to the peripheral sites without attenuation by the large arteries, in individuals with stiffened arteries. Thus, the effect of a BP surge on cardiovascular risk would be especially exaggerated in high-risk patients with vascular disease. Based on this concept, our group recently proposed a new theory of systemic hemodynamic atherothromboltic syndrome (SHATS), a vicious cycle of hemodynamic stress and vascular disease that advances organ damage and triggers cardiovascular disease. Clinical phenotypes of SHATS are large-artery atherothombotic diseases such as stroke, coronary artery disease, and aortic and pheripheral artery disease; small-artery diseases, and microcirculation-related disease such as vascular cognitive dysfunction, heart failure, and chronic kidney disease. The careful consideration of BP variability and vascular diseases such as SHATS, and the early detection and management of SHATS, will achieve more effective individualized cardiovascular protection. In the near future, information and communication technology-based 'anticipation medicine' predicted by the changes of individual BP values could be a promising approach to achieving zero cardiovascular events. PMID:27482253

  16. Systemic Hemodynamic Atherothrombotic Syndrome and Resonance Hypothesis of Blood Pressure Variability: Triggering Cardiovascular Events.

    PubMed

    Kario, Kazuomi

    2016-07-01

    Blood pressure (BP) exhibits different variabilities and surges with different time phases, from the shortest beat-by-beat to longest yearly changes. We hypothesized that the synergistic resonance of these BP variabilites generates an extraordinarily large dynamic surge in BP and triggers cardiovascular events (the resonance hypothesis). The power of pulses is transmitted to the peripheral sites without attenuation by the large arteries, in individuals with stiffened arteries. Thus, the effect of a BP surge on cardiovascular risk would be especially exaggerated in high-risk patients with vascular disease. Based on this concept, our group recently proposed a new theory of systemic hemodynamic atherothromboltic syndrome (SHATS), a vicious cycle of hemodynamic stress and vascular disease that advances organ damage and triggers cardiovascular disease. Clinical phenotypes of SHATS are large-artery atherothombotic diseases such as stroke, coronary artery disease, and aortic and pheripheral artery disease; small-artery diseases, and microcirculation-related disease such as vascular cognitive dysfunction, heart failure, and chronic kidney disease. The careful consideration of BP variability and vascular diseases such as SHATS, and the early detection and management of SHATS, will achieve more effective individualized cardiovascular protection. In the near future, information and communication technology-based 'anticipation medicine' predicted by the changes of individual BP values could be a promising approach to achieving zero cardiovascular events.

  17. Regional Fat Distribution and Blood Pressure Level and Variability: The Dallas Heart Study.

    PubMed

    Yano, Yuichiro; Vongpatanasin, Wanpen; Ayers, Colby; Turer, Aslan; Chandra, Alvin; Carnethon, Mercedes R; Greenland, Philip; de Lemos, James A; Neeland, Ian J

    2016-09-01

    Our aim was to investigate the associations of regional fat distribution with home and office blood pressure (BP) levels and variability. Participants in the Dallas Heart Study, a multiethnic cohort, underwent 5 BP measurements on 3 occasions during 5 months (2 in home and 1 in office) and quantification of visceral adipose tissue, abdominal subcutaneous adipose tissue, and liver fat by magnetic resonance imaging, and lower body subcutaneous fat by dual x-ray absorptiometry. The relation of regional adiposity with short-term (within-visit) and long-term (overall visits) mean BP and average real variability was assessed with multivariable linear regression. We have included 2595 participants with a mean age of 44 years (54% women; 48% black), and mean body mass index was 29 kg/m(2) Mean systolic BP/diastolic BP was 127/79 mm Hg and average real variability systolic BP was 9.8 mm Hg during 3 visits. In multivariable-adjusted models, higher amount of visceral adipose tissue was associated with higher short-term (both home and office) and long-term mean systolic BP (β[SE]: 1.9[0.5], 2.7[0.5], and 2.1[0.5], respectively; all P<0.001) and with lower long-term average real variability systolic BP (β[SE]: -0.5[0.2]; P<0.05). In contrast, lower body fat was associated with lower short-term home and long-term mean BP (β[SE]: -0.30[0.13] and -0.24[0.1], respectively; both P<0.05). Neither subcutaneous adipose tissue or liver fat was associated with BP levels or variability. In conclusion, excess visceral fat was associated with persistently higher short- and long-term mean BP levels and with lower long-term BP variability, whereas lower body fat was associated with lower short- and long-term mean BP. Persistently elevated BP, coupled with lower variability, may partially explain increased risk for cardiac hypertrophy and failure related to visceral adiposity. © 2016 American Heart Association, Inc.

  18. Relationship between cardiovascular health score and year-to-year blood pressure variability in China: a prospective cohort study

    PubMed Central

    An, Shasha; Bao, Minghui; Wang, Yang; Li, Zhifang; Zhang, Wenyan; Chen, Shuohua; Li, Junjuan; Yang, Xinchun; Wu, Shouling; Cai, Jun

    2015-01-01

    Objectives On the basis of cardiovascular health factors and behaviours, the American Heart Association proposed the Cardiovascular Health Score (CHS). It has been widely used to estimate the cardiovascular health status of individuals. The aim of this study was to investigate the relationship between CHS and year-to-year blood pressure variability (BPV). Design Prospective cohort study. Settings We stratified participants into two groups by gender: first group, female group; second group, male group. The relationship between CHS and year-to-year blood pressure variability were analysed. Participants A total of 41 613 individuals met the inclusion criteria (no history of stroke, transient ischaemic attack, myocardial infarction, malignant tumour or atrial fibrillation) and had complete blood pressure data. Results The coefficient of the variation of systolic blood pressure (SCV) was 8.33% in the total population and 8.68% and 8.22% in female and male groups, respectively (p<0.05). Multivariable linear regression analysis revealed that higher CHS was inversely associated with increasing year-to-year BPV, which persisted after adjusting for baseline systolic blood pressure and other risk factors. Each SD increase in CHS could lead to a 0.016SD decrease in SCV (p<0.05). Conclusions In summary, CHS was inversely related to year-to-year BPV, which suggested that a healthy lifestyle may contribute to better blood pressure management. PMID:26503389

  19. Extended duration orbiter medical project variability of blood pressure and heart rate (STS-50/USML-1)

    NASA Technical Reports Server (NTRS)

    Fritsch-Yelle, Janice M.; Charles, John B.; Boettcher, Sheila W.

    1994-01-01

    Decreases in arterial baroreflex function after space flight may be related to changes in blood pressure and heart rate patterns during flight. Ambulatory blood pressure and heart rate were measured for 24 hours, in fourteen astronauts on two occasions before flight, two to three occasions in flight, and 2 days after landing on Shuttle missions lasting 4 to 14 days. Blood pressure and heart rate were recorded every 20minutes during awake periods and every 30 minutes during sleep. In pre- and postflight studies, the 24-hour ambulatory measurements were followed by studies of carotid baroreceptor-cardiac reflex responses. Carotid baroreceptors were stimulated using a sequence of neck pressure and suction from +40 to -65 mmHg.

  20. Day-to-Day Blood Pressure Variability and Risk of Dementia in a General Japanese Elderly Population: The Hisayama Study.

    PubMed

    Oishi, Emi; Ohara, Tomoyuki; Sakata, Satoko; Fukuhara, Masayo; Hata, Jun; Yoshida, Daigo; Shibata, Mao; Ohtsubo, Toshio; Kitazono, Takanari; Kiyohara, Yutaka; Ninomiya, Toshiharu

    2017-08-08

    Several observational studies have reported that higher visit-to-visit blood pressure variability is a risk factor for cognitive impairment and dementia. However, no studies have investigated the association of day-to-day blood pressure variability assessed by home blood pressure measurement with the development of dementia. A total of 1674 community-dwelling Japanese elderly without dementia, ≥60 years of age, were followed up for 5 years (2007-2012). Home blood pressure was measured 3 times every morning for a median of 28 days. Day-to-day systolic (SBP) and diastolic blood pressure variabilities, calculated as coefficients of variation (CoV) of home SBP and diastolic blood pressure, were categorized into quartiles. The hazard ratios and their 95% confidence intervals of the CoV levels of home blood pressure on the development of all-cause dementia, vascular dementia (VaD), and Alzheimer disease (AD) were computed with a Cox proportional hazards model. During the follow-up, 194 subjects developed all-cause dementia; of these, 47 had VaD and 134 had AD. The age- and sex-adjusted incidences of all-cause dementia, VaD, and AD increased significantly with increasing CoV levels of home SBP (all P for trend <0.05). These associations remained unchanged after adjustment for potential confounding factors, including home SBP. Compared with subjects in the first quartile of CoV levels of home SBP, the risks of the development of all-cause dementia, VaD, and AD were significantly higher in those in the fourth quartile (hazard ratio=2.27, 95% confidence interval=1.45-3.55, P<0.001 for all-cause dementia; hazard ratio=2.79, 95% confidence interval=1.04-7.51, P=0.03 for VaD; hazard ratio=2.22, 95% confidence interval=1.31-3.75, P<0.001 for AD). Similar associations were observed for CoV levels of home diastolic blood pressure. Meanwhile, home SBP levels were significantly associated with the risk of VaD but not with the risks of all-cause dementia and AD. There was no

  1. How Many Measurements Are Needed to Estimate Blood Pressure Variability Without Loss of Prognostic Information?

    PubMed Central

    2014-01-01

    BACKGROUND Average real variability (ARV) is a recently proposed index for short-term blood pressure (BP) variability. We aimed to determine the minimum number of BP readings required to compute ARV without loss of prognostic information. METHODS ARV was calculated from a discovery dataset that included 24-hour ambulatory BP measurements for 1,254 residents (mean age = 56.6 years; 43.5% women) of Copenhagen, Denmark. Concordance between ARV from full (≥80 BP readings) and randomly reduced 24-hour BP recordings was examined, as was prognostic accuracy. A test dataset that included 5,353 subjects (mean age = 54.0 years; 45.6% women) with at least 48 BP measurements from 11 randomly recruited population cohorts was used to validate the results. RESULTS In the discovery dataset, a minimum of 48 BP readings allowed an accurate assessment of the association between cardiovascular risk and ARV. In the test dataset, over 10.2 years (median), 806 participants died (335 cardiovascular deaths, 206 cardiac deaths) and 696 experienced a major fatal or nonfatal cardiovascular event. Standardized multivariable-adjusted hazard ratios (HRs) were computed for associations between outcome and BP variability. Higher diastolic ARV in 24-hour ambulatory BP recordings predicted (P < 0.01) total (HR = 1.12), cardiovascular (HR = 1.19), and cardiac (HR = 1.19) mortality and fatal combined with nonfatal cerebrovascular events (HR = 1.16). Higher systolic ARV in 24-hour ambulatory BP recordings predicted (P < 0.01) total (HR = 1.12), cardiovascular (HR = 1.17), and cardiac (HR = 1.24) mortality. CONCLUSIONS Forty-eight BP readings over 24 hours were observed to be adequate to compute ARV without meaningful loss of prognostic information. PMID:23955605

  2. Influence of blood pressure variability on early carotid atherosclerosis in hypertension with and without diabetes

    PubMed Central

    Wu, Dan; Li, Chunyue; Chen, Yujie; Xiong, Huahua; Tian, Xiaohong; Wu, Wanqing; Huang, Wenhua; Zhang, Yuan-Ting; Zhang, Heye

    2016-01-01

    Abstract Carotid intima-media thickness (IMT) has been one widely used index of early carotid atherosclerosis. We speculated that the influence of blood pressure variability (BPV) on early carotid atherosclerosis may be varied by the location of the carotid artery and diabetes history. Thus, the goal of this study was to evaluate the effects of BPV on early arteriosclerosis progression in different segments of the carotid artery for hypertension with and without diabetes. A total of 148 hypertension patients who underwent 24 hours ambulatory blood pressure (BP) monitoring and carotid ultrasonography were enrolled in this study. Of them, 84 subjects were without diabetes, and 64 subjects were with diabetes. Short-term BPV during daytime, nighttime, and over 24 hours were evaluated through standard deviation (SD) and average real variability (ARV). We measured carotid IMT at left and right common carotid artery (CCA), carotid bulb, and the origin of the internal carotid artery (ICA). The associations between segment-specific measurements of carotid IMT and 24 hours ambulatory BPV were analyzed. We found that IMT at the common carotid artery (CCA-IMT) and IMT at the internal carotid artery (ICA-IMT) were more closely associated with BPV than was carotid bulb IMT. In addition, for all subjects, BPV was clearly associated with left CCA-IMT but not with right CCA-IMT. Furthermore, in diabetes patients, nighttime systolic BPV was independently related to mean CCA-IMT (P < 0.01) and mean bulb IMT (P < 0.01). In contrast, in nondiabetes patients, daytime and 24 hours systolic BPV was positively associated with mean CCA-IMT (P < 0.05), but not independent after adjusting for baseline characteristics such as age and sex. The findings of our study indicate a segment-specific association between carotid IMT and 24 hours ambulatory BPV, and the associations also vary according to the diabetes history. We conclude that BPV plays a distinct role in early

  3. Influence of blood pressure variability on early carotid atherosclerosis in hypertension with and without diabetes.

    PubMed

    Wu, Dan; Li, Chunyue; Chen, Yujie; Xiong, Huahua; Tian, Xiaohong; Wu, Wanqing; Huang, Wenhua; Zhang, Yuan-Ting; Zhang, Heye

    2016-06-01

    Carotid intima-media thickness (IMT) has been one widely used index of early carotid atherosclerosis. We speculated that the influence of blood pressure variability (BPV) on early carotid atherosclerosis may be varied by the location of the carotid artery and diabetes history. Thus, the goal of this study was to evaluate the effects of BPV on early arteriosclerosis progression in different segments of the carotid artery for hypertension with and without diabetes.A total of 148 hypertension patients who underwent 24 hours ambulatory blood pressure (BP) monitoring and carotid ultrasonography were enrolled in this study. Of them, 84 subjects were without diabetes, and 64 subjects were with diabetes. Short-term BPV during daytime, nighttime, and over 24 hours were evaluated through standard deviation (SD) and average real variability (ARV). We measured carotid IMT at left and right common carotid artery (CCA), carotid bulb, and the origin of the internal carotid artery (ICA). The associations between segment-specific measurements of carotid IMT and 24 hours ambulatory BPV were analyzed.We found that IMT at the common carotid artery (CCA-IMT) and IMT at the internal carotid artery (ICA-IMT) were more closely associated with BPV than was carotid bulb IMT. In addition, for all subjects, BPV was clearly associated with left CCA-IMT but not with right CCA-IMT. Furthermore, in diabetes patients, nighttime systolic BPV was independently related to mean CCA-IMT (P < 0.01) and mean bulb IMT (P < 0.01). In contrast, in nondiabetes patients, daytime and 24 hours systolic BPV was positively associated with mean CCA-IMT (P < 0.05), but not independent after adjusting for baseline characteristics such as age and sex.The findings of our study indicate a segment-specific association between carotid IMT and 24 hours ambulatory BPV, and the associations also vary according to the diabetes history. We conclude that BPV plays a distinct role in early carotid

  4. Enantioselective pharmacokinetic and pharmacodynamic properties of carvedilol in spontaneously hypertensive rats: focus on blood pressure variability.

    PubMed

    Bertera, Facundo Martín; Del Mauro, Julieta Sofía; Chiappetta, Diego; Polizio, Ariel Héctor; Buontempo, Fabián; Taira, Carlos Alberto; Höcht, Christian

    2012-03-01

    The cardiovascular effects and pharmacokinetics of carvedilol were assessed in spontaneously hypertensive (SH) and Wistar Kyoto (WKY) animals with special focus on short-term blood pressure variability (BPV). Male SH and WKY rats were acutely treated with vehicle or carvedilol 1 or 5 mg kg(-1) (i.v.), and effects on blood pressure (BP), heart rate (HR) and BPV were recorded. Plasma pharmacokinetics of R- and S-carvedilol was studied by traditional blood sampling. Relationship between carvedilol concentrations and their hypotensive and bradycardic effects was established by pharmacokinetic-pharmacodynamic (PK-PD) modelling. Short-term BPV was assessed by standard deviation of BP recording. Vascular sympatholytic activity of carvedilol was studied by estimation of drug effects on ratio between low frequency (LF) and high frequency (HF) BPV (LF/HF ratio). Although pharmacokinetic properties of carvedilol remained mainly unaffected in SH rats with regard to WKY rats, hypertensive animals showed a reduction in drug clearance of R- and S-carvedilol after administration of 1 mg kg(-1) compared with WKY rats. PK-PD analysis of HR changes induced by S-carvedilol showed a greater maximal bradycardic response to carvedilol in SH rats (E (max), -27.6 ± 3.9%; p < 0.05) compared with WKY group (E (max), -13.4 ± 2.5%). SH rats showed a greater hypotensive effect of racemic carvedilol (E (max), -45.5 ± 5.0%; p < 0.05) with regard to WKY group (E (max), -17.9 ± 4.5%). Carvedilol induced a greater reduction of LF/HF ratio in SH rats compared with WKY rats. Short-term BPV was markedly reduced by carvedilol in WKY and SH rats. In conclusion, as a consequence of an enhanced bradycardic response and a greater vascular sympatholytic activity, carvedilol exerts a greater hypotensive response in SH rats compared with WKY animals and dramatically reduces short-term BPV.

  5. High Blood Pressure

    MedlinePlus

    ... normal blood pressure 140/90 or higher is high blood pressure Between 120 and 139 for the top number, ... prehypertension. Prehypertension means you may end up with high blood pressure, unless you take steps to prevent it. High ...

  6. High Blood Pressure (Hypertension)

    MedlinePlus

    ... Print Page Text Size: A A A Listen High Blood Pressure (Hypertension) Nearly 1 in 3 American adults has ... weight. How Will I Know if I Have High Blood Pressure? High blood pressure is a silent problem — you ...

  7. High blood pressure

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000468.htm High blood pressure To use the sharing features on this page, ... body. Hypertension is the term used to describe high blood pressure. Blood pressure readings are given as two numbers. ...

  8. Increased Blood Pressure Variability Prior to Chronic Kidney Disease Exacerbates Renal Dysfunction in Rats

    PubMed Central

    Freitas, Frederico F. C. T.; Araujo, Gilberto; Porto, Marcella L.; Freitas, Flavia P. S.; Graceli, Jones B.; Balarini, Camille M.; Vasquez, Elisardo C.; Meyrelles, Silvana S.; Gava, Agata L.

    2016-01-01

    Increased blood pressure variability (BPV), which can be experimentally induced by sinoaortic denervation (SAD), has emerged as a new marker of the prognosis of cardiovascular and renal outcomes. Considering that increased BPV can lead to organ-damage, the goal of the present study was to evaluate the effects of SAD on renal function in an experimental model of chronic kidney disease (CKD). SAD was performed in male Wistar rats 2 weeks before 5/6 nephrectomy and the animals were evaluated 4 weeks after the induction of CKD. Our data demonstrated that BPV was increased in SAD and CKD animals and that the combination of both conditions (SAD+CKD) exacerbated BPV. The baroreflex sensitivity index was diminished in the SAD and CKD groups; this reduction was more pronounced when SAD and CKD were performed together. 5/6 nephrectomy led to hypertension, which was higher in SAD+CKD animals. Regarding renal function, the combination of SAD and CKD resulted in reduced renal plasma and blood flow, increased renal vascular resistance and augmented uraemia when compared to CKD animals. Glomerular filtration rate and BPV were negatively correlated in SAD, CKD, and SAD+CKD animals. Moreover, SAD+CKD animals presented a higher level of glomerulosclerosis when compared to all other groups. Cardiac and renal hypertrophy, as well as oxidative stress, was also further increased when SAD and CKD were combined. These results show that SAD prior to 5/6 nephrectomy exacerbates renal dysfunction, suggesting that previous augmented BPV should be considered as an important factor to the progression of renal diseases. PMID:27721797

  9. Blood Pressure Variability and Cardiovascular Risk in the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER)

    PubMed Central

    Poortvliet, Rosalinde K. E.; Ford, Ian; Lloyd, Suzanne M.; Sattar, Naveed; Mooijaart, Simon P.; de Craen, Anton J. M.; Westendorp, Rudi G. J.; Jukema, J. Wouter; Packard, Christopher J.; Gussekloo, Jacobijn; de Ruijter, Wouter; Stott, David J.

    2012-01-01

    Variability in blood pressure predicts cardiovascular disease in young- and middle-aged subjects, but relevant data for older individuals are sparse. We analysed data from the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) study of 5804 participants aged 70–82 years with a history of, or risk factors for cardiovascular disease. Visit-to-visit variability in blood pressure (standard deviation) was determined using a minimum of five measurements over 1 year; an inception cohort of 4819 subjects had subsequent in-trial 3 years follow-up; longer-term follow-up (mean 7.1 years) was available for 1808 subjects. Higher systolic blood pressure variability independently predicted long-term follow-up vascular and total mortality (hazard ratio per 5 mmHg increase in standard deviation of systolic blood pressure = 1.2, 95% confidence interval 1.1–1.4; hazard ratio 1.1, 95% confidence interval 1.1–1.2, respectively). Variability in diastolic blood pressure associated with increased risk for coronary events (hazard ratio 1.5, 95% confidence interval 1.2–1.8 for each 5 mmHg increase), heart failure hospitalisation (hazard ratio 1.4, 95% confidence interval 1.1–1.8) and vascular (hazard ratio 1.4, 95% confidence interval 1.1–1.7) and total mortality (hazard ratio 1.3, 95% confidence interval 1.1–1.5), all in long-term follow-up. Pulse pressure variability was associated with increased stroke risk (hazard ratio 1.2, 95% confidence interval 1.0–1.4 for each 5 mmHg increase), vascular mortality (hazard ratio 1.2, 95% confidence interval 1.0–1.3) and total mortality (hazard ratio 1.1, 95% confidence interval 1.0–1.2), all in long-term follow-up. All associations were independent of respective mean blood pressure levels, age, gender, in-trial treatment group (pravastatin or placebo) and prior vascular disease and cardiovascular disease risk factors. Our observations suggest variability in diastolic blood pressure is more strongly associated

  10. The blood pressure variability, arterial elasticity and humoral factors in subjects with family history of hypertension.

    PubMed

    Rafidah, H M; Azizi, A; Suhaimi, H; Noriah, M N

    2008-03-01

    Normotensive subjects with family history of hypertension (FHT) have been reported to have increased left ventricular mass index and reduced ventricular compliance. Of interest is whether blood pressure variability (BPV), which has been associated with target organ damage, is then part of this complex inherited syndrome? The objectives of this study are to determine whether there are any significant differences in BPV, arterial compliance and humoral factors in subjects with FHT as compared to controls. Thirty-five subjects with self reported FHT and 35 matched controls underwent 24 hour BP monitoring (BR-102, Schiller Inc. Germany). Arterial compliance was measured using systolic pulse wave tonometry (HDI/Pulsewave Cardiovascular Profiling Instrument, Hypertension Diagnostic Inc. USA). None of the subjects were hypertensive or diabetic. Out of these numbers, 25 subjects with FHT and 26 controls had measurements of plasma catecholamines, plasma renin and serum aldosterone. Catecholamines were assayed with high performance liquid chromatography, while both renin and aldosterone measurements were by radioimmunoassay. Subjects with FHT have higher night time BPV. There was no significant difference in arterial compliances between both groups. There were increased level of norepinephrine (NE) in subjects with FHT but epinephrine (E), renin and aldosterone levels were similar in both groups. There were no correlations between NE and BPV but E was negatively associated with daytime and mean arterial systolic BPV. In conclusion subjects with FHT demonstrated a higher night time BPV and NE level as compared to controls.

  11. Frequency components of systolic blood pressure variability reflect vasomotor and cardiac sympathetic functions in conscious rats.

    PubMed

    Yoshimoto, Takahiko; Eguchi, Kunihiro; Sakurai, Hiroki; Ohmichi, Yusuke; Hashimoto, Tatsuyuki; Ohmichi, Mika; Morimoto, Atsuko; Yamaguchi, Yoshiko; Ushida, Takahiro; Iwase, Satoshi; Sugenoya, Junichi; Kumazawa, Takao

    2011-09-01

    In this study, after confirming the suppression of autonomic nervous function by isoflurane anesthesia using autonomic antagonists, we pharmacologically investigated the involvement of vasomotor and cardiac sympathetic functions in systolic blood pressure variability (SBPV) frequency components in conscious rats at rest and during exposure to low-ambient temperature (LT-exposure, 9°C for 90 min). Under unanesthesia, phentolamine administration (α-adrenoceptor antagonist, 10 mg/kg) decreased the mid-frequency component (MF 0.33-0.73 Hz) and inversely increased the high-frequency component (HF 1.3-2.5 Hz). The increased HF was suppressed by subsequent treatment with atenolol (β-adrenoceptor antagonist, 10 mg/kg), but not with atropine (muscarinic receptor antagonist, 10 mg/kg). Moreover, phentolamine administration after atenolol decreased MF, but did not increase HF. LT-exposure increased MF and HF; however, phentolamine pretreatment suppressed the increased MF during LT-exposure, and atenolol pretreatment dose-dependently decreased the increased HF. These results suggest that MF and HF of SBPV may reflect α-adrenoceptor-mediated vasomotor function and β-adrenoceptor-mediated cardiac sympathetic function, respectively, in the conscious state.

  12. High Blood Pressure

    MedlinePlus

    ... version of this page please turn Javascript on. High Blood Pressure What Is High Blood Pressure? High blood pressure is a common disease in ... the heart, kidneys, brain, and eyes. Types of High Blood Pressure There are two main types of high blood ...

  13. Heart rate and blood pressure variability during heavy training and overtraining in the female athlete.

    PubMed

    Uusitalo, A L; Uusitalo, A J; Rusko, H K

    2000-01-01

    We investigated heavy training- and overtraining-induced changes in heart rate and blood pressure variability during supine rest and in response to head-up tilt in female endurance athletes. Nine young female experimental athletes (ETG) increased their training volume at the intensity of 70-90% of maximal oxygen uptake (VO2max) by 125% and training volume at the intensity of < 70% of VO2max by 100% during 6-9 weeks. The corresponding increases in 6 female control athletes were 5% and 10%. The VO2max of the ETG and the control athletes did not change, but it decreased from 53.0 +/- 2.2 ml x kg(-1) x min(-1) to 50.2 +/- 2.3 ml x kg(-1) x min(-1) (mean+/-SEM, p < 0.01) in five overtrained experimental athletes. In the ETG, low-frequency power of R-R interval (RRI) variability during supine rest increased from 6 +/- 1 ms2 x 10(2) to 9 +/- 2 ms2 x 10(2) (p < 0.05). The 30/15 index (= RRI(max 30)/RRI(min 15), where RRI(max 30) denotes the longest RRI close to the 30th RRI and RRI(min 15) denotes the shortest RRI close to the 15th RRI after assuming upright position in the head-up tilt test), decreased as a result of training (analysis of variance, p = 0.05). In the ETG, changes in VO2max were related to the changes in total power of RRI variability during standing (r = 0.74, p < 0.05). Heart rate response to prolonged standing after head-up tilt was either accentuated or attenuated in the overtrained athletes as compared to the normal training state. We conclude that heavy training could increase cardiac sympathetic modulation during supine rest and attenuated biphasic baroreflex-mediated response appearing just after shifting to an upright position. Heavy-training-/overtraining-induced decrease in maximal aerobic power was related to decreased heart rate variability during standing. Physiological responses to overtraining were individual.

  14. Association between heart rate variability, blood pressure and autonomic activity in cyclic alternating pattern during sleep.

    PubMed

    Kondo, Hideaki; Ozone, Motohiro; Ohki, Noboru; Sagawa, Yohei; Yamamichi, Keiichirou; Fukuju, Mitsuki; Yoshida, Takeshi; Nishi, Chikako; Kawasaki, Akiko; Mori, Kaori; Kanbayashi, Takashi; Izumi, Motomori; Hishikawa, Yasuo; Nishino, Seiji; Shimizu, Tetsuo

    2014-01-01

    Cyclic alternating pattern (CAP) is frequently followed by changes in heart rate (HR) and blood pressure (BP), but the sequential associations between CAP and autonomic nerve activity have not been studied. The study aimed to reveal the precise changes in heart rate variability (HRV) during phase A of the CAP cycle. Polysomnography was recorded according to the CAP Atlas (Terzano, 2002), and BP and electrocardiogram were simultaneously recorded. The complex demodulation method was used for analysis of HRV and evaluation of autonomic nerve activity. Academic sleep laboratory. Ten healthy males. The increase in HR (median [first quartile - third quartile]) for each subtype was as follows: A1, 0.64 (-0.30 to 1.69), A2, 1.44 (0.02 to 3.79), and A3, 6.24 (2.53 to 10.76) bpm (A1 vs. A2 P < 0.001, A1 vs. A3 P < 0.001, A2 vs. A3 P < 0.001). The increase in BP for each subtype was as follows: A1, 1.23 (-2.04 to 5.75), A2, 1.76 (-1.46 to 9.32), and A3, 12.51 (4.75 to 19.94) mm Hg (A1 vs. A2 P = 0.249, A1 vs. A3 P < 0.001, A2 vs. A3 P < 0.001). In all of phase A, the peak values for HR and BP appeared at 4.2 (3.5 to 5.4) and 8.4 (7.0 to 10.3) seconds, respectively, after the onset of phase A. The area under the curve for low-frequency and high-frequency amplitude significantly increased after the onset of CAP phase A (P < 0.001) and was higher in the order of subtype A3, A2, and A1 (P < 0.001). All phase A subtypes were accompanied with increased heart rate variability, and the largest heart rate variability was seen in subtype A3, while a tendency for less heart rate variability was seen in subtype A1.

  15. Daily environmental differences in blood pressure and heart rate variability in healthy premenopausal women.

    PubMed

    James, Gary D; Bovbjerg, Dana H; Hill, Leah A

    2015-01-01

    As daily environments change, behavior and activity also change and as blood pressure (BP) and heart rate (HR) are allostatically tied to these factors, one might expect that environments that elicit the greatest behavioral/activity variation should also evince the highest BP and HR variability [standard deviation (SD) or coefficient of variation (CV)]. The purpose of this study was to evaluate this premise. Two hundred and six women (age = 37.6 ± 9.1 years) wore an ambulatory BP monitor on a midweek workday. All worked in clerical, technical, or professional positions. Ambulatory BP and HR Means, SDs and CVs at work (11 AM-3 PM), home (∼6-10 PM) and during sleep (∼10 PM-6 AM) were compared using repeated measures ANCOVA. Mean BP and HR decreased from work and home to sleep [121 ± 11, 120 ± 11 vs. 107 ± 12 systolic; 82 ± 10, 80 ± 11 vs. 66 ± 11 diastolic; 79 ± 12, 80 ± 12 vs. 68 ± 11 HR (all P < 0.001)], while the CV of systolic and diastolic BP increased [0.06 ± 0.02, 0.07 ± 0.02 vs. 0.08 ± 0.03 systolic; 0.09 ± 0.03, 0.10 ± 0.04 vs. 0.12 ± 0.05 diastolic (P < 0.001)]. The HR SD decreased during sleep [8.1 ± 3.8, 8.2 ± 3.8 vs. 6.9 ± 3.2 (P < 0.001)]. HR variability follows the expected variability pattern with behavior and activity, whereas BP does not. © 2014 Wiley Periodicals, Inc.

  16. Hypertension (High Blood Pressure)

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Hypertension (High Blood Pressure) KidsHealth > For Teens > Hypertension (High Blood Pressure) A ... rest temperature diet emotions posture medicines Why Is High Blood Pressure Bad? High blood pressure means a person's heart ...

  17. Time course of changes in heart rate and blood pressure variability in rats with myocardial infarction

    PubMed Central

    Aires, R.; Pimentel, E.B.; Forechi, L.; Dantas, E.M.; Mill, J.G.

    2017-01-01

    Our aim was to determine the time course of changes in autonomic balance in the acute (1 and 3 days), sub-acute (7 days) and chronic (28 days) phases of myocardial infarction (MI) in rats. Autonomic balance was assessed by temporal and spectral analyses of blood pressure variability (BPV) and heart rate variability (HRV). Pulsatile blood pressure (BP) recordings (30 min) were obtained in awake and unrestrained male Wistar rats (N = 77; 8-10 weeks old) with MI (coronary ligature) or sham operation (SO). Data are reported as means±SE. The high frequency (HF) component (n.u.) of HRV was significantly lower in MI-1- (P<0.01) and MI-3-day rats (P<0.05) than in their time-control groups (SO-1=68±4 vs MI-1=35.3±4.3; SO-3=71±5.8 vs MI-3=45.2±3.8), without differences thereafter (SO-7=69.2±4.8 vs MI-7=56±5.8; SO-28=73±4 vs MI-28=66±6.6). A sharp reduction (P<0.05) of BPV (mmHg2) was observed in the first week after MI (SO-1=8.55±0.80; SO-3=9.11±1.08; SO-7=7.92±1.10 vs MI-1=5.63±0.73; MI-3=5.93±0.30; MI-7=5.30±0.25). Normal BPV, however, was observed 4 weeks after MI (SO-28=8.60±0.66 vs MI-28=8.43±0.56 mmHg2; P>0.05). This reduction was mainly due to attenuation of the low frequency (LF) band of BPV in absolute and normalized units (SO-1=39.3±7%; SO-3=55±4.5%; SO-7=46.8±4.5%; SO-28=45.7±5%; MI-1=13±3.5%; MI-3=35±4.7%; MI-7=25±2.8%; MI-28=21.4±2.8%). The results suggest that the reduction in HRV was associated with decrease of the HF component of HRV suggesting recovery of the vagal control of heartbeats along the post-infarction healing period. The depression of BPV was more dependent on the attenuation of the LF component, which is linked to the baroreflex modulation of the autonomic balance. PMID:28076450

  18. Validity and Usefulness of `Wearable Blood Pressure Sensing' for Detection of Inappropriate Short-Term Blood Pressure Variability in the Elderly

    NASA Astrophysics Data System (ADS)

    Iijima, Katsuya; Kameyama, Yumi; Akishita, Masahiro; Ouchi, Yasuyoshi; Yanagimoto, Shintaro; Imai, Yasushi; Yahagi, Naoki; Lopez, Guillaume; Shuzo, Masaki; Yamada, Ichiro

    An increase in short-term blood pressure (BP) variability is a characteristic feature in the elderly. It makes the management of hemodynamics more difficult, because it is frequently seen disturbed baro-reflex function and increased arterial stiffness, leading to isolated systolic hypertension. Large BP variability aggravates hypertensive target organ damage and is an independent risk factor for the cardiovascular (CV) events in elderly hypertensive patients. Therefore, appropriate control in BP is indispensable to manage lifestyle-related diseases and to prevent subsequent CV events. In addition, accumulating recent reports show that excessive BP variability is also associated with a decline in cognitive function and fall in the elderly. In the clinical settings, we usually evaluate their health condition, mainly with single point BP measurement using cuff inflation. However, unfortunately we are not able to find the close changes in BP by the traditional way. Here, we can show our advantageous approach of continuous BP monitoring using newly developing device `wearable BP sensing' without a cuff stress in the elderly. The new device could reflect systolic BP and its detailed changes, in consistent with cuff-based BP measurement. Our new challenge suggests new possibility of its clinical application with high accuracy.

  19. Relationship between cardiovascular health score and year-to-year blood pressure variability in China: a prospective cohort study.

    PubMed

    An, Shasha; Bao, Minghui; Wang, Yang; Li, Zhifang; Zhang, Wenyan; Chen, Shuohua; Li, Junjuan; Yang, Xinchun; Wu, Shouling; Cai, Jun

    2015-10-26

    On the basis of cardiovascular health factors and behaviours, the American Heart Association proposed the Cardiovascular Health Score (CHS). It has been widely used to estimate the cardiovascular health status of individuals. The aim of this study was to investigate the relationship between CHS and year-to-year blood pressure variability (BPV). Prospective cohort study. We stratified participants into two groups by gender: first group, female group; second group, male group. The relationship between CHS and year-to-year blood pressure variability were analysed. A total of 41,613 individuals met the inclusion criteria (no history of stroke, transient ischaemic attack, myocardial infarction, malignant tumour or atrial fibrillation) and had complete blood pressure data. The coefficient of the variation of systolic blood pressure (SCV) was 8.33% in the total population and 8.68% and 8.22% in female and male groups, respectively (p<0.05). Multivariable linear regression analysis revealed that higher CHS was inversely associated with increasing year-to-year BPV, which persisted after adjusting for baseline systolic blood pressure and other risk factors. Each SD increase in CHS could lead to a 0.016SD decrease in SCV (p<0.05). In summary, CHS was inversely related to year-to-year BPV, which suggested that a healthy lifestyle may contribute to better blood pressure management. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. The effect of GSM and TETRA mobile handset signals on blood pressure, catechol levels and heart rate variability.

    PubMed

    Barker, Anthony T; Jackson, Peter R; Parry, Helen; Coulton, Leslie A; Cook, Greg G; Wood, Steven M

    2007-09-01

    An acute rise in blood pressure has been reported in normal volunteers during exposure to signals from a mobile phone handset. To investigate this finding further we carried out a double blind study in 120 healthy volunteers (43 men, 77 women) in whom we measured mean arterial pressure (MAP) during each of six exposure sessions. At each session subjects were exposed to one of six different radio frequency signals simulating both GSM and TETRA handsets in different transmission modes. Blood catechols before and after exposure, heart rate variability during exposure, and post exposure 24 h ambulatory blood pressure were also studied. Despite having the power to detect changes in MAP of less than 1 mmHg none of our measurements showed any effect which we could attribute to radio frequency exposure. We found a single statistically significant decrease of 0.7 mmHg (95% CI 0.3-1.2 mmHg, P = .04) with exposure to GSM handsets in sham mode. This may be due to a slight increase in operating temperature of the handsets when in this mode. Hence our results have not confirmed the original findings of an acute rise in blood pressure due to exposure to mobile phone handset signals. In light of this negative finding from a large study, coupled with two smaller GSM studies which have also proved negative, we are of the view that further studies of acute changes in blood pressure due to GSM and TETRA handsets are not required.

  1. The Impact of Blood Pressure Variability on Subclinical Ventricular, Renal and Vascular Dysfunction, in Patients with Hypertension and Diabetes

    PubMed Central

    CIOBANU, Andrea O; GHERGHINESCU, Carmen Lucia; DULGHERU, Raluca; MAGDA, Stefania; DRAGOI GALRINHO, Ruxandra; FLORESCU, Maria; GUBERNA, Suzana; CINTEZA, Mircea; VINEREANU, Dragos

    2013-01-01

    ABSTRACT Background: Blood pressure variability (BPV) was proved as a cardiovascular risk factor. One of its mechanisms is related to arterial stiffness and ventriculo-arterial coupling; however its impact on subclinical cardiovascular dysfunction has not been evaluated yet. Objectives: To assess the relationship between BPV on 24 hours, and subclinical left ventricle (LV), renal, and vascular dysfunction in diabetic and hypertensive patients. Material and methods: We studied 56 patients (57±9 years, 29 men) with mild-to-moderate hypertension and type 2 diabetes, no cardiovascular disease, normal ejection fraction and normal renal function. 24 hours ambulatory blood pressure monitoring (ABPM) was used to assess BPV, daytime (d) and night time (n), by: 1. mean (M); 2. standard deviation of mean (SD); 3. variance (Vr); 4. coefficient of variation (CV); 5. day/night variation: reverse dippers, non-dippers, dippers and extreme dippers; conventional and 2D speckle tracking echo to assess LV function; myocardial deformation was measured as global longitudinal strain (GLS). Endothelial (flow mediated dilation, FMD) and arterial function (intima media-thickness, IMT; pulse wave velocity, PWV), microalbuminuria were tested. Outcomes: Daytime BPV correlates inversely with subclinical myocardial function evaluated through GLS. Daytime systolic BPV correlates positively with IMT (all rho > 0.30, all p < 0.05). Also, there is a significantly inverse correlation between mean BP and GLS. We found a direct correlation between mean BP, but not BPV, and microalbuminuria (all rho > - 0.30 and all p < 0.05). We found no correlation between BPV and FMD, PWV. There were no differences for GLS, microalbuminuria and FMD between dipper groups. Conclusions: In diabetic patients with mild-to-moderate hypertension, increased daytime blood pressure variability correlates with subclinical left ventricular dysfunction and arterial function (IMT), while microalbuminuria correlates with elevated

  2. The influence of subclinical hyperthyroidism on blood pressure, heart rate variability, and prevalence of arrhythmias.

    PubMed

    Kaminski, Grzegorz; Makowski, Karol; Michałkiewicz, Dariusz; Kowal, Jarosław; Ruchala, Marek; Szczepanek, Ewelina; Gielerak, Grzegorz

    2012-05-01

    The impact of subclinical hyperthyroidism (sHT) on the cardiovascular system still needs to be elucidated. The aim of the study was to prospectively assess blood pressure (BP), variability in heart rate, and the prevalence of arrhythmias in patients with sHT, both before and after they are restored to the euthyroid state. The study group consisted of 44 normotensive patients (37 women, 7 men), aged 22-65 years (mean±SD: 45.9±11.0) with sHT. Enrolled patients were drawn from 1080 patients referred to our department for treatment of hyperthyroidism. Study patients were treated with radioiodine treatment to restore the euthyroid state. Ambulatory BP monitoring and Holter electrocardiography were performed (i) when sHT was diagnosed and (ii) at least 6 months after they became euthyroid. sHT in comparison to the euthyroid state was associated with higher (109.3±7.1 vs. 107.1±7.7 mmHg) nocturnal systolic mean BP (p=0.035) and BP load (14.8 vs. 10.2%, p=0.033), mean diastolic BP (66.4±6.6 vs. 64.8±6.6 mmHg, p=0.047), and mean arterial pressure (80.8±43.1 vs. 79.3±43.6 mmHg, p=0.049). Moreover, significant changes in both the time and frequency domain measures of heart rate variability (HRV) were observed: decrease of the square root of the mean squared differences of successive NN intervals (rMSSD) (45.68±34.1 vs. 65.09±50.6 ms, p=0.03) and the low frequency power (LF) (5.71±0.99 vs. 6.0±1.01 ms(2), p=0.049) as well as increase of QT interval dispersion (58.25±28.5 vs. 46.90±12.1 ms, p=0.020). This was accompanied by a clinically insignificant increase in the frequency of ventricular extrasystoles (VES) (3.1±7.4 vs. 0.6±1.2 per hour, p=0.048) and increased mean heart rate (78.4±6.8 vs. 76.0±8.0 beats/min, p=0.004). Some of the parameters correlated positively with thyroid hormones: nocturnal diastolic BP with free triiodothyronine (FT(3)) (r=0.397, p=0.008), rMSSD with free thyroxine (FT(4)) (r=0.389, p=0.013), and QT interval dispersion with FT(4

  3. Circadian blood pressure variability in type 1 diabetes subjects and their nondiabetic siblings - influence of erythrocyte electron transfer

    PubMed Central

    2010-01-01

    Background Normotensive non-diabetic relatives of type 1 diabetes (T1D) patients have an abnormal blood pressure response to exercise testing that is associated with indices of metabolic syndrome and increased oxidative stress. The primary aim of this study was to investigate the circadian variability of blood pressure and the ambulatory arterial stiffness index (AASI) in healthy siblings of T1D patients vs healthy control subjects who had no first-degree relative with T1D. Secondary aims of the study were to explore the influence of both cardiovascular autonomic function and erythrocyte electron transfer activity as oxidative marker on the ambulatory blood pressure profile. Methods Twenty-four hour ambulatory blood pressure monitoring (ABPM) was undertaken in 25 controls, 20 T1D patients and 20 siblings. In addition to laboratory examination (including homeostasis model assessment of insulin sensitivity) and clinical testing of autonomic function, we measured the rate of oxidant-induced erythrocyte electron transfer to extracellular ferricyanide (RBC vfcy). Results Systolic blood pressure (SBP) midline-estimating statistic of rhythm and pulse pressure were higher in T1D patients and correlated positively with diabetes duration and RBC vfcy; autonomic dysfunction was associated with diastolic BP ecphasia and increased AASI. Siblings had higher BMI, lower insulin sensitivity, larger SBP amplitude, and higher AASI than controls. Daytime SBP was positively, independently associated with BMI and RBC vfcy. Among non-diabetic people, there was a significant correlation between AASI and fasting plasma glucose. Conclusions Siblings of T1D patients exhibited a cluster of sub-clinical metabolic abnormalities associated with consensual perturbations in BP variability. Moreover, our findings support, in a clinical setting, the proposed role of transplasma membrane electron transport systems in vascular pathobiology. PMID:20920366

  4. School burnout: increased sympathetic vasomotor tone and attenuated ambulatory diurnal blood pressure variability in young adult women.

    PubMed

    May, Ross W; Sanchez-Gonzalez, Marcos A; Fincham, Frank D

    2015-01-01

    Two studies examined autonomic and cardiovascular functioning that may link school burnout to cardiovascular risk factors in young healthy adult females. Study 1 (N = 136) investigated whether school burnout was related to resting values of blood pressure (BP) and blood pressure variability (BPV) through laboratory beat-to-beat BP assessment. Study 2 (N = 94) examined the link between school burnout and diurnal BPV through ambulatory BP monitoring. Controlling for anxiety and depressive symptomatology, school burnout demonstrated strong positive relationships with indices of cardiac sympathovagal tone, sympathetic vasomotor tone, inefficient myocardial oxygen consumption, increased 24-h ambulatory heart rate and BP, blunted BP diurnal variability, and increased arterial stiffness. These studies establish cardiovascular biomarkers of school burnout and suggest that even in a seemingly healthy sample school burnout may predispose females to increased cardiovascular risk. Several future lines of research are outlined.

  5. High Blood Pressure in Pregnancy

    MedlinePlus

    ... The Health Information Center High Blood Pressure in Pregnancy What Is High Blood Pressure? Blood pressure is ... Are the Effects of High Blood Pressure in Pregnancy? Although many pregnant women with high blood pressure ...

  6. Blood pressure measurement

    MedlinePlus

    ... have this problem. High blood pressure is often discovered during a visit to the provider for another ... to develop high blood pressure. If you have diabetes, heart disease, or kidney problems, or if you ...

  7. Low blood pressure

    MedlinePlus

    Hypotension; Blood pressure - low; Postprandial hypotension; Orthostatic hypotension; Neurally mediated hypotension; NMH ... Blood pressure varies from one person to another. A drop as little as 20 mmHg, can cause problems for ...

  8. Blood Pressure Quiz

    MedlinePlus

    ... high blood pressure can lead to… stroke. kidney failure. heart attack and heart failure. all of the above. ... high blood pressure can lead to stroke, kidney failure, heart attack and heart failure A is the correct ...

  9. High blood pressure - infants

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007329.htm High blood pressure - infants To use the sharing features on this page, please enable JavaScript. High blood pressure (hypertension) is an increase in the force of ...

  10. High Blood Pressure Prevention

    MedlinePlus

    ... version of this page please turn Javascript on. High Blood Pressure Prevention Steps You Can Take You can take steps to prevent high blood pressure by adopting these healthy lifestyle habits. Follow a ...

  11. Blood Pressure Medicines

    MedlinePlus

    High blood pressure, also called hypertension, usually has no symptoms. But it can cause serious problems such as stroke, ... and kidney failure. If you cannot control your high blood pressure through lifestyle changes such as losing weight and ...

  12. Hypertension (High Blood Pressure)

    MedlinePlus

    ... Visitor Information RePORT NIH Fact Sheets Home > Hypertension (High Blood Pressure) Small Text Medium Text Large Text Hypertension (High Blood Pressure) YESTERDAY Hypertension is a silent killer because it ...

  13. Structural equation modeling with latent variables for longitudinal blood pressure traits using general pedigrees.

    PubMed

    Song, Yeunjoo E; Morris, Nathan J; Stein, Catherine M

    2016-01-01

    Structural equation modeling (SEM) has been used in a wide range of applied sciences including genetic analysis. The recently developed R package, strum, implements a framework for SEM for general pedigree data. We explored different SEM techniques using strum to analyze the multivariate longitudinal data and to ultimately test the association of genotypes on blood pressure traits. The quantitative blood pressure (BP) traits, systolic BP (SBP) and diastolic BP (DBP) were analyzed as the main traits of interest with age, sex, and smoking status as covariates. The single nucleotide polymorphism (SNP) genotype information from genome-wide association studies (GWAS) data was used for the test of association. The adjustment for hypertension treatment effect was done by the censored regression approach. Two different longitudinal data models, autoregressive model and latent growth curve model, were used to fit the longitudinal BP traits. The test of association for SNP was done using a novel score test within the SEM framework of strum. We found the 10 SNPs within the GWAS suggestive P value level, and among those 10, the most significant top 3 SNPs agreed in rank in both analysis models. The general SEM framework in strum is very useful to model and test for the association with massive genotype data and complex systems of multiple phenotypes with general pedigree data.

  14. Understanding Blood Pressure Readings

    MedlinePlus

    ... Disease Venous Thromboembolism Aortic Aneurysm More Understanding Blood Pressure Readings Updated:Mar 22,2017 What do your ... it’s too high for blood pressure High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  15. Low Blood Pressure

    MedlinePlus

    ... Disease Venous Thromboembolism Aortic Aneurysm More Low Blood Pressure - When Blood Pressure Is Too Low Updated:Dec 13,2016 How ... content was last reviewed October 2016 High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  16. High Blood Pressure (Hypertension)

    MedlinePlus

    ... For Consumers Consumer Information by Audience For Women High Blood Pressure (Hypertension) Share Tweet Linkedin Pin it More sharing ... En Español Who is at risk? How is high blood pressure treated? Understanding your blood pressure: What do the ...

  17. Heart Rate Variability Moderates the Association Between Separation-Related Psychological Distress and Blood Pressure Reactivity Over Time.

    PubMed

    Bourassa, Kyle J; Hasselmo, Karen; Sbarra, David A

    2016-08-01

    Divorce is a stressor associated with long-term health risk, though the mechanisms of this effect are poorly understood. Cardiovascular reactivity is one biological pathway implicated as a predictor of poor long-term health after divorce. A sample of recently separated and divorced adults (N = 138) was assessed over an average of 7.5 months to explore whether individual differences in heart rate variability-assessed by respiratory sinus arrhythmia-operate in combination with subjective reports of separation-related distress to predict prospective changes in cardiovascular reactivity, as indexed by blood pressure reactivity. Participants with low resting respiratory sinus arrhythmia at baseline showed no association between divorce-related distress and later blood pressure reactivity, whereas participants with high respiratory sinus arrhythmia showed a positive association. In addition, within-person variation in respiratory sinus arrhythmia and between-persons variation in separation-related distress interacted to predict blood pressure reactivity at each laboratory visit. Individual differences in heart rate variability and subjective distress operate together to predict cardiovascular reactivity and may explain some of the long-term health risk associated with divorce.

  18. Effects of acute exposure to WIFI signals (2.45GHz) on heart variability and blood pressure in Albinos rabbit.

    PubMed

    Saili, Linda; Hanini, Amel; Smirani, Chiraz; Azzouz, Ines; Azzouz, Amina; Sakly, Mohsen; Abdelmelek, Hafedh; Bouslama, Zihad

    2015-09-01

    Electrocardiogram and arterial pressure measurements were studied under acute exposures to WIFI (2.45GHz) during one hour in adult male rabbits. Antennas of WIFI were placed at 25cm at the right side near the heart. Acute exposure of rabbits to WIFI increased heart frequency (+22%) and arterial blood pressure (+14%). Moreover, analysis of ECG revealed that WIFI induced a combined increase of PR and QT intervals. By contrast, the same exposure failed to alter maximum amplitude and P waves. After intravenously injection of dopamine (0.50ml/kg) and epinephrine (0.50ml/kg) under acute exposure to RF we found that, WIFI alter catecholamines (dopamine, epinephrine) action on heart variability and blood pressure compared to control. These results suggest for the first time, as far as we know, that exposure to WIFI affect heart rhythm, blood pressure, and catecholamines efficacy on cardiovascular system; indicating that radiofrequency can act directly and/or indirectly on cardiovascular system. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Relationship between heart rate variability, blood pressure and arterial wall properties during air and oxygen breathing in healthy subjects.

    PubMed

    Graff, Beata; Szyndler, Anna; Czechowicz, Krzysztof; Kucharska, Wiesława; Graff, Grzegorz; Boutouyrie, Pierre; Laurent, Stephane; Narkiewicz, Krzysztof

    2013-11-01

    Previous studies reported that normobaric hyperoxia influences heart rate, arterial pressure, cardiac output and systemic vascular resistance, but the mechanisms underlying these changes are still not fully understood. Several factors are considered including degeneration of endothelium-derived nitric oxide by reactive oxygen species, the impact of oxygen-free radicals on tissues and alterations of autonomic nervous system function. Recently, new devices for the detailed non-invasive assessment of large and small arteries have been developed. Therefore, the aim of our study was to assess heart rate variability (HRV) as a potential indicator of autonomic balance and its relation to blood pressure and vascular properties during medical air (MAB) and 100% oxygen breathing (OXB) in healthy volunteers. In 12 healthy subjects we assessed heart rate and blood pressure variability, baroreflex sensitivity, respiratory frequency, common carotid artery diameter and its wall distensibility, as well as changes in the digital artery pulse waveform, stroke index and systemic vascular resistance during MAB and OXB. Mean and systolic blood pressure have increased significantly while digital pulse amplitude and carotid artery diameter were significantly lower during hyperoxia. Heart rate variability measures did not differ during MAB and OXB. However, the correlations between spectral HRV components and those hemodynamic parameters which have changed due to hyperoxia varied substantially during MAB (correlated significantly) and OXB (no significant correlations were noted). Our findings suggest that autonomic nervous system might not be the main mediator of the cardiovascular changes during 100% oxygen breathing in healthy subjects. It seems that the direct vascular responses are initial consequences of hyperoxia and other cardiovascular parameter alterations are secondary to them. Copyright © 2013 Elsevier B.V. All rights reserved.

  20. The relationship between dietary salt intake and ambulatory blood pressure variability in non-diabetic hypertensive patients.

    PubMed

    Ozkayar, Nihal; Dede, Fatih; Ates, Ihsan; Akyel, Fatma; Yildirim, Tolga; Altun, Bulent

    High dietary salt intake was reported to increase blood pressure by numerous studies, but no study has investigated the effect of dietary salt intake on blood pressure variability (BPV). This study aimed to determine if daily salt intake is related to ambulatory BPV. The study included 136 primary hypertensive patients (92 male, 44 female) with a mean age of 50.7±11.1 years. All the patients underwent 24-h ambulatory blood pressure monitoring to determine both the 24-h systolic and 24-h diastolic BPV. 24-h urine sodium was measured. The correlation between BPV and 24-h urinary sodium was investigated. Logarithmic transformation of 24-h urinary sodium [log(24-h urinary sodium)] was positively correlated with the mean 24-h systolic ARV, and nighttime systolic ARV (r=0.371 and p=0.001, r=0.329 and p=0.028, respectively). Similarly, log(24-h urinary sodium) was positively correlated with mean 24-h diastolic ARV and nighttime diastolic ARV (r=0.381 and p=0.001, r=0.320 and p=0.020 respectively). Log(24-h urinary sodium) was an independent predictor of BPV based on multivariate regression analysis. Dietary salt intake might play a role in the pathogenesis of ambulatory BPV. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  1. Comparisons of Measured and Self-Reported Anthropometric Variables and Blood Pressure in a Sample of Hong Kong Female Nurses

    PubMed Central

    Xie, Yao Jie; Ho, Suzanne C.; Liu, Zhao Min; Hui, Stanley Sai-Chuen

    2014-01-01

    Objectives To assess the validity of self-reported weight, height, body mass index (BMI), waist circumference and blood pressure compared with standardized clinical measurements and to determine the classification accuracy in overweight/obesity and central adiposity. Methods This pilot study was integrated into a life-course study entitled “Hong Kong Women's Health Study” among 1,253 female nurses in Hong Kong who were aged 35 years to 65 years. Data were collected from self-administered questionnaires that were mailed to the respondents. Of these participants, we obtained the standard body measurements of 144 (11.5%) at our research center. We then compared the self-reported anthropometric variables and blood pressure with the measured data to assess validity based on the level of misreporting, percentage of agreement, consistency, sensitivity and specificity. Results The self-reported and measured values were highly correlated in terms of anthropometry and blood pressure (correlation coefficients ranged from 0.72 to 0.96). Height was overestimated at an average of 0.42 cm, and waist circumference was underestimated at 2.33 cm (both P<0.05), while no significant differences were observed from weight, blood pressure and BMI (all P>0.05). The proportions of overweight, obesity, and central adiposity by self-reported data did not vary greatly from the measured data (all P>0.05). The self-reporting resulted in correct classifications of BMI, waist circumference, and systolic blood pressure in 85%, 78%, and 87% of women, with corresponding Kappa index values of 0.79, 0.55, and 0.82, respectively. Sensitivity and specificity were 84.6% and 95.7%, respectively, with respect to overweight/obesity detection, whereas those for central adiposity detection were 70.6% and 83.8%, respectively. Conclusion In a sample of female Hong Kong nurses, the self-reported measures of height, weight, BMI, waist circumference and blood pressure were generally valid. Furthermore, the

  2. High blood pressure variability predicts 30-day mortality but not 1-year mortality in hospitalized elderly patients.

    PubMed

    Weiss, Avraham; Rudman, Yaron; Beloosesky, Yichayaou; Akirov, Amit; Shochat, Tzippy; Grossman, Alon

    2017-10-01

    The association of blood pressure (BP) variability (BPV) in hospitalized patients, which represents day-to-day variability, with mortality has been extensively reported in patients with stroke, but poorly defined for other medical conditions. To assess the association of day-to-day blood pressure variability in hospitalized patients, 10 BP measurements were obtained in individuals ≥75 years old hospitalized in a geriatric ward. Day-to-day BPV, measured 3 times a day, was calculated in each patient as the coefficient of variation of systolic BP. Patients were stratified by quartiles of coefficient of variation of systolic BP, and 30-day and 1-year mortality data were compared between those in the highest versus the lowest (reference) group. Overall, 469 patients were included in the final analysis. Mean coefficient of variation of systolic BP was 12.1%. 30-day mortality and 1-year mortality occurred in 29/469 (6.2%) and 95/469 (20.2%) individuals respectively. Patients in the highest quartile of BPV were at a significantly higher risk for 30-day mortality (HR =4.12, CI 1.12-15.10) but not for 1-year mortality compared with the lowest BPV quartile (HR =1.61, CI 0.81-3.23). Day-to-day BPV is associated with 30-day, but not with 1-year mortality in hospitalized elderly patients.

  3. The Relationship between the 24 h Blood Pressure Variability and Carotid Intima-Media Thickness: A Compared Study

    PubMed Central

    Xiong, Huahua; Tian, Xiaohong; Lin, Wan-Hua; Li, Chunyue; Zhang, Heye; Zhang, Yuan-Ting

    2014-01-01

    Large blood pressure variability (BPV) will not only harm the target organ but also increase the possibility of the cardiovascular events. Since the damage of vascular system always leads to the alteration of the carotid wall, the structure and function of the carotid artery have been extensively examined in previous studies. In this work we conduct a study (60 subjects, aged 33–79) to evaluate the relationship between BPV and carotid intima-media thickness (IMT) in Shenzhen, which is one large city in the southern area of China. In our study, the blood pressure (BP) was collected using the 24 h ambulatory BP monitoring, and the BPV was evaluated using standard deviation (SD), coefficient of variation (CV), and average real variability (ARV) during 24 h, daytime and nighttime. All the IMT measurements are collected by ultrasound. The results show that both the daytime, and 24 h systolic BPV evaluated by three indices are positively associated with IMT. Among them, daytime systolic BPV evaluated with ARV is the best variable to represent the increasing of carotid IMT. In addition, after adjusting by age, sex, smoking, hypertension, and mean BP and PP values, 24 h diastolic BPV evaluated with SD also presents the favorable performance. PMID:24660021

  4. [Estimating cardiovascular age of civil flying personnel by means of heart rate and blood pressure variability analysis].

    PubMed

    Niu, Y G; Zhang, L F; Zhang, Y H; Wang, S Y; Xu, X Y; Su, J X; Yan, Y B

    2001-06-01

    Objective. To estimate the cardiovascular age of civil flying personnel by means of heart rate and blood pressure variability analysis and to evaluate its significance in aviation medicine. Method. First, heart rate variability (HRV), blood pressure variability (BPV) and spontaneous baroreflex sensitivity (BRS) were analyzed among 89 healthy civil flying personnel by using conventional AR spectral analysis and sequence method respectively. Then, principal component analysis was conducted over original and derived variables of HRV and BPV spectral and BRS data. Finally, by the use of multiple regression in which the chronological age acted as the dependent variable and the components significantly related to age were used as the regressors, the equation for estimating the cardiovascular age was established. Result. Only seven principal components can exactly reflect the same information of autonomic regulatory function which was embodied in the 17 variables of HRV and BPV spectral and BRS parameters. Among the seven principal components, the PC2orig, PC4orig and PC2deri were negatively correlated with chronological age (P<0.05), whereas the PC3orig was positively correlated with the chronological age (P<0.01). The cardiovascular age derived from the equation was significantly correlated with the chronological age of the civil flying personnel (r= 0.73, P<0.01). Conclusion. The cardiovascular age estimated by means of a multi-variate analysis of HRV, BPV and BRS can be treated as a comprehensive indicator reflecting the age dependency of autonomic regulatory function of cardiovascular system in healthy civil flying personnel, and its interpretation and significance in application are surely worthy of further and fully dedicated efforts.

  5. Low Blood Pressure (Hypotension)

    MedlinePlus

    ... and fatigue. Fever, vomiting, severe diarrhea, overuse of diuretics and strenuous exercise can lead to dehydration. Blood ... can cause low blood pressure, including: Water pills (diuretics), such as furosemide (Lasix) and hydrochlorothiazide (Maxzide, Microzide, ...

  6. Evaluation of IVAC Variable Pressure Volumetric Pump Model 560 for the delivery of red blood cells, adenine-saline added.

    PubMed

    Gurdak, R G; Anderson, G; Mintz, P D

    1989-02-01

    Mechanical pump systems for the delivery of intravenous solutions have been used for the transfusion of red blood cells. In this study, the IVAC Variable Pressure Volumetric Pump Model 560 was evaluated for that purpose using flow rates of 70 mL/hour and 999 mL/hour through 16-, 19-, and 23-gauge needles and an 18-gauge angiocatheter. The largest degree of hemolysis induced by the delivery system resulted in a mean increase of plasma hemoglobin of 150 mg/L (15 mg/dL); this is equivalent to the loss of 0.03% of the red blood cells. When programmed to deliver 15 mL of red blood cells, the IVAC 560 delivered 15.0 +/- 0.3 mL at a rate of 70 mL/hour and 14.9 +/- 0.3 mL at 999 mL/hour. The authors conclude that the IVAC 560 can be used to deliver red blood cells with a minimal, acceptable level of hemolysis. It also delivers an accurate and precise volume of red blood cells that may be an aid to the transfusionist.

  7. Impact of perioperative blood pressure variability on health resource utilization after cardiac surgery: an analysis of the ECLIPSE trials.

    PubMed

    Aronson, Solomon; Levy, Jerrold H; Lumb, Philip D; Fontes, Manuel; Wang, Yamei; Crothers, Tracy A; Sulham, Katherine A; Navetta, Marco S

    2014-06-01

    To examine the impact of blood pressure control on hospital health resource utilization using data from the ECLIPSE trials. Post-hoc analysis of data from 3 prospective, open-label, randomized clinical trials (ECLIPSE trials). Sixty-one medical centers in the United States. Patients 18 years or older undergoing cardiac surgery. Clevidipine was compared with nitroglycerin, sodium nitroprusside, and nicardipine. The ECLIPSE trials included 3 individual randomized open-label studies comparing clevidipine to nitroglycerin, sodium nitroprusside, and nicardipine. Blood pressure control was assessed as the integral of the cumulative area under the curve (AUC) outside specified systolic blood pressure ranges, such that lower AUC represents less variability. This analysis examined surgery duration, time to extubation, as well as intensive care unit (ICU) and hospital length of stay (LOS) in patients with AUC≤10 mmHg×min/h compared to patients with AUC>10 mmHg×min/h. One thousand four hundred ten patients were included for analysis; 736 patients (52%) had an AUC≤10 mmHg×min/h, and 674 (48%) had an AUC>10 mmHg×min/h. The duration of surgery and ICU LOS were similar between groups. Time to extubation and postoperative LOS were both significantly shorter (p = 0.05 and p<0.0001, respectively) in patients with AUC≤10. Multivariate analysis demonstrates AUC≤10 was significantly and independently associated with decreased time to extubation (hazard ratio 1.132, p = 0.0261) and postoperative LOS (hazard ratio 1.221, p = 0.0006). Based on data derived from the ECLIPSE studies, increased perioperative BP variability is associated with delayed time to extubation and increased postoperative LOS. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Chaos in blood pressure control.

    PubMed

    Wagner, C D; Nafz, B; Persson, P B

    1996-03-01

    A number of control mechanisms are comprised within blood pressure regulation, ranging from events on the cellular level up to circulating hormones. Despite their vast number, blood pressure fluctuations occur preferably within a certain range (under physiological conditions). A specific class of dynamic systems has been extensively studied over the past several years: nonlinear coupled systems, which often reveal a characteristic form of motion termed "chaos". The system is restricted to a certain range in phase space, but the motion is never periodic. The attractor the system moves on has a non-integer dimension. What all chaotic systems have in common is their sensitive dependence on initial conditions. The question arises as to whether blood pressure regulation can be explained by such models. Many efforts have been made to characterise heart rate variability and EEG dynamics by parameters of chaos theory (e.g., fractal dimensions and Lyapunov exponents). These method were successfully applied to dynamics observed in single organs, but very few studies have dealt with blood pressure dynamics. This mini-review first gives an overview on the history of blood pressure dynamics and the methods suitable to characterise the dynamics by means of tools derived from the field of nonlinear dynamics. Then applications to systemic blood pressure are discussed. After a short survey on heart rate variability, which is indirectly reflected in blood pressure variability, some dynamic aspects of resistance vessels are given. Intriguingly, systemic blood pressure reveals a change in fractal dimensions and Lyapunov exponents, when the major short-term control mechanism--the arterial baroreflex--is disrupted. Indeed it seems that cardiovascular time series can be described by tools from nonlinear dynamics [66]. These methods allow a novel description of some important aspects of biological systems. Both the linear and the nonlinear tools complement each other and can be useful in

  9. Blood Pressure and Physical Function

    PubMed Central

    Forbang, Nketi; Ix, Joachim; Criqui, Michael; Rifkin, Dena

    2014-01-01

    Background: Hypertension in older adults is a dynamic process, with significant diurnal fluctuation. Little research has been done on the associations between increased short-term blood pressure variability and blunted night-time dipping in respect to decreased physical function in the elderly. Our aim is to use a cross-sectional analysis to illuminate any associations. Methods: A cross-sectional sub-study (mean age: 72, 67.5% female) was performed on selected participants from the San Diego Population Study (Criqui, et al, 2003). Blood pressure was measured both in the office (3 independent blood pressure readings) and using a 24-hour ambulatory blood pressure monitoring cuff. Blood pressure variability was measured using average real variability (ARV). Physical function was measured using the Short Physical Performance Battery (SPPB) test. Statistical analysis was performed on IBM SPSS Statistics (1911) software. Results: An unadjusted univariate analysis adjusted for age and gender showed associations between 24-hr ARV of SBP (P = .001), 24-hr ARV pulse pressure (P < .001), and percent systolic dipping (P = .011) and SPPB score. After multivariate analysis adjusted for age and gender was performed, the results were substantially attenuated. However, the association of ARV of SBP was not significant with a P-value of .052 and the ARV of pulse pressure remained significant with a P-value of .022. Multivariate hierarchical linear regression models revealed insignificant trends. Conclusions: Increased short-term variability and blunted night-time dipping were associated physical function but were not independent of age and body mass index (BMI). Further research can be done as to the biology of how both age and BMI influence blood pressure patterns. The trends observed in this study may warrant the investigation of abnormal blood pressure patterns in those who are either elderly or have increased BMI.

  10. Low birth weight is associated with higher blood pressure variability from childhood to young adulthood: the Bogalusa Heart Study.

    PubMed

    Chen, Wei; Srinivasan, Sathanur R; Yao, Lu; Li, Shengxu; Dasmahapatra, Pronabesh; Fernandez, Camilo; Xu, Jihua; Berenson, Gerald S

    2012-10-01

    The association between birth weight and long-term within-individual variability of blood pressure (BP) was examined in a longitudinal cohort of 1,454 adults (939 whites and 515 blacks; adulthood age = 19-50 years) enrolled in the Bogalusa Heart Study in Bogalusa, Louisiana, in 1973-2010. BP variability was depicted as standard deviation, coefficient of variation, and deviation from age-predicted values using 6-15 serial BP measurements from childhood to adulthood over an average of 25.7 years. Birth weight was significantly and negatively associated with adulthood BP levels, long-term BP levels, and rate of change. Importantly, low birth weight was significantly associated with increased BP variability in terms of standard deviation, coefficient of variation, and deviation. As evaluated using the regression coefficients, a 1-kg lower birth weight was associated with increases in systolic BP variability measures (-0.38 mm Hg, P = 0.04 for standard deviation; -0.004 mm Hg, P = 0.01 for coefficient of variation; and -0.16 mm Hg, P = 0.04 for deviation) after adjustment for race, age, sex, mean BP levels, and gestational age; similar trends in the associations were noted for diastolic BP variability measures. In conclusion, these findings suggest that birth weight affects not only BP levels but also the magnitude of within-individual BP fluctuations over time through fetal programming in BP regulation mechanisms.

  11. Olmesartan with azelnidipine versus with trichlormethiazide on home blood pressure variability in patients with type II diabetes mellitus.

    PubMed

    Ushigome, Emi; Matsumoto, Shinobu; Oyabu, Chikako; Ushigome, Hidetaka; Yokota, Isao; Hasegawa, Goji; Nakamura, Naoto; Tanaka, Muhei; Yamazaki, Masahiro; Fukui, Michiaki

    2017-03-01

    The aim of the present study was to compare the effects of olmesartan combined with azelnidipine versus olmesartan combined with trichlormethiazide, on home blood pressure (BP) and pressure variability in type II diabetes mellitus patients using home BP telemonitoring system. We performed an open-label cross-over pilot study of 28 patients with type II diabetes mellitus. Patients received combination treatment with either olmesartan 20 mg plus azelnidipine 16 mg or olmesartan 20 mg plus trichlormethiazide 1 mg for more than 6 weeks each in a cross-over method. The coefficient of morning systolic BP variability in the olmesartan plus azelnidipine group was significantly lower than that in the olmesartan plus trichlormethiazide group (6.4 ± 1.9 vs. 7.5 ± 2.6, P = .004). There were no significant differences in mean morning systolic BP between the two groups. Using home BP telemonitoring for hypertensive patients with type II diabetes, this study revealed for the first time that the olmesartan with azelnidipine combination is superior to the olmesartan with trichlormethiazide combination in reducing home BP variability. Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  12. Day-by-Day Blood Pressure Variability and Functional Outcome After Acute Ischemic Stroke: Fukuoka Stroke Registry.

    PubMed

    Fukuda, Kenji; Kai, Hisashi; Kamouchi, Masahiro; Hata, Jun; Ago, Tetsuro; Nakane, Hiroshi; Imaizumi, Tsutomu; Kitazono, Takanari

    2015-07-01

    The relationship between blood pressure (BP) variability and functional outcome in patients with acute ischemic stroke remains unclear. This study aimed to elucidate whether in-hospital day-by-day BP variability is associated with functional outcome after acute ischemic stroke. Using the Fukuoka Stroke Registry, we included 2566 patients with a first-ever ischemic stroke who had been functionally independent before the onset and were hospitalized within 24 hours. BP was measured daily, and its variability was assessed by SD, coefficients of variance, and variations independent of mean. Poor functional outcome was assessed by modified Rankin Scale scores ≥3 at 3 months. After adjustment for multiple confounding factors including age, sex, risk factors, stroke features, baseline severity, thrombolytic therapy, antihypertensive agents, and mean BP, day-by-day BP variability during the subacute stage (4-10 days after onset) was independently associated with a poor functional outcome (multivariable-adjusted odds ratios [95% confidence interval] in the top versus bottom quartile of systolic BP variability, 1.51 [1.09-2.08] for SD; 1.63 [1.20-2.22] for coefficients of variance; 1.64 [1.21-2.24] for variations independent of mean). Similar trends were also observed for diastolic BP variability. These trends were unchanged in patients who were not treated with antihypertensive drugs. In contrast, no association was found between indices of BP variability during the acute stage and functional outcome after adjusting for potential confounders. These data suggest that intraindividual day-by-day BP variability during the subacute stage is associated with the 3-month functional outcome after acute ischemic stroke. © 2015 American Heart Association, Inc.

  13. Blood Pressure Control

    NASA Technical Reports Server (NTRS)

    1986-01-01

    Engineering Development Laboratory developed a system for the cardiovascular study of weightless astronauts. This was designed to aid people with congestive heart failure and diabetes. While in space, astronauts' blood pressure rises, heart rate becomes unstable, and there are sometimes postflight lightheadedness or blackouts. The Baro-Cuff studies the resetting of blood pressure. When a silicone rubber chamber is strapped to the neck, the Baro-Cuff stimulates the carotid arteries by electronically controlled pressure application. Blood pressure controls in patients may be studied.

  14. THE EFFECT OF HORMONE THERAPY ON MEAN BLOOD PRESSURE AND VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY IN POSTMENOPAUSAL WOMEN: RESULTS FROM THE WOMEN’S HEALTH INITIATIVE RANDOMIZED CONTROLLED TRIALS

    PubMed Central

    Shimbo, Daichi; Wang, Lu; Lamonte, Michael J.; Allison, Matthew; Wellenius, Gregory A.; Bavry, Anthony A.; Martin, Lisa W.; Aragaki, Aaron; Newman, Jonathan D.; Swica, Yael; Rossouw, Jacques E.; Manson, JoAnn E.; Wassertheil-Smoller, Sylvia

    2014-01-01

    Objectives Mean and visit-to-visit variability (VVV) of blood pressure are associated with an increased cardiovascular disease risk. We examined the effect of hormone therapy on mean and VVV of blood pressure in postmenopausal women from the Women’s Health Initiative (WHI) randomized controlled trials. Methods Blood pressure was measured at baseline and annually in the two WHI hormone therapy trials in which 10,739 and 16,608 postmenopausal women were randomized to conjugated equine estrogens (CEE, 0.625 mg/day) or placebo, and CEE plus medroxyprogesterone acetate (MPA, 2.5 mg/day) or placebo, respectively. Results At the first annual visit (Year 1), mean systolic blood pressure was 1.04 mmHg (95% CI 0.58, 1.50) and 1.35 mmHg (95% CI 0.99, 1.72) higher in the CEE and CEE+MPA arms respectively compared to corresponding placebos. These effects remained stable after Year 1. CEE also increased VVV of systolic blood pressure (ratio of VVV in CEE vs. placebo, 1.03, P<0.001), whereas CEE+MPA did not (ratio of VVV in CEE+MPA vs. placebo, 1.01, P=0.20). After accounting for study drug adherence, the effects of CEE and CEE+MPA on mean systolic blood pressure increased at Year 1, and the differences in the CEE and CEE+MPA arms vs. placebos also continued to increase after Year 1. Further, both CEE and CEE+MPA significantly increased VVV of systolic blood pressure (ratio of VVV in CEE vs. placebo, 1.04, P<0.001; ratio of VVV in CEE+MPA vs. placebo, 1.05, P<0.001). Conclusions Among postmenopausal women, CEE and CEE+MPA at conventional doses increased mean and VVV of systolic blood pressure. PMID:24991872

  15. Pulse oximetry-derived pleth variability index can predict dexmedetomidine-induced changes in blood pressure in spontaneously breathing patients.

    PubMed

    Sato, Makoto; Kunisawa, Takayuki; Kurosawa, Atsushi; Sasakawa, Tomoki

    2016-11-01

    Hypertension or hypotension in patients receiving continuous infusions of dexmedetomidine (DEX) is often due to changes in vascular resistance caused by α2 receptor stimulation. We investigated whether baseline perfusion index (PI) and pleth variability index (PVI), derived from pulse oximetry readings, could predict DEX-induced changes in the hemodynamic status in spontaneously breathing patients. Observational study. Operating room. Patients (American Society of Anesthesiologists performance status 1 or 2) scheduled to undergo lower extremity or abdominal procedures under regional anesthesia were approached. The PI and PVI were set as baseline upon arrival in theater and were then measured at 2.5-minute intervals. Upon attaining stable hemodynamic status under spontaneous breathing, intravenous administration of DEX was initiated at 6 μg kg(-1) h(-1) for 10minutes, followed by continuous infusion at 0.6 μg kg(-1) h(-1). Blood pressure, heart rate, PI, and PVI were measured. Hypertension was defined as an increase in systolic blood pressure (SBP) >15% and hypotension as a decrease in SBP <15% from baseline. Baseline PI and PVI correlated with the degree of change in SBP. The maximum percentage increase as well as the maximum percentage of decrease in SBP from baseline correlated with baseline PI (r=0.418 [P=.005] and r=0.507 [P<.001], respectively) and PVI (r=-0.658 [P<.001] and r=-0.438 [P=.003], respectively). PVI <15 identified DEX-induced hypertension (sensitivity 94%, specificity 85%) and PVI >16 identified DEX-induced hypotension (sensitivity 83%, specificity 64%). PVI may predict DEX-induced changes in blood pressure in spontaneously breathing patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Cardiovascular risk factor and familial aggregation of blood pressure with respect to anthropometric variables in a scheduled caste population in Punjab, a North Indian state.

    PubMed

    Badaruddoza; Kumar, Raman

    2009-06-01

    Based on anthropometric data, this study aims to detect cardiovascular risk factor and familial aggregation of blood pressure in a specific community in India. A total of 1096 adult individuals, constituting 350 families in a scheduled caste community in Punjab, India, was surveyed for blood pressure, pulse rate, pulse pressure and fifteen anthropometric measurements. Estimates of correlation among blood pressure phenotypes with other significant variables and stepwise multiple regression analysis have been carried out for both offspring and parent generations. The hypothesis for common household effects was examined by likelihood ratio tests. Almost all anthropometric variables were found to be significant with blood pressure between both generations. The percent of variance for the regression (R2) was found to be higher for the offspring generation than for the parent one. The results suggest that despite of genetic effects, common household environment for many anthropometric measurements is a significant determinant of blood pressure. The data indicate a strong familial aggregation of blood pressure and anthropometric measurements should be a useful tool for screening cardiovascular risk factor with elevated blood pressure.

  17. Aortic stiffness and blood pressure variability in young people: a multimodality investigation of central and peripheral vasculature

    PubMed Central

    Boardman, Henry; Lewandowski, Adam J.; Lazdam, Merzaka; Kenworthy, Yvonne; Whitworth, Polly; Zwager, Charlotte L.; Francis, Jane M.; Aye, Christina Y.L.; Williamson, Wilby; Neubauer, Stefan; Leeson, Paul

    2017-01-01

    Introduction: Increased blood pressure (BP) variability is a cardiovascular risk marker for young individuals and may relate to the ability of their aorta to buffer cardiac output. We used a multimodality approach to determine relations between central and peripheral arterial stiffness and BP variability. Methods: We studied 152 adults (mean age of 31 years) who had BP variability measures based on SD of awake ambulatory BPs, 24-h weighted SD and average real variability (ARV). Global and regional aortic distensibility was measured by cardiovascular magnetic resonance, arterial stiffness by cardio-ankle vascular index (CAVI) and pulse wave velocity (PWV) by SphygmoCor (carotid–femoral) and Vicorder (brachial–femoral). Results: In young people, free from overt cardiovascular disease, all indices of SBP and DBP variability correlated with aortic distensibility (global aortic distensibility versus awake SBP SD: r = −0.39, P < 0.001; SBP ARV: r = −0.34, P < 0.001; weighted 24-h SBP SD: r = −0.42, P < 0.001). CAVI, which closely associated with aortic distensibility, also related to DBP variability, as well as awake SBP SD (r = 0.19, P < 0.05) and weighted 24-h SBP SD (r = 0.24, P < 0.01), with a trend for SBP ARV (r = 0.17, P = 0.06). In contrast, associations with PWV were only between carotid–femoral PWV and weighted SD of SBP (r = 0.20, P = 0.03) as well as weighted and ARV of DBP. Conclusion: Greater BP variability in young people relates to increases in central aortic stiffness, strategies to measure and protect aortic function from a young age may be important to reduce cardiovascular risk. PMID:27846043

  18. Association Between Long-Term Blood Pressure Variability and 10-Year Progression in Arterial Stiffness: The Multiethnic Study of Atherosclerosis.

    PubMed

    Tedla, Yacob G; Yano, Yuichiro; Carnethon, Mercedes; Greenland, Philip

    2017-01-01

    Experimental studies conducted on animal and human endothelium suggested that higher systolic blood pressure (SBP) variability reduces bioavailability of nitric oxide and increases vascular smooth muscle cell proliferation. These vascular wall changes could stiffen the arterial wall. Using data from the Multiethnic Study of Atherosclerosis, we investigated the association between long-term SBP variability and 10-year percent change in arterial stiffness among 1122 individuals (mean age 57 years, 46% males at baseline) who were not taking antihypertensive medications. Within-individual standard deviation, variability independent of the mean, and coefficient of variation of SBP across 5 visits were used to capture long-term SBP variability. Carotid arterial stiffness was measured using distensibility coefficient and Young's elastic modulus at baseline and after a mean of 9.5 years of follow-up (visit 5). In a multivariate linear regression model, individuals in the fifth quintile as compared with those in the first quintile of standard deviation, variability independent of the mean, and coefficient of variation of SBP had a 9.8% (95% confidence interval [CI] -17.0%, -2.7%), 6.4% (95% CI -13.2%, 0.4%), and 8.7% (95% CI -15.4%, -1.9%) higher decline in distensibility coefficient and a 27.5% (95% CI 15.8%, 39.3%), 25.8% (95% CI 14.7%, 36.9%), and 27.9% (95% CI 16.8%, 39.1%) higher progression in Young's elastic modulus, respectively, after 10 years of follow-up. Linear trends in the decline of distensibility coefficient and progression of Young's elastic modulus were observed across the quintiles of SBP variability indices. These findings suggest that higher long-term SBP variability may be a risk factor for arterial stiffness progression independent of mean BP. © 2016 American Heart Association, Inc.

  19. Association Between Short-Term Systolic Blood Pressure Variability and Carotid Intima-Media Thickness in ELSA-Brasil Baseline.

    PubMed

    Ribeiro, Adèle H; Lotufo, Paulo A; Fujita, André; Goulart, Alessandra C; Chor, Dora; Mill, José G; Bensenor, Isabela M; Santos, Itamar S

    2017-10-01

    Blood pressure (BP) is associated with carotid intima-media thickness (CIMT), but few studies have explored the association between BP variability and CIMT. We aimed to investigate this association in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline. We analyzed data from 7,215 participants (56.0% women) without overt cardiovascular disease (CVD) or antihypertensive use. We included 10 BP readings in varying positions during a 6-hour visit. We defined BP variability as the SD of these readings. We performed a 2-step analysis. We first linearly regressed the CIMT values on main and all-order interaction effects of the variables age, sex, body mass index, race, diabetes diagnosis, dyslipidemia diagnosis, family history of premature CVD, smoking status, and ELSA-Brasil site, and calculated the residuals (residual CIMT). We used partial least square path analysis to investigate whether residual CIMT was associated with BP central tendency and BP variability. Systolic BP (SBP) variability was significantly associated with residual CIMT in models including the entire sample (path coefficient [PC]: 0.046; P < 0.001), and in women (PC: 0.046; P = 0.007) but not in men (PC: 0.037; P = 0.09). This loss of significance was probably due to the smaller subsample size, as PCs were not significantly different according to sex. We found a small but significant association between SBP variability and CIMT values. This was additive to the association between SBP central tendency and CIMT values, supporting a role for high short-term SBP variability in atherosclerosis.

  20. Blood Pressure Checker

    NASA Technical Reports Server (NTRS)

    1979-01-01

    An estimated 30 million people in the United States have high blood pressure, or hypertension. But a great many of them are unaware of it because hypertension, in its initial stages, displays no symptoms. Thus, the simply-operated blood pressure checking devices now widely located in public places are useful health aids. The one pictured above, called -Medimax 30, is a direct spinoff from NASA technology developed to monitor astronauts in space. For manned space flights, NASA wanted a compact, highly-reliable, extremely accurate method of checking astronauts' blood pressure without the need for a physician's interpretive skill. NASA's Johnson Space Center and Technology, Inc., a contractor, developed an electronic sound processor that automatically analyzes blood flow sounds to get both systolic (contracting arteries) and diastolic (expanding arteries) blood pressure measurements. NASA granted a patent license for this technology to Advanced Life Sciences, Inc., New York City, manufacturers of Medimax 30.

  1. Influence of number of sets on blood pressure and heart rate variability after a strength training session.

    PubMed

    Figueiredo, Tiago; Rhea, Matthew R; Peterson, Mark; Miranda, Humberto; Bentes, Claudio M; dos Reis, Victor Machado de Ribeiro; Simão, Roberto

    2015-06-01

    The purpose of this study was to compare the acute effects of 1, 3, and 5 sets of strength training (ST), on heart rate variability (HRV) and blood pressure. Eleven male volunteers (age: 26.1 ± 3.6 years; body mass: 74.1 ± 8.1 kg; height: 172 ± 4 cm) with at least 6 months previous experience in ST participated in the study. After determining the 1 repetition maximum (1RM) load for the bench press (BP), lat pull down (LPD), shoulder press (SP), biceps curl (BC), triceps extension (TE), leg press (LP), leg extension (LE), and leg curl (LC), the participants performed 3 different exercise sequences in a random order and 72 hours apart. During the first sequence, subjects performed a single set of 8-10 repetitions, at 70% 1RM, and with 2-minute rest interval between exercises. Exercises were performed in the following order: BP, LPD, SP, BC, TE, LP, LE, and LC. During the second sequence, subjects performed the same exercise sequence, with the same intensity, 2-minute rest interval between sets and exercises, but with 3 consecutive sets of each exercise. During the third sequence, the same protocol was followed but with 5 sets of each exercise. Before and after the training sessions, blood pressure and HRV were measured. The statistical analysis demonstrated a greater duration of postexercise hypotension after the 5-set program vs. the 1 set or 3 sets (p ≤ 0.05). However, the 5-set program promoted a substantial cardiac stress, as demonstrated by HRV (p ≤ 0.05). These results indicate that 5 sets of 8-10 repetitions at 70% 1RM load may provide the ideal stimulus for a postexercise hypotensive response. Therefore, ST composed of upper- and lower-body exercises and performed with high volumes are capable of producing significant and extended postexercise hypotensive response. In conclusion, strength and conditioning professionals can prescribe 5 sets per exercises if the goal is to reduce blood pressure after training. In addition, these findings may have

  2. Influence of polyunsaturated fatty acids on blood pressure, resting heart rate and heart rate variability among French Polynesians.

    PubMed

    Valera, Beatriz; Suhas, Edouard; Counil, Emilie; Poirier, Paul; Dewailly, Eric

    2014-01-01

    To analyze the associations between marine n-3 polyunsaturated fatty acids (PUFAs) and blood pressure (BP), resting heart rate (HR), and heart rate variability (HRV) in a population highly exposed to methylmercury through the diet. Concentrations of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) in erythrocytes membranes were measured in 180 French Polynesian adults (≥18 years) residing in Tubuai, which is a community with a traditional lifestyle, or Papeete, which has a modern lifestyle. HRV was measured using a 2-hour ambulatory electrocardiogram (Holter). Resting HR and BP were measured using standardized protocols and pulse pressure (PP) was calculated as systolic BP - diastolic BP. The associations between n-3 PUFAs and the dependent variables were studied using simple and multiple linear regressions. Increasing DHA concentration was associated with lower resting HR (β = -2.57, p = 0.005) and diastolic BP (β = -1.96, p = 0.05) and higher HRV in multivariable models. Specifically, DHA was associated with high frequency (HF; β = 0.19, p = 0.02) and the square root of the mean squared differences of successive R-R intervals (difference between two consecutive R waves; rMSSD; β = 0.08, p = 0.03), which are specific indices of the parasympathetic activity of the autonomic nervous system. DHA was associated with lower BP and resting HR and higher HRV among French Polynesians who are also exposed to high methylmercury levels.

  3. [Measuring blood pressure].

    PubMed

    Estrada Reventos, Dolors; Pujol Navarro, Ester

    2008-09-01

    High blood pressure is one of the main factors which lead to cardiovascular cerebral-vascular and kidney diseases; therefore, nursing professionals should have enough basic knowledge to enable them to carry out a precocious diagnosis and correct follow-up procedures. Although students in nursing schools are taught how to correctly measure blood pressure, often this teaching does not meet the recommendations provided by different national and international guidelines. Thus it is important to know how to use the correct methodology to measure blood pressure.

  4. Short-Term Blood Pressure Variability Relates to the Presence of Subclinical Brain Small Vessel Disease in Primary Hypertension.

    PubMed

    Filomena, Josefina; Riba-Llena, Iolanda; Vinyoles, Ernest; Tovar, José L; Mundet, Xavier; Castañé, Xavier; Vilar, Andrea; López-Rueda, Antonio; Jiménez-Baladó, Joan; Cartanyà, Anna; Montaner, Joan; Delgado, Pilar

    2015-09-01

    Blood pressure (BP) variability is associated with stroke risk, but less is known about subclinical cerebral small vessel disease (CSVD). We aimed to determine whether CSVD relates to short-term BP variability independently of BP levels and also, whether they improve CSVD discrimination beyond clinical variables and office BP levels. This was a cohort study on asymptomatic hypertensives who underwent brain magnetic resonance imaging and 24-hour ambulatory BP monitoring. Office and average 24-hour, daytime and nighttime BP levels, and several metrics of BP variability (SD, weighted SD, coefficient of variation, and average real variability [ARV]) were calculated. Definition of CSVD was based on the presence of lacunar infarcts and white matter hyperintensity grades. Multivariate analysis and integrated discrimination improvement were performed to assess whether BP variability and levels were independently associated with CSVD and improved its discrimination. Four hundred eighty-seven individuals participated (median age, 64; 47% women). CSVD was identified in 18.9%, related to age, male sex, diabetes mellitus, use of treatment, ambulatory BP monitoring-defined BP levels, and ARV of systolic BP at any period. The highest prevalence (33.7%) was found in subjects with both 24-hour BP levels and ARV elevated. BP levels at any period and ARV (24 hours and nocturnal) emerged as independent predictors of CSVD, and discrimination was incrementally improved although not to a clinically significant extent (integrated discrimination improvement, 5.31%, 5.17% to 5.4%). Ambulatory BP monitoring-defined BP levels and ARV of systolic BP relate to subclinical CSVD in hypertensive individuals. © 2015 American Heart Association, Inc.

  5. Evaluation of heart rate and blood pressure variability as indicators of physiological compensation to hemorrhage before shock.

    PubMed

    Scully, Christopher G; Kramer, George C; Strauss, David G

    2015-05-01

    Individual responses to hemorrhage vary, with varying periods of compensation before the development of shock. We characterized heart rate and blood pressure variability measures during hemorrhage of 25 mL/kgBody Weight for 15 min in conscious sheep (N = 7, 14 total hemorrhages) as markers of the transition from compensated to decompensated shock using the continuous wavelet transform. Heart rate-low frequency (HR-LF) and systolic blood pressure-low frequency (SBP-LF) indices were developed to represent the change in spectral power during hemorrhage as low-frequency (0.06 - 0.15 Hz) power divided by the sum of high (0.15 - 1.0 Hz)- and very low (0.02 - 0.06 Hz) frequency power. Heart rate rose from 96.3 (22.2) beats/min (mean [SD] across all trials) to a peak of 176.0 (25.4) beats/min occurring at a minimum time of 5.3 min to a maximum of 22.1 min (11.7 [1.6] min), depending on the trial, after the start of hemorrhage. During the HR-compensated response to hemorrhage, there was elevated HR-LF and SBP-LF in five of the seven animals. In these animals, HR-LF and SBP-LF dropped to below baseline levels around the time of the peak HR. The results from this conscious-animal study suggest that HR and SBP low-frequency power rise during the compensation phase of the response to hemorrhage in conscious sheep. Use of variability monitoring could aid in describing an individual's current response to hemorrhage and anticipation of impending decompensation; however, individual differences in the response limit this potential.

  6. Effect of heavy exercise on spectral baroreflex sensitivity, heart rate, and blood pressure variability in well-trained humans.

    PubMed

    Cottin, François; Médigue, Claire; Papelier, Yves

    2008-09-01

    The aim of the study was to assess the instantaneous spectral components of heart rate variability (HRV) and systolic blood pressure variability (SBPV) and determine the low-frequency (LF) and high-frequency baroreflex sensitivity (HF-BRS) during a graded maximal exercise test. The first hypothesis was that the hyperpnea elicited by heavy exercise could entail a significant increase in HF-SBPV by mechanical effect once the first and second ventilatory thresholds (VTs) were exceeded. It was secondly hypothesized that vagal tone progressively withdrawing with increasing load, HF-BRS could decrease during the exercise test. Fifteen well-trained subjects participated in this study. Electrocardiogram (ECG), blood pressure, and gas exchanges were recorded during a cycloergometer test. Ventilatory equivalents were computed from gas exchange parameters to assess VTs. Spectral analysis was applied on cardiovascular series to compute RR and systolic blood pressure power spectral densities, cross-spectral coherence, gain, and alpha index of BRS. Three exercise intensity stages were compared: below (A1), between (A2), and above (A3) VTs. From A1 to A3, both HF-SBPV (A1: 45 +/- 6, A2: 65 +/- 10, and A3: 120 +/- 23 mm2Hg, P < 0.001) and HF-HRV increased (A1: 20 +/- 5, A2: 23 +/- 8, and A3:40 +/- 11 ms2, P < 0.02), maintaining HF-BRS (gain, A1: 0.68 +/- 0.12, A2: 0.63 +/- 0.08, and A3: 0.57 +/- 0.09; alpha index, A1: 0.58 +/- 0.08, A2: 0.48 +/- 0.06, and A3: 0.50 +/- 0.09 ms/mmHg, not significant). However, LF-BRS decreased (gain, A1: 0.39 +/- 0.06, A2: 0.17 +/- 0.02, and A3: 0.11 +/- 0.01, P < 0.001; alpha index, A1: 0.46 +/- 0.07, A2: 0.20 +/- 0.02, and A3: 0.14 +/- 0.01 ms/mmHg, P < 0.001). As expected, once VTs were exceeded, hyperpnea induced a marked increase in both HF-HRV and HF-SBPV. However, this concomitant increase allowed the maintenance of HF-BRS, presumably by a mechanoelectric feedback mechanism.

  7. Impact of Glycemic and Blood Pressure Variability on Surrogate Measures of Cardiovascular Outcomes in Type 2 Diabetic Patients

    PubMed Central

    Di Flaviani, Alessandra; Picconi, Fabiana; Di Stefano, Paola; Giordani, Ilaria; Malandrucco, Ilaria; Maggio, Paola; Palazzo, Paola; Sgreccia, Fabrizio; Peraldo, Carlo; Farina, Fabrizio; Frajese, Gaetano; Frontoni, Simona

    2011-01-01

    OBJECTIVE The effect of glycemic variability (GV) on cardiovascular risk has not been fully clarified in type 2 diabetes. We evaluated the effect of GV, blood pressure (BP), and oxidative stress on intima-media thickness (IMT), left ventricular mass index (LVMI), flow-mediated dilation (FMD), and sympathovagal balance (low frequency [LF]/high frequency [HF] ratio) in 26 type 2 diabetic patients (diabetes duration 4.41 ± 4.81 years; HbA1c 6.70 ± 1.25%) receiving diet and/or metformin treatment, with no hypotensive treatment or complications. RESEARCH DESIGN AND METHODS Continuous glucose monitoring (CGM) data were used to calculate mean amplitude of glycemic excursion (MAGE), continuous overall net glycemic action (CONGA)-2, mean blood glucose (MBG), mean postprandial glucose excursion (MPPGE), and incremental area under the curve (IAUC). Blood pressure (BP), circadian rhythm, and urinary 15-F2t-isoprostane (8-iso-prostaglandin F2α [PGF2α]) were also evaluated. Subjects were divided into dipper (D) and nondipper (ND) groups according to ΔBP. RESULTS IMT and LVMI were increased in ND versus D (0.77 ± 0.08 vs. 0.68 ± 0.13 [P = 0.04] and 67 ± 14 vs. 55 ± 11 [P = 0.03], respectively). MBG, MAGE, and IAUC were significantly associated with LF/HF ratio at night (r = 0.50, P = 0.01; r = 0.40, P = 0.04; r = 0.41, P = 0.04, respectively), MPPGE was negatively associated with FMD (r = −0.45, P = 0.02), and CONGA-2 was positively associated with LVMI (r = 0.55, P = 0.006). The Δsystolic BP was negatively associated with IMT (r = −0.43, P = 0.03) and with LVMI (r = −0.52, P = 0.01). Urinary 8-iso-PGF2α was positively associated with LVMI (r = 0.68 P < 0.001). CONCLUSIONS An impaired GV and BP variability is associated with endothelial and cardiovascular damage in short-term diabetic patients with optimal metabolic control. Oxidative stress is the only independent predictor of increased LV mass and correlates with glucose and BP variability. PMID:21610126

  8. High Blood Pressure

    MedlinePlus

    ... is at rest between beats Health care workers write blood pressure numbers with the systolic number above ... available to discuss recent findings and ongoing research projects about health conditions and social determinants that disproportionately ...

  9. High Blood Pressure (Hypertension)

    MedlinePlus

    ... Practice healthy coping techniques, such as muscle relaxation, deep breathing or meditation. Getting regular physical activity and ... blood pressure at home. Practice relaxation or slow, deep breathing. Practice taking deep, slow breaths to help ...

  10. High Blood Pressure (Hypertension)

    MedlinePlus

    ... can improve your health in other ways. Mastering stress management techniques can lead to other behavior changes — including those that reduce your blood pressure. When looking for ways to manage stress, remember that you have many options. For example: ...

  11. Visit-to-visit blood pressure variability, average BP level and carotid arterial stiffness in the elderly: a prospective study.

    PubMed

    Nagai, M; Dote, K; Kato, M; Sasaki, S; Oda, N; Kagawa, E; Nakano, Y; Yamane, A; Kubo, Y; Higashihara, T; Miyauchi, S; Harada, W; Masuda, H

    2016-10-20

    In a cross-sectional study, visit-to-visit blood pressure (BP) variability was shown to be associated with artery remodelling. Here, we investigated the impact of visit-to-visit BP variability and average BP on the carotid artery remodelling progression in high-risk elderly according to different classes of antihypertension medication use/non-use. BP measurements and carotid ultrasound were performed in the common carotid artery in 164 subjects (mean age 79.7 years at baseline, 74.7% females) with one or more cardiovascular risk factors. Based on 12 visits (1 × /month for 1 year), we calculated visit-to-visit BP variability expressed as the standard deviation (s.d.), coefficient of variation (CV), maximum BP, minimum BP and delta (maximum-minimum) BP. We measured mean intima-media thickness (IMT) as well as stiffness parameter β were measured at baseline and at the mean 4.2-year follow-up. In a multiple regression analysis, the maximum, minimum, s.d. and average of systolic BP (SBP) were significantly associated with a change in β-values between the baseline and follow-up after adjustment for age, smoking, lower high-density lipoprotein level, baseline β-value and follow-up period. There were no significant associations between the visit-to-visit BP variability measures and the change in mean IMT. Significant associations of maximum, minimum, s.d. and average SBP were found with increased β-values in the subjects without calcium channel blocker (CCB) use and in the subjects using renin-angiotensin system inhibitors (RASIs). Thus, exaggerated visit-to-visit SBP variability and a high average SBP level were significant predictors of progression in carotid arterial stiffness in high-risk elderly without CCBs use and in those using a RASI.Journal of Human Hypertension advance online publication, 20 October 2016; doi:10.1038/jhh.2016.77.

  12. Prevention of High Blood Pressure

    MedlinePlus

    ... page from the NHLBI on Twitter. Prevention of High Blood Pressure Healthy lifestyle habits, proper use of medicines, and ... prevent high blood pressure or its complications. Preventing High Blood Pressure Onset Healthy lifestyle habits can help prevent high ...

  13. Blood pressure monitors for home

    MedlinePlus

    ... type of blood pressure monitor for home use. DIGITAL BLOOD PRESSURE MONITORS A digital device will also have a cuff that wraps ... on its own. The screen will show a digital readout of your systolic and diastolic blood pressure. ...

  14. Automated Blood Pressure Measurement

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The Vital-2 unit pictured is a semi-automatic device that permits highly accurate blood pressure measurement, even by untrained personnel. Developed by Meditron Instrument Corporation, Milford, New Hampshire, it is based in part on NASA technology found in a similar system designed for automatic monitoring of astronauts' blood pressure. Vital-2 is an advancement over the familiar arm cuff, dial and bulb apparatus customarily used for blood pressure checks. In that method, the physician squeezes the bulb to inflate the arm cuff, which restricts the flow of blood through the arteries. As he eases the pressure on the arm, he listens, through a stethoscope, to the sounds of resumed blood flow as the arteries expand and contract. Taking dial readings related to sound changes, he gets the systolic (contracting) and diastolic (expanding) blood pressure measurements. The accuracy of the method depends on the physician's skill in interpreting the sounds. Hospitals sometimes employ a more accurate procedure, but it is "invasive," involving insertion of a catheter in the artery.

  15. Impact of early blood pressure variability on stroke outcomes after thrombolysis: the SAMURAI rt-PA Registry.

    PubMed

    Endo, Kaoru; Kario, Kazuomi; Koga, Masatoshi; Nakagawara, Jyoji; Shiokawa, Yoshiaki; Yamagami, Hiroshi; Furui, Eisuke; Kimura, Kazumi; Hasegawa, Yasuhiro; Okada, Yasushi; Okuda, Satoshi; Namekawa, Michito; Miyagi, Tetsuya; Osaki, Masato; Minematsu, Kazuo; Toyoda, Kazunori

    2013-03-01

    The present study determines associations between early blood pressure (BP) variability and stroke outcomes after intravenous thrombolysis. In 527 stroke patients receiving intravenous alteplase (0.6 mg/kg), BP was measured 8 times within the first 25 hours. BP variability was determined as ΔBP (maximum-minimum), standard deviation (SD), coefficient of variation, and successive variation. The systolic BP course was lower among patients with modified Rankin Scale (mRS) 0 to 1 than those without (P<0.001). Most of systolic BP variability profiles were significantly associated with outcomes. Adjusted odds ratios (95% confidence interval) per 10 mm Hg (or 10% for coefficient of variation) on symptomatic intracerebral hemorrhage were as follows: ΔBP, 1.33 (1.08-1.66); SD, 2.52 (1.26-5.12); coefficient of variation, 3.15 (1.12-8.84); and successive variation, 1.82 (1.04-3.10). The respective values were 0.88 (0.77-0.99), 0.73 (0.48-1.09), 0.77 (0.43-1.34), and 0.76 (0.56-1.03) for 3-month mRS 0 to 1; and 1.40 (1.14-1.75), 2.85 (1.47-5.65), 4.67 (1.78-12.6), and 1.99 (1.20-3.25) for death. Initial BP values before thrombolysis were not associated with any outcomes. Early systolic BP variability was positively associated with symptomatic intracerebral hemorrhage and death after intravenous thrombolysis.

  16. Differentiation of Overweight from Normal Weight Young Adults by Postprandial Heart Rate Variability and Systolic Blood Pressure

    PubMed Central

    Taffe, Lauren; Stancil, Kimani; Bond, Vernon; Pemminati, Sudhakar; Gorantla, Vasavi Rakesh; Kadur, Kishan

    2016-01-01

    Introduction Obesity and cardiovascular disease are inextricably linked and the health community’s response to the current epidemic of adolescent obesity may be improved by the ability to target adolescents at highest risk for developing cardiovascular disease in the future. Overweight manifests early as autonomic dysregulation and current methods do not permit differentiation of overweight adolescents or young adults at highest risk for developing cardiovascular disease. Aim This study was designed to test the hypothesis that scaling exponents motivated by nonlinear fractal analyses of Heart Rate Variability (HRV) differentiate overweight, otherwise healthy adolescent/young adult subjects at risk for developing prehypertension, the primary forerunner of cardiovascular disease. Materials and Methods The subjects were 18-20year old males with Body Mass Index (BMI) 20.1-42.5kg/m2. Electrocardiographic inter-beat (RR) intervals were measured during 3h periods of bed rest after overnight fasting and ingestion of 900Cal high-carbohydrate and high-fat test beverages on separate days. Detrended Fluctuation Analysis (DFA), k-means cluster and ANOVA analyses of scaling coefficients α, α1, and α2, showed dependencies on hourly measurements of systolic blood pressure and on premeasured BMI. Results It was observed that α value increased during the caloric challenge, appears to represent metabolically-induced changes in HRV across the participants. An ancillary analysis was performed to determine the dependency on BMI without BMI as a parameter. Cluster analysis of the high-carbohydrate test beverage treatment and the high-fat treatment produced grouping with very little overlap. ANOVA on both clusters demonstrated significance at p<0.001. We were able to demonstrate increased sympathetic modulation of our study group during ingestion and metabolism of isocaloric high-carbohydrate and high-fat test beverages. Conclusion These findings demonstrate significantly different

  17. Blood Pressure Self-Measurement.

    PubMed

    Wagner, Stefan

    2017-01-01

    Blood pressure self-measurement has been used extensively as part of several clinical processes including in the home monitoring setting for mitigating white coat effect and gaining more detailed insights into the blood pressure variability of patients over time. Self-measurement of BP is also being used as part of telemonitoring and telemedicine processes, as well as in the waiting rooms and self-measurement rooms of general practice clinics, specialized hospital department's outpatient clinics, and in other types of care facilitates and institutions.The aim of this review is to provide an overview of where, when, and how blood pressure self-measurement is being used, which official clinical guidelines and procedures are available for its implementation, as well as the opportunities and challenges that are related to its use.

  18. Test Your Blood Pressure IQ

    MedlinePlus

    ... How High Blood Pressure is Diagnosed BP vs. Heart Rate Low Blood Pressure Resistant Hypertension Pulmonary Hypertension High Blood Pressure Myths ... Healthy 6 What are the Symptoms of High Blood Pressure? 7 All About Heart Rate (Pulse) 8 Tachycardia | Fast Heart Rate 9 Warning ...

  19. Living with High Blood Pressure

    MedlinePlus

    ... page from the NHLBI on Twitter. Living With High Blood Pressure If you have high blood pressure, the best thing to do is to talk ... help you track your blood pressure. Pregnancy Planning High blood pressure can cause problems for mother and baby. High ...

  20. Effects of cigarette smoking on ambulatory blood pressure, heart rate, and heart rate variability in treated hypertensive patients.

    PubMed

    Ohta, Yuko; Kawano, Yuhei; Hayashi, Shinichiro; Iwashima, Yoshio; Yoshihara, Fumiki; Nakamura, Satoko

    We investigated the influence of cigarette smoking on the levels and circadian patterns of blood pressure (BP), heart rate (HR), and HR variability (HRV) in hypertensive patients. Sixteen hypertensive smokers (57 ± 2 years old) receiving antihypertensive treatments participated in this study. Ambulatory monitoring of BP, HR, and electrocardiograms was performed every 30 min for 24 hours on a smoking day and nonsmoking day in a randomized crossover manner. Average 24-hour BP and daytime BP were significantly higher in the smoking period than in the nonsmoking period. No significant differences were observed in nighttime BP between the two periods. Average 24-hour and daytime HR, but not nighttime HR, were also higher in the smoking period than in the nonsmoking period. The daytime high frequency (HF) component of HRV was attenuated more in the smoking period than in the nonsmoking period. No significant differences were observed in the low frequency (LF) components of HRV or LF/HF ratio between the two periods. These results demonstrated that cigarette smoking increased the daytime and average 24-hour BP and HR, and the increases observed in daytime BP and HR were associated with the attenuation of parasympathetic nerve activity.

  1. Long-term prognostic implications of visit-to-visit blood pressure variability in patients with ischemic stroke.

    PubMed

    Lau, Kui-Kai; Wong, Yuen-Kwun; Teo, Kay-Cheong; Chang, Richard S K; Chan, Koon-Ho; Hon, Sonny F K; Wat, Ka-Lung; Cheung, Raymond T F; Li, Leonard S W; Siu, Chung-Wah; Tse, Hung-Fat

    2014-12-01

    Blood pressure (BP) variability (BPV) is a novel risk factor for the development of atherosclerotic diseases. High BPV has recently been shown to predict all-cause and cardiovascular mortality in patients with lacunar infarct. Whether BPV has prognostic implications in patients with ischemic stroke subtypes, other than those due to small-vessel occlusion, remains uncertain. We prospectively followed up the clinical outcome of 632 consecutive ischemic stroke patients without atrial fibrillation. The average BP and BPV, as determined by the coefficient of variation of the systolic and diastolic BP, were recorded during a mean 12 ± 6 outpatient clinic visits. The average age of the population was 71 ± 11 years. After a mean of 76 ± 18 months of follow-up, 161 patients died (26%); 35% (n = 56 of 161) of these deaths were due to cardiovascular causes. Sixteen percent and 5% developed recurrent stroke and acute coronary syndrome (ACS), respectively. After adjusting for mean systolic BP and confounding variables, patients with high systolic BPV were at significantly greater risk of cardiovascular mortality (hazards ratio (HR) = 2.36; 95% confidence interval (CI) = 1.02-5.49; P < 0.05). High systolic BPV also predicted all-cause mortality after adjusting for mean systolic BP (HR = 1.79; 95% CI = 1.16-2.75; P < 0.05). There was no association between systolic BPV and nonfatal recurrent stroke or nonfatal ACS. Raised diastolic BPV did not predict recurrent nonfatal stroke, nonfatal ACS, or mortality. Visit-to-visit systolic BPV predicts long-term all-cause and cardiovascular mortality in patients with ischemic stroke without atrial fibrillation, independent of other conventional risk factors, including average BP control. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Prediction of hypertensive crisis based on average, variability and approximate entropy of 24-h ambulatory blood pressure monitoring.

    PubMed

    Schoenenberger, A W; Erne, P; Ammann, S; Perrig, M; Bürgi, U; Stuck, A E

    2008-01-01

    Approximate entropy (ApEn) of blood pressure (BP) can be easily measured based on software analysing 24-h ambulatory BP monitoring (ABPM), but the clinical value of this measure is unknown. In a prospective study we investigated whether ApEn of BP predicts, in addition to average and variability of BP, the risk of hypertensive crisis. In 57 patients with known hypertension we measured ApEn, average and variability of systolic and diastolic BP based on 24-h ABPM. Eight of these fifty-seven patients developed hypertensive crisis during follow-up (mean follow-up duration 726 days). In bivariate regression analysis, ApEn of systolic BP (P<0.01), average of systolic BP (P=0.02) and average of diastolic BP (P=0.03) were significant predictors of hypertensive crisis. The incidence rate ratio of hypertensive crisis was 14.0 (95% confidence interval (CI) 1.8, 631.5; P<0.01) for high ApEn of systolic BP as compared to low values. In multivariable regression analysis, ApEn of systolic (P=0.01) and average of diastolic BP (P<0.01) were independent predictors of hypertensive crisis. A combination of these two measures had a positive predictive value of 75%, and a negative predictive value of 91%, respectively. ApEn, combined with other measures of 24-h ABPM, is a potentially powerful predictor of hypertensive crisis. If confirmed in independent samples, these findings have major clinical implications since measures predicting the risk of hypertensive crisis define patients requiring intensive follow-up and intensified therapy.

  3. Visit-to-Visit Variability of Blood Pressure and Coronary Heart Disease, Stroke, Heart Failure, and Mortality: A Cohort Study.

    PubMed

    Muntner, Paul; Whittle, Jeff; Lynch, Amy I; Colantonio, Lisandro D; Simpson, Lara M; Einhorn, Paula T; Levitan, Emily B; Whelton, Paul K; Cushman, William C; Louis, Gail T; Davis, Barry R; Oparil, Suzanne

    2015-09-01

    Variability of blood pressure (BP) across outpatient visits is frequently dismissed as random fluctuation around a patient's underlying BP. To examine the association of visit-to-visit variability (VVV) of systolic BP (SBP) and diastolic BP with cardiovascular disease (CVD) and mortality outcomes. Prospective cohort study. Post hoc analysis of ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial). 25 814 ALLHAT participants. The VVV of SBP was defined as the SD across SBP measurements obtained at 7 visits conducted from 6 to 28 months after ALLHAT enrollment. Participants without CVD events during the first 28 months of follow-up were followed from the 28-month visit through the end of active ALLHAT follow-up. Outcomes included fatal coronary heart disease (CHD) or nonfatal myocardial infarction, all-cause mortality, stroke, and heart failure. During follow-up, 1194 fatal CHD or nonfatal MI events, 1948 deaths, 606 strokes, and 921 heart failure events occurred. After multivariable adjustment, including for mean SBP, the hazard ratio comparing participants in the highest versus lowest quintile of SD of SBP (≥14.4 mm Hg vs. <6.5 mm Hg) was 1.30 (95% CI, 1.06 to 1.59) for fatal CHD or nonfatal MI, 1.58 (CI, 1.32 to 1.90) for all-cause mortality, 1.46 (CI, 1.06 to 2.01) for stroke, and 1.25 (CI, 0.97 to 1.61) for heart failure. Higher VVV of diastolic BP was also associated with CVD events and mortality. Long-term outcomes were not available. Higher VVV of SBP is associated with an increased risk for CVD and mortality. Future studies should examine whether reducing VVV of BP lowers this risk. National Institutes of Health.

  4. What Causes High Blood Pressure?

    MedlinePlus

    ... can cause high blood pressure. Renin-Angiotensin-Aldosterone System The renin-angiotensin-aldosterone system makes angiotensin and ... blood volumes and high blood pressure. Sympathetic Nervous System Activity The sympathetic nervous system has important functions ...

  5. Identification of low and high frequency ranges for heart rate variability and blood pressure variability analyses using pharmacological autonomic blockade with atropine and propranolol in swine.

    PubMed

    Poletto, Rosangela; Janczak, Andrew M; Marchant-Forde, Ruth M; Marchant-Forde, Jeremy N; Matthews, Donald L; Dowell, Carol A; Hogan, Daniel F; Freeman, Lynetta J; Lay, Donald C

    2011-05-03

    Understanding autonomic nervous system functioning, which mediates behavioral and physiological responses to stress, offers great potential for assessing farm animal stress and welfare. Evaluation of heart rate variability (HRV) and blood pressure variability (BPV), using time and frequency domain analyses may provide a sensitive and reliable measure of affective states and stress-mediated changes in sympathetic and parasympathetic tones. The aim of this research was to define low (LF) and high frequency (HF) power spectral ranges using pharmacological autonomic blockade, and to examine HRV and BPV parameter changes in response to atropine and propranolol in swine. Ten, 13-week old, barrows (n=6) and gilts (n=4) underwent surgery to place an intra-cardiac electrode and a blood pressure catheter attached to a biotelemetric transmitter; pigs had a 3-week recovery period prior to data collection. Each pig was subjected to administration of 4 intravenous (i.v.) drug treatments: a control treatment, 3 mL of saline, and 3 blockade treatments; 0.1 mg/kg of atropine, 1.0 mg/kg of propranolol, and .1 mg/kg of atropine together with 1.0 mg/kg of propranolol. All treatments were delivered by injection in the jugular vein with a minimum of 48 h between individual treatments. Behavior, ECG and blood pressure data were recorded continuously for a total of 1h, from 30 min pre-injection to 30 min post-injection. For data analyses, two 512-beat intervals were selected for each treatment while the pig was lying and inactive. The first interval was selected from the pre-injection period (baseline), and the second was selected between 10 and 30 min post-injection. Time and frequency domain (power spectral density) analyses were performed on each data interval. Subsequent, LF and HF bands from the power spectral densities were defined based on general linear and regression analyses. The HRV and BPV were computed with a covariate (baseline) factorial analysis of treatment by sex

  6. Towards development of a mobile RF Doppler sensor for continuous heart rate variability and blood pressure monitoring.

    PubMed

    Insoo Kim; Bhagat, Yusuf A

    2016-08-01

    The standard in noninvasive blood pressure (BP) measurement is an inflatable cuff device based on the oscillometric method, which poses several practical challenges for continuous BP monitoring. Here, we present a novel ultra-wide band RF Doppler radar sensor for next-generation mobile interface for the purpose of characterizing fluid flow speeds, and for ultimately measuring cuffless blood flow in the human wrist. The system takes advantage of the 7.1~10.5 GHz ultra-wide band signals which can reduce transceiver complexity and power consumption overhead. Moreover, results obtained from hardware development, antenna design and human wrist modeling, and subsequent phantom development are reported. Our comprehensive lab bench system setup with a peristaltic pump was capable of characterizing various speed flow components during a linear velocity sweep of 5~62 cm/s. The sensor holds potential for providing estimates of heart rate and blood pressure.

  7. Visit-to-visit blood pressure variability and classes of antihypertensive agents; associations with artery remodeling and the risk of stroke.

    PubMed

    Nagai, Michiaki; Dote, Keigo; Kato, Masaya; Sasaki, Shota; Oda, Noboru; Kagawa, Eisuke; Nakano, Yoshinori; Yamane, Aya; Kubo, Yumiko; Higashihara, Tasuku; Miyauchi, Shunsuke; Harada, Wakako

    2016-01-01

    Recent studies have shown that visit-to-visit blood pressure (BP) variability was emerging as an independent risk factor for stroke. Although the mechanism is not fully understood, artery remodeling would be closely associated with the relationship between visit-to-visit BP variability and stroke. In addition, the class of antihypertensive agents is suggested to be an important determinant of visit-to-visit BP variability. This review article summarizes the recent literature on these topics. In the elderly hypertensives, strict BP control using calcium channel blockade would play a crucial role to prevent stroke via reducing the visit-to-visit BP variability.

  8. Variable pressure washer

    NASA Technical Reports Server (NTRS)

    Smeltzer, III, Stanley S. (Inventor); Estrada, Hector (Inventor)

    2004-01-01

    A variable pressure washer has two interlocking channel rings separated by a channel and retained by a captive set of fasteners. Within the channel between the rings are multiple rows of springs having at least two different spring moduli. The washer is particularly suited for use with a polar boss assembly secured to a bulkhead of a pressure vessel such as of propellent tank dome structure where the washer allows for the substantially uniform deflection of multiple O-rings as affected by the curved structure.

  9. Blood vessels, circulation and blood pressure.

    PubMed

    Hendry, Charles; Farley, Alistair; McLafferty, Ella

    This article, which forms part of the life sciences series, describes the vessels of the body's blood and lymphatic circulatory systems. Blood pressure and its regulatory systems are examined. The causes and management of hypertension are also explored. It is important that nurses and other healthcare professionals understand the various mechanisms involved in the regulation of blood pressure to prevent high blood pressure or ameliorate its damaging consequences.

  10. Blood Pressure Control

    NASA Technical Reports Server (NTRS)

    1992-01-01

    Engineering Development Lab., Inc.'s E-2000 Neck Baro Reflex System was developed for cardiovascular studies of astronauts. It is regularly used on Space Shuttle Missions, and a parallel version has been developed as a research tool to facilitate studies of blood pressure reflex controls in patients with congestive heart failure, diabetes, etc. An advanced version, the PPC-1000, was developed in 1991, and the technology has been refined substantially. The PPC provides an accurate means of generating pressure for a broad array of laboratory applications. An improved version, the E2010 Barosystem, is anticipated.

  11. Effect of Azilsartan on Day-to-Day Variability in Home Blood Pressure: A Prospective Multicenter Clinical Trial.

    PubMed

    Miyoshi, Toru; Suetsuna, Ryoji; Tokunaga, Naoto; Kusaka, Masayasu; Tsuzaki, Ryuichiro; Koten, Kazuya; Kunihisa, Kohno; Ito, Hiroshi

    2017-07-01

    The blood pressure variability (BPV) such as visit-to-visit, day-by-day, and ambulatory BPV has been also shown to be a risk of future cardiovascular events. However, the effects of antihypertensive therapy on BPV remain unclear. The purpose of this study was to evaluate the effect of azilsartan after switching from another angiotensin II receptor blocker (ARB) on day-to-day BPV in home BP monitoring. This prospective, multicenter, open-labeled, single-arm study included 28 patients undergoing treatment with an ARB, which was switched to azilsartan after enrollment. The primary outcome was the change in the mean of the standard deviation and the coefficient of variation of morning home BP for 5 consecutive days from baseline to the 24-week follow-up. The secondary outcome was the change in arterial stiffness measured by the cardio-ankle vascular index. The mean BPs in the morning and evening for 5 days did not statistically differ between baseline and 24 weeks. For the morning BP, the means of the standard deviations and coefficient of variation of the systolic BP were significantly decreased from 7.4 ± 3.6 mm Hg to 6.1 ± 3.2 mm Hg and from 5.4±2.7% to 4.6±2.3% (mean ± standard deviation, P = 0.04 and P = 0.04, respectively). For the evening BP, no significant change was observed in the systolic or diastolic BPV. The cardio-ankle vascular index significantly decreased from 8.3 ± 0.8 to 8.1 ± 0.8 (P = 0.03). Switching from another ARB to azilsartan reduced day-to-day BPV in the morning and improved arterial stiffness.

  12. Effect of Azilsartan on Day-to-Day Variability in Home Blood Pressure: A Prospective Multicenter Clinical Trial

    PubMed Central

    Miyoshi, Toru; Suetsuna, Ryoji; Tokunaga, Naoto; Kusaka, Masayasu; Tsuzaki, Ryuichiro; Koten, Kazuya; Kunihisa, Kohno; Ito, Hiroshi

    2017-01-01

    Background The blood pressure variability (BPV) such as visit-to-visit, day-by-day, and ambulatory BPV has been also shown to be a risk of future cardiovascular events. However, the effects of antihypertensive therapy on BPV remain unclear. The purpose of this study was to evaluate the effect of azilsartan after switching from another angiotensin II receptor blocker (ARB) on day-to-day BPV in home BP monitoring. Methods This prospective, multicenter, open-labeled, single-arm study included 28 patients undergoing treatment with an ARB, which was switched to azilsartan after enrollment. The primary outcome was the change in the mean of the standard deviation and the coefficient of variation of morning home BP for 5 consecutive days from baseline to the 24-week follow-up. The secondary outcome was the change in arterial stiffness measured by the cardio-ankle vascular index. Results The mean BPs in the morning and evening for 5 days did not statistically differ between baseline and 24 weeks. For the morning BP, the means of the standard deviations and coefficient of variation of the systolic BP were significantly decreased from 7.4 ± 3.6 mm Hg to 6.1 ± 3.2 mm Hg and from 5.4±2.7% to 4.6±2.3% (mean ± standard deviation, P = 0.04 and P = 0.04, respectively). For the evening BP, no significant change was observed in the systolic or diastolic BPV. The cardio-ankle vascular index significantly decreased from 8.3 ± 0.8 to 8.1 ± 0.8 (P = 0.03). Conclusions Switching from another ARB to azilsartan reduced day-to-day BPV in the morning and improved arterial stiffness. PMID:28611863

  13. Blood Pressure and Heart Rate Variability during Yoga-Based Alternate Nostril Breathing Practice and Breath Awareness

    PubMed Central

    Telles, Shirley; Sharma, Sachin Kumar; Balkrishna, Acharya

    2014-01-01

    Background Previous research has shown a reduction in blood pressure (BP) immediately after the practice of alternate nostril yoga breathing (ANYB) in normal healthy male volunteers and in hypertensive patients of both sexes. The BP during ANYB has not been recorded. Material/Methods Participants were 26 male volunteers (group mean age ±SD, 23.8±3.5 years). We assessed (1) heart rate variability, (2) non-invasive arterial BP, and (3) respiration rate, during (a) ANYB and (b) breath awareness (BAW) sessions. Each session was 25 minutes. We performed assessments at 3 time points: Pre (5 minutes), during (15 minutes; for ANYB or BAW) and Post (5 minutes). A naïve-to-yoga control group (n=15 males, mean age ±SD 26.1±4.0 years) were assessed while seated quietly for 25 minutes. Results During ANYB there was a significant decrease (repeated measures ANOVA) in systolic BP and respiration rate; while RMSSD (the square root of the mean of the sum of squares of differences between adjacent NN intervals) and NN50 (the number of interval differences of successive normal to normal intervals greater than 50 ms) significantly increased. During BAW respiration rate decreased. In contrast, respiration rate increased during the control state. ANYB and BAW were significantly different (2-factor ANOVA) in RMSSD and respiration rate. BAW and control were different with respect to respiration rate. Conclusions The results suggest that vagal activity increased during and after ANYB, which could have contributed to the decrease in BP and changes in the HRV. PMID:25408140

  14. Effect of telmisartan vs. ramipril on 'dipping' status and blood pressure variability: pooled analysis of the PRISMA studies.

    PubMed

    Gosse, Philippe; Schumacher, Helmut

    2014-02-01

    A retrospective pooled analysis of the 'Prospective, Randomized Investigation of the Safety and Efficacy of MICARDIS vs. Ramipril Using ABPM' studies conducted in Europe and South Africa (PRISMA I) and in the United States of America and Canada (PRISMA II) was carried out to investigate the effects of telmisartan and ramipril on dipper status (extreme dippers, dippers, non-dippers, risers/reverse dippers), and blood pressure (BP) variability in 1279 patients (with normal sleeping patterns and valid 24-h ambulatory BP monitoring recordings at baseline and end point). After 14 weeks' treatment, telmisartan had a greater systolic BP (SBP) reduction and higher smoothness index in all four dipper groups compared with ramipril. In addition, the tendency toward dipping was significantly higher in patients treated with) telmisartan than ramipril (P=0.032; odds ratio for telmisartan vs. ramipril: 1.27 (95% confidence interval: 1.102-1.58)). In patients with an early morning SBP surge 35 mm Hg, telmisartan treatment was associated with significantly greater reductions from baseline in the night-time low mean, early morning mean and early morning SBP surge compared with ramipril (P=0.026, P<0.0001 and P=0.0006, respectively). In this retrospective analysis, telmisartan was shown to normalize the circadian BP pattern to a dipper profile in a larger proportion of patients than ramipril, and reduce early-morning SBP surge in high-risk patients, indicative of a cardioprotective effect. These findings need to be confirmed in long-term prospective trials and observational studies.

  15. Blood pressure variability is increasing from the first to the second day of the interdialytic interval in hemodialysis patients.

    PubMed

    Karpetas, Antonios; Loutradis, Charalampos; Bikos, Athanasios; Tzanis, Georgios; Koutroumpas, Georgios; Lazaridis, Antonios A; Mavromatidis, Konstantinos; Liakopoulos, Vassilios; Papagianni, Aikaterini; Zebekakis, Pantelis; Ruilope, Luis M; Parati, Gianfranco; Sarafidis, Pantelis A

    2017-08-12

    Patients with end-stage renal-disease under hemodialysis have increased cardiovascular risk and experience severe blood pressure (BP) fluctuations during the dialysis session and the subsequent interdialytic period. BP variability (BPV) may be an additional risk factor for cardiovascular events and preliminary data suggest increased BPV with advancing stages of chronic kidney disease. This is the first study to examine BPV during the whole intradialytic and interdialytic period in hemodialysis patients with ambulatory BP monitoring. A total of 160 patients receiving maintenance hemodialysis had 48-h ambulatory BP monitoring with the Mobil-O-Graph device during a regular dialysis session and the subsequent interdialytic interval. Brachial and aortic BPV were calculated with validated formulas and were compared between Days 1 and 2 of the interdialytic period (44-h), Days 1 and 2 of the total 48-h interval (including the dialysis session), and between the two respective daytime periods and night-time periods. All brachial SBPV indices [SD: 14.75 ± 4.38 vs. 15.91 ± 4.41, P = 0.001; weighted SD: 13.80 ± 4.00 vs. 14.89 ± 3.90, P < 0.001; coefficient of variation (CV): 11.34 ± 2.91 vs. 11.93 ± 2.94, P = 0.011; average real variability (ARV): 11.38 ± 3.44 vs. 12.32 ± 3.65, P < 0.001)] were increasing from Days 1 to 2 of the 44-h interdialytic period. Similarly, all indexes of DBPV were significantly increased in Day 2, except for CV. Aortic SBPV and DBPV indices displayed a similar pattern. Furthermore, all studied brachial SBPV and DBPV indexes were also lower during daytimes 1 than 2 (systolic ARV 11.56 ± 3.98 vs. 12.44 ± 4.03, P = 0.002); systolic ARV was lower in night-time 1 compared with night-time 2 (11.20 ± 5.09 vs. 12.18 ± 4.66, P = 0.045). In multivariate regression analysis prehemodialysis SBP, age and diabetes were independently associated with increased SBP ARV. BPV is

  16. Visit-to-visit variability of blood pressure and coronary heart disease, stroke, heart failure and mortality: A cohort study

    PubMed Central

    Muntner, Paul; Whittle, Jeff; Lynch, Amy I.; Colantonio, Lisandro D.; Simpson, Lara M.; Einhorn, Paula T.; Levitan, Emily B.; Whelton, Paul K; Cushman, William C.; Louis, Gail T.; Davis, Barry R.; Oparil, Suzanne

    2016-01-01

    Background Variability of blood pressure (BP) across outpatient visits is frequently dismissed as random fluctuation around a patient’s underlying BP. Objective: Examine the association between visit-to-visit variability (VVV) of systolic and diastolic BP (SBP and DBP) on cardiovascular disease and mortality outcomes. Design Prospective cohort study Setting Post-hoc analysis of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Participants 25,814 ALLHAT participants. Measurements VVV of SBP was defined as the standard deviation (SD) across BP measurements obtained at 7 visits conducted from 6 to 28 months following ALLHAT enrollment. Participants free of cardiovascular disease events during the first 28 months of follow-up were followed from the month 28 study visit through the end of active ALLHAT follow-up. Outcomes included fatal coronary heart disease or non-fatal myocardial infarction, all-cause mortality, stroke and heart failure. Results There were 1194 cases of fatal CHD or non-fatal MI, 1948 deaths, 606 cases of stroke and 921 cases of heart failure during follow-up. After multivariable adjustment including mean SBP, the hazard ratio comparing participants in the highest versus lowest quintile of SD of SBP (≥14.4 mmHg versus <6.5 mmHg) was 1.30 (1.06–1.59) for fatal coronary heart disease or non-fatal myocardial infarction, 1.58 (1.32–1.90) for all-cause mortality, 1.46 (1.06–2.01) for stroke, and 1.25 (0.97–1.61) for heart failure. Higher VVV of DBP was also associated with cardiovascular disease events and mortality. Limitations Long-term outcomes were not available. Conclusions Higher VVV of SBP is associated with increased cardiovascular disease and mortality risk. Future studies should examine whether reducing VVV of BP lowers this risk. Primary funding source National Institutes of Health PMID:26215765

  17. An alternative approach to approximate entropy threshold value (r) selection: application to heart rate variability and systolic blood pressure variability under postural challenge.

    PubMed

    Singh, A; Saini, B S; Singh, D

    2016-05-01

    This study presents an alternative approach to approximate entropy (ApEn) threshold value (r) selection. There are two limitations of traditional ApEn algorithm: (1) the occurrence of undefined conditional probability (CPu) where no template match is found and (2) use of a crisp tolerance (radius) threshold 'r'. To overcome these limitations, CPu is substituted with optimum bias setting ɛ opt which is found by varying ɛ from (1/N - m) to 1 in the increments of 0.05, where N is the length of the series and m is the embedding dimension. Furthermore, an alternative approach for selection of r based on binning the distance values obtained by template matching to calculate ApEnbin is presented. It is observed that ApEnmax, ApEnchon and ApEnbin converge for ɛ opt = 0.6 in 50 realizations (n = 50) of random number series of N = 300. Similar analysis suggests ɛ opt = 0.65 and ɛ opt = 0.45 for 50 realizations each of fractional Brownian motion and MIX(P) series (Lu et al. in J Clin Monit Comput 22(1):23-29, 2008). ɛ opt = 0.5 is suggested for heart rate variability (HRV) and systolic blood pressure variability (SBPV) signals obtained from 50 young healthy subjects under supine and upright position. It is observed that (1) ApEnbin of HRV is lower than SBPV, (2) ApEnbin of HRV increases from supine to upright due to vagal inhibition and (3) ApEnbin of BPV decreases from supine to upright due to sympathetic activation. Moreover, merit of ApEnbin is that it provides an alternative to the cumbersome ApEnmax procedure.

  18. Variable transcriptional regulation of the human aldosterone synthase gene causes salt-dependent high blood pressure in transgenic mice.

    PubMed

    Mopidevi, Brahmaraju; Kaw, Meenakshi K; Puri, Nitin; Ponnala, Madhusudan; Jain, Sudhir; Rana, Anita; Keetha, Narsimha R; Khuder, Sadik A; Fiering, Steven N; Kumar, Ashok

    2015-02-01

    Aldosterone, synthesized in the adrenal cortex by the enzyme CYP11B2, induces positive sodium balance and predisposes to hypertension. Various investigators, using genomic DNA analyses, have linked -344T polymorphism in the human CYP11B2 (hCYP11B2) gene to human hypertension. hCYP11B2 gene promoter has 3 single-nucleotide polymorphisms in linkage disequilibrium: T/A at -663, T/C at -470, and C/T at -344. Variants ACT occur together and form the haplotype-I (Hap-I), whereas variants TTC constitute Hap-II. We hypothesize that these single-nucleotide polymorphisms, when present together, will lead to haplotype-dependent differences in the transcriptional regulation of the hCYP11B2 gene and affect blood pressure regulation. We evaluated differences in tissue expression in vivo and consequential effects on blood pressure stemming from the 2 haplotypes. Novel transgenic mice with the hCYP11B2 gene, targeted to the mouse HPRT locus, with either Hap-II or Hap-I variant are used in this study. Our results show increased adrenal and renal expression of hCYP11B2 in transgenic mice with Hap-I when compared with mice with Hap-II. Importantly, we observed increased baseline blood pressure in Hap-I transgenic mice, an effect accentuated by a high-salt diet. Pathophysiological effects of elevated aldosterone were corroborated by our results showing upregulation of proinflammatory markers in renal tissues from the transgenic mice with Hap-I. These findings characterize the haplotype-dependent regulation of the hCYP11B2 gene where -344T serves as a reporter polymorphism and show that Hap-I leads to increased expression of hCYP11B2, with permissive effects on blood pressure and inflammatory milieu. © 2014 American Heart Association, Inc.

  19. The effects of 2 levels of the inspired oxygen fraction on blood gas variables in propofol-anesthetized dogs with high intracranial pressure

    PubMed Central

    Dias, Luis Gustavo Gosuen Gonçalves; Nunes, Newton; Lopes, Patrícia Cristina Ferro; de Almeida, Ricardo Miyasaka; Neto, Gláucia Bueno Pereira; de Souza, Ana Letícia Groszewicz; de Almeida Belmonte, Emílio

    2009-01-01

    The influence of 2 different levels of the inspired oxygen fraction (FiO2) on blood gas variables was evaluated in dogs with high intracranial pressure (ICP) during propofol anesthesia (induction followed by a continuous rate infusion [CRI] of 0.6 mg/kg/min) and intermittent positive pressure ventilation (IPPV). Eight adult mongrel dogs were anesthetized on 2 occasions, 21 d apart, and received oxygen at an FiO2 of 1.0 (G100) or 0.6 (G60) in a randomized crossover fashion. A fiberoptic catheter was implanted on the surface of the right cerebral cortex for assessment of the ICP. An increase in the ICP was induced by temporary ligation of the jugular vein 50 min after induction of anesthesia and immediately after baseline measurement of the ICP. Blood gas measurements were taken 20 min later and then at 15-min intervals for 1 h. Numerical data were submitted to Morrison’s multivariate statistical methods. The ICP, the cerebral perfusion pressure and the mean arterial pressure did not differ significantly between FiO2 levels or measurement times after jugular ligation. The only blood gas values that differed significantly (P < 0.05) were the arterial oxygen partial pressure, which was greater with G100 than with G60 throughout the procedure, and the venous haemoglobin saturation, that was greater with G100 than with G60 at M0. There were no significant differences between FiO2 levels or measurement times in the following blood gas variables: arterial carbon dioxide partial pressure, arterial hemoglobin saturation, base deficit, bicarbonate concentration, pH, venous oxygen partial pressure, venous carbon dioxide partial pressure and the arterial-to-end-tidal carbon dioxide difference. PMID:19436579

  20. Effect of antihypertensive agents on blood pressure variability: the Natrilix SR versus candesartan and amlodipine in the reduction of systolic blood pressure in hypertensive patients (X-CELLENT) study.

    PubMed

    Zhang, Yi; Agnoletti, Davide; Safar, Michel E; Blacher, Jacques

    2011-08-01

    To investigate the effect of different antihypertensive agents on blood pressure (BP) variability (BPV) and the underlying mechanism, we analyzed the ambulatory BP monitoring data of 577 patients before and after 3-month antihypertensive treatment, in the Natrilix SR Versus Candesartan and Amlodipine in the Reduction of Systolic Blood Pressure in Hypertensive Patients (X-CELLENT) Study, a multicenter, multinational, randomized, double-blind, placebo-controlled study with 4 parallel treatment arms (placebo, candesartan, indapamide sustained release, and amlodipine). Within-subject mean and SD of 24-hour BP, weighted by time interval between consecutive readings, were calculated in 3 time frames (daytime, nighttime, and 24 hours) to evaluate BP and BPV. The mean 24-hour heart rate (HR) and HR variability were calculated with the same algorithms. We found that the 3 antihypertensive drugs had a similar BP-lowering effect (P<0.001 for all), but amlodipine (P<0.007) and indapamide sustained release (P<0.04) were the only agents associated with a significantly decreased BPV after 3-month treatment. On the other hand, the major determinants of BPV at baseline were age, mean BP, and the corresponding HR variability. However, the reduction in BPV by amlodipine was significantly associated with the reduction in BP (P<0.006) and the reduction in HR variability (P<0.02), whereas the corresponding reduction by indapamide sustained release was only associated with the reduction in HR variability at night (P=0.004). In summary, 3-month amlodipine or indapamide sustained release treatment was associated with a significant reduction in BPV, and the mechanism of those reductions was possibly attributable to lowering BP or ameliorating the autonomic nervous system regulation or both. The combination of the 2 agents might help to optimize such properties.

  1. Effects of carvedilol or amlodipine on target organ damage in L-NAME hypertensive rats: their relationship with blood pressure variability.

    PubMed

    Del Mauro, Julieta S; Prince, Paula D; Donato, Martín; Fernandez Machulsky, Nahuel; Morettón, Marcela A; González, Germán E; Bertera, Facundo M; Carranza, Andrea; Gorzalczany, Susana B; Chiappetta, Diego A; Berg, Gabriela; Morales, Celina; Gelpi, Ricardo J; Taira, Carlos A; Höcht, Christian

    2017-04-01

    The aim of the study was to compare the effects of chronic oral treatment with carvedilol or amlodipine on blood pressure, blood pressure variability and target organ damage in N-nitro-l-arginine methyl ester (L-NAME) hypertensive rats. Wistar rats were treated with L-NAME administered in the drinking water for 8 weeks together with oral administration of carvedilol 30 mg/kg (n = 6), amlodipine 10 mg/kg (n = 6), or vehicle (n = 6). At the end of the treatment, echocardiographic evaluation, blood pressure, and short-term variability measurements were performed. Left ventricular and thoracic aortas were removed to assess activity of metalloproteinase 2 and 9 and expression levels of transforming growth factor β, tumor necrosis factor α, and interleukin 6. Histological samples were prepared from both tissues. Carvedilol and amlodipine induced a comparable reduction of systolic and mean arterial pressure and its short-term variability in L-NAME rats. The expression of transforming growth factor β, tumor necrosis factor α, and interleukin 6 decreased in both organs after carvedilol or amlodipine treatment and the activity of metalloproteinase was reduced in aortic tissue. Treatment with carvedilol or amlodipine completely prevented left ventricular collagen deposition and morphometric alterations in aorta. Oral chronic treatment with carvedilol or amlodipine significantly attenuates blood pressure variability and reduces target organ damage and biomarkers of tissue fibrosis and inflammation in L-NAME hypertensive rats. Copyright © 2017 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  2. High Blood Pressure Fact Sheet

    MedlinePlus

    ... this? Submit What's this? Submit Button Related CDC Web Sites Heart Disease Stroke High Blood Pressure Salt ... Prevent and Control Chronic Diseases Million Hearts® WISEWOMAN Web Sites with More Information About High Blood Pressure ...

  3. Blood Pressure vs. Heart Rate

    MedlinePlus

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Blood Pressure vs. Heart Rate (Pulse) Updated:Jan 18,2017 ... content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  4. High Blood Pressure in Pregnancy

    MedlinePlus

    ... of the baby. Controlling your blood pressure during pregnancy and getting regular prenatal care are important for ... your baby. Treatments for high blood pressure in pregnancy may include close monitoring of the baby, lifestyle ...

  5. High blood pressure and diet

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007483.htm High blood pressure and diet To use the sharing features on ... diet is a proven way to help control high blood pressure . These changes can also help you lose weight ...

  6. High Blood Pressure - Multiple Languages

    MedlinePlus

    ... Well-Being 8 - High Blood Pressure - العربية (Arabic) MP3 Siloam Family Health Center High Blood Pressure - العربية ( ... Being 8 - High Blood Pressure - myanma bhasa (Burmese) MP3 Siloam Family Health Center Chinese, Simplified (Mandarin dialect) ( ...

  7. Controlling your high blood pressure

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000101.htm Controlling your high blood pressure To use the sharing features on this page, ... JavaScript. Hypertension is another term used to describe high blood pressure. High blood pressure can lead to: Stroke Heart ...

  8. Influence of exercise training on heart rate variability in post-menopausal women with elevated arterial blood pressure.

    PubMed

    Davy, K P; Willis, W L; Seals, D R

    1997-01-01

    Low heart rate variability (HRV) has been reported to be an independent risk factor for the development of coronary heart disease in women and has recently been identified as a risk factor for cardiac sudden death and all-cause mortality. We have recently demonstrated that endurance-trained post-menopausal women demonstrate higher levels of HRV than sedentary control subjects. The purpose of the present study was to test the hypothesis that 12 weeks of regular aerobic exercise would increase HRV in sedentary post-menopausal women with elevated arterial blood pressure (BP) (i.e. either high normal BP or stage I hypertension). A secondary aim was to test the hypothesis that the increase in HRV with exercise training, if observed, would be associated with an increase in spontaneous cardiac baroreflex sensitivity (SBRS), an important physiological determinant of HRV. To accomplish these aims, we studied eight sedentary post-menopausal women (age = 54.5 +/- 1.3 years) before and after 12 weeks of aerobic exercise training (3.3 +/- 0.3 days per week at 70% +/- 2% of maximal heart rate for 43 +/- 3 min per day). Maximal oxygen uptake and body weight did not change (P > 0.05) with training, but percentage fat (35.5 +/- 2.6% vs. 34.5 +/- 2.3%, P < 0.05) decreased and treadmill time to exhaustion increased (9.8 +/- 0.5 vs. 11.3 +/- 0.5 min, P < 0.05). Supine resting levels of heart rate, RR interval and the standard deviation of the RR interval (time domain measure of HRV) were unchanged (all P > 0.05) from baseline levels after 12 weeks of aerobic training. Similarly, the high-frequency, low-frequency and total power of HRV (frequency domain measures) were also unchanged from baseline (all P > 0.05). SBRS was also not different before and after aerobic exercise training (10 +/- 2 vs. 13 +/- 3 ms mmHg-1 respectively, P > 0.05). In contrast, systolic and diastolic BP were reduced approximately 8 and approximately 5 mmHg with training (both P < 0.05) respectively. These

  9. High sensitivity test for the early diagnosis of gestational hypertension and preeclampsia. II. Circadian blood pressure variability in health and hypertensive pregnant women.

    PubMed

    Hermida, R C; Ayala, D E; Mojón, A; Iglesias, M

    1997-01-01

    The aim of this study was to describe the circadian pattern of non-invasive ambulatorily monitored blood pressure during the trimesters of pregnancy in clinically healthy women as well as in pregnant women who developed gestational hypertension or preeclampsia, and to compare sensitivity and specificity of diagnosis based on the average of the blood pressure series with the values obtained on the basis of casual measurements. We analyzed a total of 745 blood pressure series sampled by ambulatory monitoring for about 48 hours in each of several occasions in 189 women with uncomplicated pregnancies, 71 with gestational hypertension, and 29 with preeclampsia. The circadian pattern of BP variation for each group (complicated vs. uncomplicated pregnancies) and trimester of gestation was established by linear least-squares methods. Highly statistically different circadian patterns are demonstrated for systolic, mean arterial and diastolic blood pressure for both groups of pregnant women in all trimesters (P < 0.001 in all cases). Blood pressure decreases from the first trimester to the second and raises again in the third for healthy pregnant women, but continuously increases during gestation in women who developed gestational hypertension or preeclampsia. The differences in circadian rhythm-adjusted mean between complicated and uncomplicated pregnancies are highly statistically significant in all trimesters (P < .001). Sensitivity and specificity of diagnosing gestational hypertension based on the circadian mean are 73% and 48%, respectively, too low for a proper individualized diagnosis of gestational hypertension or preeclampsia. This study confirms the predictable circadian variability in blood pressure during gestation. The differences between healthy and complicated pregnancies can be observed as early as in the first trimester of pregnancy, but the use of the 24-hour mean BP does not provide a good approach for early diagnosis of gestational hypertension or

  10. Correlates of Blood Pressure in Elementary Schoolchildren.

    ERIC Educational Resources Information Center

    Melby, Christopher L.; And Others

    1987-01-01

    This cross-sectional study determined which anthropometric, dietary, and physical fitness variables were the best predictors of blood pressure in 323 white elementary school children. Results are discussed. (Author/MT)

  11. Ambulatory 24-hour cardiac oxygen consumption and blood pressure-heart rate variability: effects of nebivolol and valsartan alone and in combination.

    PubMed

    Izzo, Joseph L; Khan, Safi U; Saleem, Osman; Osmond, Peter J

    2015-07-01

    We compared an angiotensin receptor blocker (valsartan; VAL), a beta-blocker (nebivolol; NEB) and the combination of NEB/VAL with respect to 24-hour myocardial oxygen consumption (determined by 24-hour ambulatory heart rate-central systolic pressure product [ACRPP]) and its components. Subjects with hypertension (systolic blood pressure >140 or diastolic blood pressure >90; n = 26) were studied in a double-blinded, double-dummy, forced-titration, crossover design with 3 random-order experimental periods: VAL 320 mg, NEB 40 mg, and NEB/VAL 320/40 mg daily. After 4 weeks of each drug, ambulatory pulse wave analysis (MobilOGraph) was performed every 20 minutes for 24 hours. All three treatments resulted in nearly identical brachial and central systolic blood pressures. NEB alone or in combination with VAL resulted in lower ACRPP (by 11%-14%; P < .001 each) and heart rate (by 18%-20%; P < .001 each) compared with VAL, but stroke work (ACRPP per beat) was lower with VAL. Relative and adjusted variability (standard deviation and coefficient of variation) of heart rate were also lower with NEB and NEB/VAL than VAL. Results in African Americans, the majority subpopulation, were similar to those of the entire treatment group. We conclude that the rate-slowing effects of NEB cause ambulatory cardiac myocardial oxygen consumption to be lower with NEB monotherapy or NEB/VAL combination therapy than with VAL monotherapy. NEB/VAL is not superior to NEB alone in controlling heart rate, blood pressure, or ACRPP. Heart rate variability but not ACRPP variability is reduced by NEB or the combination NEB/VAL. There is no attenuation of beta-blocker-induced rate-slowing effects of in African Americans. Copyright © 2015 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  12. Effects of magnesium sulfate on heart rate, blood pressure variability and baroreflex sensitivity in preeclamptic rats treated with L-NAME.

    PubMed

    Zhou, Qiongjie; Shen, Jie; Zhou, Guangxing; Shen, Linlin; Zhou, Shufeng; Li, Xiaotian

    2013-11-01

    Magnesium sulfate is used for the treatment of preeclampsia. This study aimed to evaluate effects of magnesium sulfate on heart rate variability (HRV), blood pressure variability (BPV) and baroreflex sensitivity (BRS) in pregnant rats treated with N(G)-nitro-.-arginine-methyl ester (L-NAME). Sprague-Dawley rats were randomly divided into four groups: non-pregnancy and three pregnant groups. From gestational day 2-12, normal pregnancy group (NOR) received sterile water through intravenous injection, LN was injected with L-NAME [25 mg/day] to induce preeclampsia, while LNM group was also treated with magnesium sulfate at 0.3 g/kg at gestational day 13. HRV, BPV and BRS were monitored, and endothelial functions were detected at gestational day 14. Rats with treatment of L-NAME showed significantly increased blood pressure and endothelin-1 concentration and decreased plasma NO concentration; concomitant treatment with magnesium sulfate suppressed blood pressure. Also, rats treated with L-NAME and magnesium sulfate underwent lower heart rate variability (lower absolute and normalized LF) and higher blood pressure variability (lower normalized HF and LF, higher normalized VLF) compared with non-pregnant or normal pregnant rats, whereas normalized LF of HRV in rats co-administered magnesium sulfate returned to normal level. Additionally, rats treated with L-NAME underwent decreased BRS-SP, BRS-NE, BRS LF and HF, and rats with concomitant magnesium sulfate partially reversed the decline (p>0.05) and had significantly lower BRS-SP, BRS-NE. Sympathetic and parasympathetic impairment exist in preeclamptic rats treated with L-NAME. Magnesium sulfate may ameliorate alterations in the autonomic nervous system noted in preeclampsia.

  13. Non-invasive evaluation of sympathovagal balance in athletes by time and frequency domain analyses of heart rate and blood pressure variability.

    PubMed

    Uusitalo, A L; Tahvanainen, K U; Uusitalo, A J; Rusko, H K

    1996-11-01

    We examined how the time and frequency domain measures of heart rate and blood pressure variability at supine rest reflect the sympathovagal balance of 23 female and male endurance athletes. Pharmacological blocking by atropine and propranolol was used as a standard for defining autonomic control of the heart. The Rosenblueth and Simeone model for neural control of heart rate was used to calculate the sympathovagal balance index (Abal). Atropinization significantly decreased all time and frequency domain measures of heart rate and blood pressure variability. beta-Blockade significantly decreased further the low- (< 0.07 Hz) and medium-frequency power (0.07-0.15 Hz) variability of R-R intervals (RRI) and SD of RRI. Abal was 0.629 +/- 0.019, indicating that parasympathetic activity predominated in the athletes. Basal heart rate (r = 0.519, P < 0.01), SD of RRI (r = -0.533, P < 0.01), root-mean-square of successive RRIs (RRI RMSSD) (r = -0.579, P < 0.05), RRI total (r = -0.557, P < 0.01) and RRI high-frequency (HF) power (r = -0.582, P < 0.01) correlated significantly with Abal and parasympathetic activity index. We concluded that the best non-invasive method of evaluating the sympathovagal balance of athletes at supine rest is to measure SD of RRI, RRI RMSSD, HF and total power of RRI variability. All heart rate variability measures were mainly parasympathetically modulated. The nature of blood pressure variability measures remained unclear and they could not be used to evaluate the sympathovagal balance among athletes.

  14. Randomised Double-Blind Comparison of Placebo and Active Drugs for Effects on Risks Associated with Blood Pressure Variability in the Systolic Hypertension in Europe Trial

    PubMed Central

    Hara, Azusa; Thijs, Lutgarde; Asayama, Kei; Jacobs, Lotte; Wang, Ji-Guang; Staessen, Jan A.

    2014-01-01

    Background In the Systolic Hypertension in Europe trial (NCT02088450), we investigated whether systolic blood pressure variability determines prognosis over and beyond level. Methods Using a computerised random function and a double-blind design, we randomly allocated 4695 patients (≥60 years) with isolated systolic hypertension (160–219/<95 mm Hg) to active treatment or matching placebo. Active treatment consisted of nitrendipine (10–40 mg/day) with possible addition of enalapril (5–20 mg/day) and/or hydrochlorothiazide (12.5–25.0 mg/day). We assessed whether on-treatment systolic blood pressure level (SBP), visit-to-visit variability independent of the mean (VIM) or within-visit variability (WVV) predicted total (n = 286) or cardiovascular (n = 150) mortality or cardiovascular (n = 347), cerebrovascular (n = 133) or cardiac (n = 217) endpoints. Findings At 2 years, mean between-group differences were 10.5 mm Hg (p<0.0001) for SBP, 0.29 units (p = 0.20) for VIM, and 0.07 mm Hg (p = 0.47) for WVV. Active treatment reduced (p≤0.048) cardiovascular (−28%), cerebrovascular (−40%) and cardiac (−24%) endpoints. In analyses dichotomised by the median, patients with low vs. high VIM had similar event rates (p≥0.14). Low vs. high WVV was not associated with event rates (p≥0.095), except for total and cardiovascular mortality on active treatment, which were higher with low WVV (p≤0.0003). In multivariable-adjusted Cox models, SBP predicted all endpoints (p≤0.0043), whereas VIM did not predict any (p≥0.058). Except for an inverse association with total mortality (p = 0.042), WVV was not predictive (p≥0.15). Sensitivity analyses, from which we excluded blood pressure readings within 6 months after randomisation, 6 months prior to an event or both were confirmatory. Conclusions The double-blind placebo-controlled Syst-Eur trial demonstrated that blood-pressure lowering treatment reduces cardiovascular complications

  15. Effects of variable blast pressures on blood flow and oxygen saturation in rat brain as evidenced using MRI.

    PubMed

    Bir, Cynthia; Vandevord, Pamela; Shen, Yimin; Raza, Waqar; Haacke, E Mark

    2012-05-01

    It has been recognized that primary blast waves may result in neurotrauma in soldiers in theater. A new type of contrast used in magnetic resonance imaging (MRI), susceptibility-weighted imaging (SWI), has been developed that is based on the different susceptibility levels in diverse tissues and can detect decreases in cerebral blood flow (CBF) using inferred oxygen saturation changes in tissue. In addition, a continuous arterial spin-labeled (ASL) MRI sequence was used as a direct measure of regional CBF within the brain tissue. Animals were subjected to whole-body blast exposures of various overpressures within a gas-driven shock tube. When exposed to low levels of overpressure, most rats demonstrated no obvious changes between pre- and postexposure in the conventional MR images. CBF changes measured by SWI and ASL were significantly higher for the overpressure exposed groups as compared to the sham group and tended to increase with pressure increases at the highest two pressures. In the hippocampus, all blast animals had a reduction in the CBF consistently in the range of 0-27%. In summary, low levels of primary blast pressure exposure demonstrated a significant physiologic effect to the brain up to 72 h postexposure. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Acute Effects of Caffeine on Heart Rate Variability, Blood Pressure and Tidal Volume in Paraplegic and Tetraplegic Compared to Able-Bodied Individuals: A Randomized, Blinded Trial

    PubMed Central

    Flueck, Joelle Leonie; Schaufelberger, Fabienne; Lienert, Martina; Schäfer Olstad, Daniela; Wilhelm, Matthias; Perret, Claudio

    2016-01-01

    Caffeine increases sympathetic nerve activity in healthy individuals. Such modulation of nervous system activity can be tracked by assessing the heart rate variability. This study aimed to investigate the influence of caffeine on time- and frequency-domain heart rate variability parameters, blood pressure and tidal volume in paraplegic and tetraplegic compared to able-bodied participants. Heart rate variability was measured in supine and sitting position pre and post ingestion of either placebo or 6 mg caffeine in 12 able-bodied, 9 paraplegic and 7 tetraplegic participants in a placebo-controlled, randomized and double-blind study design. Metronomic breathing was applied (0.25 Hz) and tidal volume was recorded during heart rate variability assessment. Blood pressure, plasma caffeine and epinephrine concentrations were analyzed pre and post ingestion. Most parameters of heart rate variability did not significantly change post caffeine ingestion compared to placebo. Tidal volume significantly increased post caffeine ingestion in able-bodied (p = 0.021) and paraplegic (p = 0.036) but not in tetraplegic participants (p = 0.34). Systolic and diastolic blood pressure increased significantly post caffeine in able-bodied (systolic: p = 0.003; diastolic: p = 0.021) and tetraplegic (systolic: p = 0.043; diastolic: p = 0.042) but not in paraplegic participants (systolic: p = 0.09; diastolic: p = 0.33). Plasma caffeine concentrations were significantly increased post caffeine ingestion in all three groups of participants (p<0.05). Plasma epinephrine concentrations increased significantly in able-bodied (p = 0.002) and paraplegic (p = 0.032) but not in tetraplegic participants (p = 0.63). The influence of caffeine on the autonomic nervous system seems to depend on the level of lesion and the extent of the impairment. Therefore, tetraplegic participants may be less influenced by caffeine ingestion. Trial Registration ClinicalTrials.gov NCT02083328 PMID:27776149

  17. Heart Rate and Systolic Blood Pressure Variability in the Time Domain in Patients with Recent and Long-Standing Diabetes Mellitus.

    PubMed

    Rivera, Ana Leonor; Estañol, Bruno; Sentíes-Madrid, Horacio; Fossion, Ruben; Toledo-Roy, Juan C; Mendoza-Temis, Joel; Morales, Irving O; Landa, Emmanuel; Robles-Cabrera, Adriana; Moreno, Rene; Frank, Alejandro

    2016-01-01

    Diabetes Mellitus (DM) affects the cardiovascular response of patients. To study this effect, interbeat intervals (IBI) and beat-to-beat systolic blood pressure (SBP) variability of patients during supine, standing and controlled breathing tests were analyzed in the time domain. Simultaneous noninvasive measurements of IBI and SBP for 30 recently diagnosed and 15 long-standing DM patients were compared with the results for 30 rigorously screened healthy subjects (control). A statistically significant distinction between control and diabetic subjects was provided by the standard deviation and the higher moments of the distributions (skewness, and kurtosis) with respect to the median. To compare IBI and SBP for different populations, we define a parameter, α, that combines the variability of the heart rate and the blood pressure, as the ratio of the radius of the moments for IBI and the same radius for SBP. As diabetes evolves, α decreases, standard deviation of the IBI detrended signal diminishes (heart rate signal becomes more "rigid"), skewness with respect to the median approaches zero (signal fluctuations gain symmetry), and kurtosis increases (fluctuations concentrate around the median). Diabetes produces not only a rigid heart rate, but also increases symmetry and has leptokurtic distributions. SBP time series exhibit the most variable behavior for recently diagnosed DM with platykurtic distributions. Under controlled breathing, SBP has symmetric distributions for DM patients, while control subjects have non-zero skewness. This may be due to a progressive decrease of parasympathetic and sympathetic activity to the heart and blood vessels as diabetes evolves.

  18. What Is High Blood Pressure?

    MedlinePlus

    ... consistently too high. How your blood pressure and circulatory system work In order to survive and function properly, ... and organs need the oxygenated blood that your circulatory system carries throughout the body. When the heart beats, ...

  19. Automated office blood pressure.

    PubMed

    Myers, Martin G; Godwin, Marshall

    2012-05-01

    Manual blood pressure (BP) is gradually disappearing from clinical practice with the mercury sphygmomanometer now considered to be an environmental hazard. Manual BP is also subject to measurement error on the part of the physician/nurse and patient-related anxiety which can result in poor quality BP measurements and office-induced (white coat) hypertension. Automated office (AO) BP with devices such as the BpTRU (BpTRU Medical Devices, Coquitlam, BC) has already replaced conventional manual BP in many primary care practices in Canada and has also attracted interest in other countries where research studies using AOBP have been undertaken. The basic principles of AOBP include multiple readings taken with a fully automated recorder with the patient resting alone in a quiet room. When these principles are followed, office-induced hypertension is eliminated and AOBP exhibits a much stronger correlation with the awake ambulatory BP as compared with routine manual BP measurements. Unlike routine manual BP, AOBP correlates as well with left ventricular mass as does the awake ambulatory BP. AOBP also simplifies the definition of hypertension in that the cut point for a normal AOBP (< 135/85 mm Hg) is the same as for the awake ambulatory BP and home BP. This article summarizes the currently available evidence supporting the use of AOBP in routine clinical practice and proposes an algorithm in which AOBP replaces manual BP for the diagnosis and management of hypertension.

  20. Carotid Stenosis and Ocular Blood Pressure Modelling

    PubMed Central

    Jullian, M.; Kinsner, W.

    1984-01-01

    A model of the human carotid vascular system was developed to study the effects of carotid stenosis on ocular blood pressure and ocular pulse waveform. The model incorporates a non-linear element representing a stenosis. A state variable representation of a reduced model is used in a computer simulation. Results show that carotid stenosis as low as 20% are detectable in the ocular blood pressure waveform.

  1. The contribution of preintervention blood pressure, VO2max, BMI, autonomic function and gender to exercise-induced changes in heart rate variability.

    PubMed

    Grant, Catharina C; Janse van Rensburg, Dina C

    2013-06-01

    The quantification of heart rate variability (HRV) is a tool to assess the interaction between exercise and autonomic control, as well as the pathophysiology of diseases affecting autonomic function. Little is known about the influence of genetically influenced physiology on exercise-induced changes in autonomic cardiac regulation. It was theorised that preintervention values for blood pressure, VO2max, body mass index (BMI), autonomic function and gender contribute significantly to the exercise-induced changes in HRV. A 12-week, medium-to-high intensity exercise intervention was completed by 183 volunteers (18-22 years). Data were sampled at baseline and after 12 weeks. Standard time domain, frequency domain and Poincaré HRV quantification techniques were implemented. Regression analysis was performed to determine the influences of the predictors (baseline values for low frequency  (LF), high frequency (HF), BMI, VO2max, gender, blood pressure) on the exercise-induced response of the dependent variables (changes in HRV-indicator values). Parameters found to be significant (p<0.05) predictors of exercise-induced changes were LF, HF and systolic blood pressure in, respectively, 10, 5 and 2 of the 12 regressions performed. The results indicated that the independent variables contribute between 12.83% and 29.82%, depending on the specific HRV indicator, to the exercise-induced changes in the autonomic nervous system. Preintervention autonomic status, as represented specifically by LF, is the most important determinant of cardiac autonomic response to an exercise intervention in a healthy study population. Baseline autonomic function could thus be a significant confounder in the outcome of exercise study results.

  2. Instrumental variable methods to assess quality of care the marginal effects of process-of-care on blood pressure change and treatment costs.

    PubMed

    Kulchaitanaroaj, Puttarin; Carter, Barry L; Goedken, Amber M; Chrischilles, Elizabeth A; Brooks, John M

    2015-01-01

    Hypertension is poorly controlled. Team-based care and changes in the process of care have been proposed to address these quality problems. However, assessing care processes is difficult because they are often confounded even in randomized behavioral studies by unmeasured confounders based on discretion of health care providers. To evaluate the effects of process measures including number of counseling sessions about lifestyle modification and number of antihypertensive medications on blood pressure change and payer-perspective treatment costs. Data were obtained from two prospective, cluster randomized controlled clinical trials (Trial A and B) implementing physician-pharmacist collaborative interventions compared with usual care over six months in community-based medical offices in the Midwest. Multivariate linear regression models with both instrumental variable methods and as-treated methods were utilized. Instruments were indicators for trial and study arms. Models of blood pressure change and costs included both process measures, demographic variables, and clinical variables. The analysis included 496 subjects. As-treated methods showed no significant associations between process and outcomes. The instruments used in the study were insufficient to simultaneously identify distinct process effects. However, the post-hoc instrumental variable models including one process measure at a time while controlling for the other process demonstrated significant associations between the processes and outcomes with estimates considerably larger than as-treated estimates. Instrumental variable methods with combined randomized behavioral studies may be useful to evaluate the effects of different care processes. However, substantial distinct process variation across studies is needed to fully capitalize on this approach. Instrumental variable methods focusing on individual processes provided larger and stronger outcome relationships than those found using as-treated methods

  3. Low Blood Pressure (Hypotension)

    MedlinePlus

    ... if you stand up after lying down. Ordinarily, gravity causes blood to pool in your legs whenever ... eating. It affects mostly older adults. Just as gravity pulls blood to your feet when you stand, ...

  4. An adaptive technique for multiscale approximate entropy (MAEbin) threshold (r) selection: application to heart rate variability (HRV) and systolic blood pressure variability (SBPV) under postural stress.

    PubMed

    Singh, Amritpal; Saini, Barjinder Singh; Singh, Dilbag

    2016-06-01

    Multiscale approximate entropy (MAE) is used to quantify the complexity of a time series as a function of time scale τ. Approximate entropy (ApEn) tolerance threshold selection 'r' is based on either: (1) arbitrary selection in the recommended range (0.1-0.25) times standard deviation of time series (2) or finding maximum ApEn (ApEnmax) i.e., the point where self-matches start to prevail over other matches and choosing the corresponding 'r' (rmax) as threshold (3) or computing rchon by empirically finding the relation between rmax, SD1/SD2 ratio and N using curve fitting, where, SD1 and SD2 are short-term and long-term variability of a time series respectively. None of these methods is gold standard for selection of 'r'. In our previous study [1], an adaptive procedure for selection of 'r' is proposed for approximate entropy (ApEn). In this paper, this is extended to multiple time scales using MAEbin and multiscale cross-MAEbin (XMAEbin). We applied this to simulations i.e. 50 realizations (n = 50) of random number series, fractional Brownian motion (fBm) and MIX (P) [1] series of data length of N = 300 and short term recordings of HRV and SBPV performed under postural stress from supine to standing. MAEbin and XMAEbin analysis was performed on laboratory recorded data of 50 healthy young subjects experiencing postural stress from supine to upright. The study showed that (i) ApEnbin of HRV is more than SBPV in supine position but is lower than SBPV in upright position (ii) ApEnbin of HRV decreases from supine i.e. 1.7324 ± 0.112 (mean ± SD) to upright 1.4916 ± 0.108 due to vagal inhibition (iii) ApEnbin of SBPV increases from supine i.e. 1.5535 ± 0.098 to upright i.e. 1.6241 ± 0.101 due sympathetic activation (iv) individual and cross complexities of RRi and systolic blood pressure (SBP) series depend on time scale under consideration (v) XMAEbin calculated using ApEnmax is correlated with cross-MAE calculated using ApEn (0.1-0.26) in steps of 0

  5. [Ambulatory measurement of blood pressure].

    PubMed

    Mallion, J M; Tremel, F; Siché, J P; Azzouzi, L; Baguet, J P

    1995-12-09

    The advent of new techniques has greatly contributed to the development of ambulatory measurement as a noninvasive method for evaluating blood pressure. The technique implies use of a validated and reliable standardized apparatus. The operator must strictly comply with operating procedures, which must also be explained to the patient. Ambulatory measurement can be meaningful only if the results are compatible with reference values, which have now been established, and if the causes of possible error can be recognized and interpreted. Ambulatory blood pressure measurement has greatly improved our knowledge of physiological and pathological variations over the circadian cycle including day/night variability and the effects of psychosensorial stimulation. Diagnostic indications are clearly identified and include borderline hypertension suspected but not identified after about 3 months, the white coat effect, severe hypertension when modifications in the circadian cycle are suspected, paroxysmal hypertension, suspected pheochromocytoma, and gravid hypertension or an inversion of the circadian cycle possibly preceding an episode of eclampsia. There are also a certain number of particular indications in patients with degenerative or primary conditions affecting their autonomy. The true prognostic value of these recordings was recognized several years ago and has been confirmed by clinical trials. For example, the white blouse effect has no significant implication in terms or predicting less favourable morbidity or mortality. Finally, ambulatory blood pressure measurement has been definitively shown to be a valid method for evaluating the therapeutic effect of an anti-hypertensive drug in a given patient, especially when resting levels are questioned. For therapeutic trials, ambulatory measurements serve as a reference to evaluate the effect of treatment on the circadian cycle. Peak/dip levels can thus be determined in comparison with the residual effect of the drug. A

  6. Visit-to-Visit Blood Pressure Variability and Arterial Stiffness Independently Predict Cardiovascular Risk Category in a General Population: Results from the SEPHAR II Study.

    PubMed

    Darabont, Roxana; Tautu, Oana-Florentina; Pop, Dana; Fruntelata, Ana; Deaconu, Alexandru; Onciul, Sebastian; Salaru, Delia; Micoara, Adolf; Dorobantu, Maria

    2015-01-01

    The aim of our study was to evaluate visit-to-visit blood pressure variability (BPV) and the association of this parameter with cardiovascular risk determinants, according to the SEPHAR II survey. Following a selection based on the multi-stratified proportional sampling procedure, a total of 1975 subjects who gave informed consent were evaluated by means of a questionnaire, anthropometric, blood pressure (BP) and arterial stiffness measurements (pulse wave velocity and augmentation index), 12-lead ECG recordings, and blood and urine analysis. BPV was quantified in terms of the standard deviation (SD) of the mean systolic blood pressure (SBP) and high BPV was defined as SBP-SD above the 4th quartile. Total cardiovascular risk was assessed by the 2013 ESH/ESC risk stratification chart. Mean BP was 132.37/82.01 mmHg. Mean systolic BPV was 6.16 mmHg, with 24.62% of values above the 75th percentile (8.48 mmHg). Factors found to be associated with high systolic BPV were age, SBP, pulse pressure, total and LDL-cholesterol, triglycerides, visceral obesity, diabetes mellitus, metabolic syndrome and increased aortic stiffness. In addition, in the hypertensive group high BPV was associated with the severity of hypertension and a lack of treatment control. Both visit-to-visit systolic BPV and aortic stiffness proved to be positively and independently correlated with the risk category. Based on these parameters it was possible to predict with 72.6% accuracy the probability of finding subjects in a high and very high cardiovascular risk category. The results of our study indicate a notable prevalence of high BPV, affecting almost a quarter of the Romanian adult population. Visit-to-visit systolic BPV and arterial stiffness are strongly correlated and together might contribute to the improvement of cardiovascular risk prediction models.

  7. Diabetes and blood pressure (image)

    MedlinePlus

    People with diabetes have a higher risk for heart attacks and strokes. Your doctor or nurse should check your blood pressure ... People with diabetes have a higher risk for heart attacks and strokes. Your doctor or nurse should check your blood pressure ...

  8. Stroke and High Blood Pressure

    MedlinePlus

    ... Disease Venous Thromboembolism Aortic Aneurysm More How High Blood Pressure Can Lead to Stroke Updated:May 3,2017 ... This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  9. Drinking pattern and blood pressure.

    PubMed

    Seppä, K; Laippala, P; Sillanaukee, P

    1994-03-01

    Large amounts of alcohol are known to increase blood pressure. There is little evidence about the effect of binge drinking of alcohol on blood pressure, although this is the dominant style of alcohol drinking in several countries. The purpose of the present study was to examine the relationship between binge drinking and blood pressure using daily heavy drinkers as a reference group. We examined 260 consecutive nonalcoholic 40- and 45-year-old men participating in a health screening. There were 37 teetotalers, 147 social drinkers, 62 weekend heavy drinkers attending the health screening 2 to 7 days after binge drinking, and 14 men who drank heavily every day. Group division was made using self-reported alcohol consumption and a structured alcohol questionnaire. Blood pressure was measured manually by a mercury manometer. BMDP statistical software was used in the statistical analysis of the material. The diastolic blood pressure of weekend heavy drinkers (mean intake during the weekend, 289 g) did not differ from that found in teetotalers but systolic blood pressure was slightly higher (5 mm Hg, P = .04). In contrast, daily heavy drinkers (mean intake during the weekend [Friday to Saturday], 151 g) had significantly higher systolic (8 mm Hg, P = .04) and diastolic (6 mm Hg, P = .05) blood pressure values than teetotalers. We conclude that different drinking habits seem to have different effects on blood pressure, those of daily heavy drinking being more prominent than those of weekend heavy drinking.

  10. Managing High Blood Pressure Medications

    MedlinePlus

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Managing High Blood Pressure Medications Updated:Jan 3,2017 When your doctor ... health. This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  11. High Blood Pressure and Women

    MedlinePlus

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More High Blood Pressure and Women Updated:Dec 14,2016 Pregnancy and ... Women . This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  12. High Blood Pressure Increasing Worldwide

    MedlinePlus

    ... other ways to control blood pressure, including healthy lifestyle choices and maintaining a normal weight, Roth said. Murray said some of the factors responsible for the worldwide increase in high blood pressure are unhealthy diets and obesity. In addition, in developing countries, more people are ...

  13. Serotonin and Blood Pressure Regulation

    PubMed Central

    Morrison, Shaun F.; Davis, Robert Patrick; Barman, Susan M.

    2012-01-01

    5-Hydroxytryptamine (5-HT; serotonin) was discovered more than 60 years ago as a substance isolated from blood. The neural effects of 5-HT have been well investigated and understood, thanks in part to the pharmacological tools available to dissect the serotonergic system and the development of the frequently prescribed selective serotonin-reuptake inhibitors. By contrast, our understanding of the role of 5-HT in the control and modification of blood pressure pales in comparison. Here we focus on the role of 5-HT in systemic blood pressure control. This review provides an in-depth study of the function and pharmacology of 5-HT in those tissues that can modify blood pressure (blood, vasculature, heart, adrenal gland, kidney, brain), with a focus on the autonomic nervous system that includes mechanisms of action and pharmacology of 5-HT within each system. We compare the change in blood pressure produced in different species by short- and long-term administration of 5-HT or selective serotonin receptor agonists. To further our understanding of the mechanisms through which 5-HT modifies blood pressure, we also describe the blood pressure effects of commonly used drugs that modify the actions of 5-HT. The pharmacology and physiological actions of 5-HT in modifying blood pressure are important, given its involvement in circulatory shock, orthostatic hypotension, serotonin syndrome and hypertension. PMID:22407614

  14. Multiscale Joint Symbolic Transfer Entropy for Quantification of Causal Interactions Between Heart Rate and Blood Pressure Variability Under Postural Stress

    NASA Astrophysics Data System (ADS)

    Singh, A.; Saini, B. S.; Singh, D.

    2015-06-01

    In this paper, joint symbolic transfer entropy (JSTE) is explored to quantify causal interactions between systolic blood pressure (SBP) and RR intervals (peak-to-peak distance between consecutive R-peaks) at multiple time scales. SBP→RR coupling (Cs-r) and RR→SBP coupling (Cr-s) coupling is analyzed at multiple time scales and delays. The ability of the approach based on JSTE to detect SBP-RR causal coupling is tested on 42 healthy subjects in supine and upright position along with 21 subjects of EUROBAVAR dataset. In addition, lack of causal coupling from SBP to RR was assessed on 20 post-acute myocardial infarction (AMI) patients. Results demonstrate that (i) standard deviation (SD) of RR interval series and SBP series decreases with time scale τ = 1 to 10 for all types of subjects. (ii) SD in supine is more than that of upright position at each time scale irrespective of types of subjects. (iii) JSTE decreases with time delay for healthy and AMI patients but does not follow decreasing trend for baroflex sensitivity BRS failure patients. (iv) JSTE in supine position is more than that of upright position irrespective of time delay. (v) JSTE decreases with time scale for healthy and AMI patients but does not follow decreasing trend for BRS failure patients. (vi) JSTE in supine position is more than that of upright position only at finer scales. (vii) Enhanced feed-forward (FF) coupling and suppressed feedback (FB) coupling found at supine position within low frequency band (0.04-0.15 Hz) as well as high frequency band (0.151-0.4 Hz) indicated prevalence on non-baroreflex mechanisms. (viii) FB coupling recovered in the upright position which was stronger than FF coupling. Upon comparison with cross conditional entropy (CCE), it is found that JSTE provides more significant differences between supine and upright position.

  15. Heart Rate and Systolic Blood Pressure Variability in the Time Domain in Patients with Recent and Long-Standing Diabetes Mellitus

    PubMed Central

    Rivera, Ana Leonor; Estañol, Bruno; Sentíes-Madrid, Horacio; Fossion, Ruben; Toledo-Roy, Juan C.; Mendoza-Temis, Joel; Morales, Irving O.; Landa, Emmanuel; Robles-Cabrera, Adriana; Moreno, Rene; Frank, Alejandro

    2016-01-01

    Diabetes Mellitus (DM) affects the cardiovascular response of patients. To study this effect, interbeat intervals (IBI) and beat-to-beat systolic blood pressure (SBP) variability of patients during supine, standing and controlled breathing tests were analyzed in the time domain. Simultaneous noninvasive measurements of IBI and SBP for 30 recently diagnosed and 15 long-standing DM patients were compared with the results for 30 rigorously screened healthy subjects (control). A statistically significant distinction between control and diabetic subjects was provided by the standard deviation and the higher moments of the distributions (skewness, and kurtosis) with respect to the median. To compare IBI and SBP for different populations, we define a parameter, α, that combines the variability of the heart rate and the blood pressure, as the ratio of the radius of the moments for IBI and the same radius for SBP. As diabetes evolves, α decreases, standard deviation of the IBI detrended signal diminishes (heart rate signal becomes more “rigid”), skewness with respect to the median approaches zero (signal fluctuations gain symmetry), and kurtosis increases (fluctuations concentrate around the median). Diabetes produces not only a rigid heart rate, but also increases symmetry and has leptokurtic distributions. SBP time series exhibit the most variable behavior for recently diagnosed DM with platykurtic distributions. Under controlled breathing, SBP has symmetric distributions for DM patients, while control subjects have non-zero skewness. This may be due to a progressive decrease of parasympathetic and sympathetic activity to the heart and blood vessels as diabetes evolves. PMID:26849653

  16. Accurate, reproducible measurement of blood pressure.

    PubMed Central

    Campbell, N R; Chockalingam, A; Fodor, J G; McKay, D W

    1990-01-01

    The diagnosis of mild hypertension and the treatment of hypertension require accurate measurement of blood pressure. Blood pressure readings are altered by various factors that influence the patient, the techniques used and the accuracy of the sphygmomanometer. The variability of readings can be reduced if informed patients prepare in advance by emptying their bladder and bowel, by avoiding over-the-counter vasoactive drugs the day of measurement and by avoiding exposure to cold, caffeine consumption, smoking and physical exertion within half an hour before measurement. The use of standardized techniques to measure blood pressure will help to avoid large systematic errors. Poor technique can account for differences in readings of more than 15 mm Hg and ultimately misdiagnosis. Most of the recommended procedures are simple and, when routinely incorporated into clinical practice, require little additional time. The equipment must be appropriate and in good condition. Physicians should have a suitable selection of cuff sizes readily available; the use of the correct cuff size is essential to minimize systematic errors in blood pressure measurement. Semiannual calibration of aneroid sphygmomanometers and annual inspection of mercury sphygmomanometers and blood pressure cuffs are recommended. We review the methods recommended for measuring blood pressure and discuss the factors known to produce large differences in blood pressure readings. PMID:2192791

  17. Buccal telomere length and its associations with cortisol, heart rate variability, heart rate, and blood pressure responses to an acute social evaluative stressor in college students.

    PubMed

    Woody, Alex; Hamilton, Katrina; Livitz, Irina E; Figueroa, Wilson S; Zoccola, Peggy M

    2017-05-01

    Understanding the relationship between stress and telomere length (a marker of cellular aging) is of great interest for reducing aging-related disease and death. One important aspect of acute stress exposure that may underlie detrimental effects on health is physiological reactivity to the stressor. This study tested the relationship between buccal telomere length and physiological reactivity (salivary cortisol reactivity and total output, heart rate (HR) variability, blood pressure, and HR) to an acute psychosocial stressor in a sample of 77 (53% male) healthy young adults. Consistent with predictions, greater reductions in HR variability (HRV) in response to a stressor and greater cortisol output during the study session were associated with shorter relative buccal telomere length (i.e. greater cellular aging). However, the relationship between cortisol output and buccal telomere length became non-significant when adjusting for medication use. Contrary to past findings and study hypotheses, associations between cortisol, blood pressure, and HR reactivity and relative buccal telomere length were not significant. Overall, these findings may indicate there are limited and mixed associations between stress reactivity and telomere length across physiological systems.

  18. High blood pressure in women.

    PubMed

    Calhoun, D A; Oparil, S

    1997-01-01

    There is a sexual dimorphism in blood pressure of humans and experimental animals: males tend to have higher blood pressure than females with functional ovaries, while ovariectomy or menopause tends to abolish the sexual dimorphism and cause females to develop a "male" pattern of blood pressure. Hypertensive male laboratory animals tend to have NaCl-sensitive blood pressure, while females are NaCl resistant unless their ovaries are removed, in which case NaCl sensitivity appears. The hormonal basis of NaCl sensitivity of blood pressure and of the sexual dimorphism of hypertension remains to be defined. Synthetic estrogens and progestins, as found in oral contraceptives, tend to elevate blood pressure, while naturally occurring estrogens lower it, or have no effect. Hypertension increases cardiovascular risk in women, as well as men, although the benefits of antihypertensive treatment have been more difficult to demonstrate in women. In the population of the United States, women are more aware of their hypertension, more likely to be treated medically, and more likely to have their blood pressure controlled.

  19. Beat-to-beat, ambulatory hour-to-hour, and home day-to-day variabilities in blood pressure, pulse pressure, and heart rate in comparison with each other and with target-organ damage.

    PubMed

    Johansson, Jouni K; Puukka, Pauli J; Virtanen, Raine; Jula, Antti M

    2015-06-01

    The objective was to compare beat-to-beat, ambulatory hour-to-hour, and home day-to-day variability in blood pressure (BP), pulse pressure (PP), and heart rate (HR) with each other and with target-organ damage. We studied a population-based sample of Finnish adults including 150 healthy participants aged between 35 and 64 years. Variability in BP and HR was assessed using self-measured morning and evening recordings from seven consecutive days and 24-h ambulatory recordings. Frequency domain measures of beat-to-beat BP variability and baroreflex sensitivity were determined from 5-min time series. The study participants underwent clinical examination, a clinical interview, measurement of urine albumin levels, and echocardiographic examination. Home BP/PP variability parameters and low frequency (LF) power of beat-to-beat BP/PP variability were mainly associated with left ventricular mass index (LVMI) in models adjusted for age, sex, and BP/PP level. The associations of LVMI with PP variability parameters were stronger than the corresponding associations with BP parameters. The associations of PP variability parameters with LVMI were stronger in old than in young individuals. Home BP/PP variability parameters were mainly associated with the LF power of beat-to-beat BP/PP variability in models adjusted for age, sex, and beat-to-beat BP/PP level and the associations were stronger in old than in young individuals. Home HR variability parameters and 24-h hour-to-hour HR variability were mainly associated with LF/high-frequency powers of beat-to-beat HR variability. Reading-to-reading BP/PP variability parameters and their corresponding beat-to-beat variability parameters are partially connected, possibly to common regulatory mechanisms. Their prognostic significance in relation to cardiovascular outcome needs further investigation.

  20. Dietary fiber and blood pressure control.

    PubMed

    Aleixandre, A; Miguel, M

    2016-04-01

    In the past few years, new strategies to control blood pressure levels are emerging by developing new bioactive components of foods. Fiber has been linked to the prevention of a number of cardiovascular diseases and disorders. β-Glucan, the main soluble fiber component in oat grains, was initially linked to a reduction in plasma cholesterol. Several studies have shown afterward that dietary fiber may also improve glycaemia, insulin resistance and weight loss. The effect of dietary fiber on arterial blood pressure has been the subject of far fewer studies than its effect on the above-mentioned variables, but research has already shown that fiber intake can decrease arterial blood pressure in hypertensive rats. Moreover, certain fibers can improve arterial blood pressure when administered to hypertensive and pre-hypertensive subjects. The present review summarizes all those studies which attempt to establish the antihypertensive effects of dietary fiber, as well as its effect on other cardiovascular risk factors.

  1. Birth weight and childhood blood pressure.

    PubMed

    Edvardsson, Vidar O; Steinthorsdottir, Sandra D; Eliasdottir, Sigridur B; Indridason, Olafur S; Palsson, Runolfur

    2012-12-01

    A large body of literature suggests an inverse relationship between birth weight and blood pressure in children, adolescents and adults. The most persistent findings have been observed in children with a history of low birth weight or intrauterine growth restriction, while a large number of studies carried out in populations with normally distributed birth weight have shown conflicting results. A recently reported strong direct association between high birth weight and blood pressure, and the significant positive effect of postnatal growth on blood pressure suggests that the fetal origins of adult disease hypothesis should be expanded to include the role of excessive fetal and postnatal growth. In this paper, we review recent studies on the relationship between birth weight and blood pressure in childhood, with a focus on confounding variables that may explain the conflicting results of published work in this field.

  2. Aortic arch atherosclerosis in patients with severe aortic stenosis can be argued by greater day-by-day blood pressure variability.

    PubMed

    Iwata, Shinichi; Sugioka, Kenichi; Fujita, Suwako; Ito, Asahiro; Matsumura, Yoshiki; Hanatani, Akihisa; Takagi, Masahiko; Di Tullio, Marco R; Homma, Shunichi; Yoshiyama, Minoru

    2015-07-01

    Although it is well known that the prevalence of aortic arch plaques, one of the risk factors for ischemic stroke, is high in patients with severe aortic stenosis, the underlying mechanisms are not well understood. Increased day-by-day blood pressure (BP) variability is also known to be associated with stroke; however, little is known on the association between day-by-bay BP variability and aortic arch atherosclerosis in patients with aortic stenosis. Our objective was to clarify the association between day-by-day BP variables (average values and variability) and aortic arch atherosclerosis in patients with severe aortic stenosis. The study population consisted of 104 consecutive patients (mean age 75 ± 8 years) with severe aortic stenosis who were scheduled for aortic valve replacement. BP was measured in the morning in at least 4 consecutive days (mean 6.8 days) prior to the day of surgery. Large (≥4 mm), ulcerated, or mobile plaques were defined as complex plaques using transesophageal echocardiography. Cigarette smoking and all systolic BP variables were associated with the presence of complex plaques (p < 0.05), whereas diastolic BP variables were not. Multiple regression analysis indicated that day-by-day mean systolic BP and day-by-day systolic BP variability remained independently associated with the presence of complex plaques (p < 0.05) after adjustment for age, male sex, cigarette smoking, hypertension, hypercholesterolemia, and diabetes mellitus. These findings suggest that higher day-by-day mean systolic BP and day-by-day systolic BP variability are associated with complex plaques in the aortic arch and consequently stroke risk in patients with aortic stenosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Sex differences in alpha-adrenergic support of blood pressure.

    PubMed

    Schmitt, Judith A M; Joyner, Michael J; Charkoudian, Nisha; Wallin, B Gunnar; Hart, Emma C

    2010-08-01

    We tested whether the inter-individual variability in alpha-adrenergic support of blood pressure plays a critical role in the sex differences in tonic support of blood pressure by the autonomic nervous system. Blockade of the alpha-adrenergic receptors was achieved via phentolamine and showed a smaller (P < 0.05) decrease in blood pressure in women compared to men, implying that alpha-adrenergic support of blood pressure is less in women than in men.

  4. High Blood Pressure and Pregnancy

    MedlinePlus

    ... damage. Some women with gestational hypertension eventually develop preeclampsia. Chronic hypertension. Chronic hypertension is high blood pressure ... determine when it began. Chronic hypertension with superimposed preeclampsia. This condition occurs in women with chronic hypertension ...

  5. Medications for High Blood Pressure

    MedlinePlus

    ... Products For Consumers Home For Consumers Consumer Updates Medications for High Blood Pressure Share Tweet Linkedin Pin ... all their lives. back to top Types of Medications FDA has approved many medications to treat high ...

  6. Indirect Blood Pressure Measuring Device

    NASA Technical Reports Server (NTRS)

    Hum, L.; Cole, C. E.

    1973-01-01

    Design and performance of a blood pressure recording device for pediatric use are reported. A strain gage transducer with a copper-beryllium strip as force sensing element is used to monitor skin movements and to convert them into electrical signals proportional to those displacements. Experimental tests with this device in recording of force developed above the left femoral artery of a dog accurately produced a blood pressure curve.

  7. Indirect Blood Pressure Measuring Device

    NASA Technical Reports Server (NTRS)

    Hum, L.; Cole, C. E.

    1973-01-01

    Design and performance of a blood pressure recording device for pediatric use are reported. A strain gage transducer with a copper-beryllium strip as force sensing element is used to monitor skin movements and to convert them into electrical signals proportional to those displacements. Experimental tests with this device in recording of force developed above the left femoral artery of a dog accurately produced a blood pressure curve.

  8. Long-term and ultra long-term blood pressure variability during follow-up and mortality in 14,522 patients with hypertension.

    PubMed

    Hastie, Claire E; Jeemon, Panniyammakal; Coleman, Holli; McCallum, Linsay; Patel, Rajan; Dawson, Jesse; Sloan, William; Meredith, Peter; Jones, Gregory C; Muir, Scott; Walters, Matthew; Dominiczak, Anna F; Morrison, David; McInnes, Gordon T; Padmanabhan, Sandosh

    2013-10-01

    Recent evidence indicates that long-term visit-to-visit blood pressure variability (BPV) may be an independent cardiovascular risk predictor. The implication of this variability in hypertension clinical practice is unclear. BPV as average real variability (ARV) was calculated in 14,522 treated patients with hypertension in 4 time frames: year 1 (Y1), years 2 to 5 (Y2-5), years 5 to 10 (Y5-10), and years >10 (Y10+) from first clinic visit. Cox proportional hazards models for cause-specific mortality were used in each time frame separately for long-term BPV, across time frames based on ultra long-term BPV, and within each time frame stratified by mean BP. ARV in systolic blood pressure (SBP), termed ARV(SBP), was higher in Y1 (21.3±11.9 mm Hg) in contrast to Y2-5 (17.7±9.9 mm Hg), Y5-10 (17.4±9.6 mm Hg), and Y10+ (16.8±8.5 mm Hg). In all time frames, ARV(SBP) was higher in women (P<0.01) and in older age (P<0.001), chronic kidney disease (P<0.01), and prevalent cardiovascular disease (P<0.01). Higher long-term and ultra long-term BPV values were associated with increased mortality (all-cause, cardiovascular, and noncardiovascular mortality; P for trend, <0.001). This relationship was also evident in subgroups with mean SBP<140 mm Hg in all time frames. Monitoring BPV in clinical practice may facilitate risk reduction strategies by identifying treated hypertensive individuals at high risk, especially those with BP within the normal range.

  9. Nutritional effects on blood pressure.

    PubMed

    Myers, Valerie H; Champagne, Catherine M

    2007-02-01

    There has not been a thorough recent evaluation of the nutritional effects on blood pressure. Apart from outstanding clinical trials like Dietary Approaches to Stop Hypertension, there have been controversial papers on a number of factors influencing blood pressure. This paper is a systematic review of the current literature as it relates to hypertension. Results from many meta-analyses and well controlled clinical trials on the effects of a variety of nutritional factors are presented in this review. Evidence suggests that dietary sodium intake needs reduction. There is a seemingly inverse relationship between protein intake and blood pressure, but data are inconclusive. High monounsaturated fat and fish oil appear to be beneficial. Several studies on dietary fiber indicate that the strongest evidence for blood pressure lowering effects is in hypertensive as opposed to normotensive participants. Vegetarians seem to have lower levels of hypertension and cardiovascular disease risk. Low carbohydrate diets show short-term beneficial effects but are not sustained. High levels of potassium, magnesium, calcium and soy seem to have some benefit, but results remain inconclusive. Weight reduction positively impacts blood pressure. More compelling research defining specific factors is needed to inform the public as to steps needed to reduce blood pressure and improve cardiovascular risk.

  10. Visit-to-Visit Blood Pressure Variability Is a Novel Risk Factor for the Development and Progression of Diabetic Nephropathy in Patients With Type 2 Diabetes

    PubMed Central

    Okada, Hiroshi; Fukui, Michiaki; Tanaka, Muhei; Matsumoto, Shinobu; Mineoka, Yusuke; Nakanishi, Naoko; Asano, Mai; Yamazaki, Masahiro; Hasegawa, Goji; Nakamura, Naoto

    2013-01-01

    OBJECTIVE Recent study has suggested that not only the presence of hypertension but also the variability in systolic blood pressure (SBP) are risk factors for vascular disease and organ damage. The aim of this study was to investigate the relationship between visit-to-visit variability in SBP and change in urinary albumin excretion (UAE) or development of albuminuria in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS We measured SBP in 354 consecutive patients at every visit during 1 year and calculated the coefficient of variation (CV) of SBP. We performed a follow-up study to assess change in UAE or development of albuminuria, the mean interval of which was 3.76 ± 0.71 years. Then, we evaluated relationships of variability of SBP to diabetic nephropathy using multiple regression analysis and multiple Cox regression model. RESULTS Multiple regression analysis demonstrated that CV of SBP was independently associated with change in UAE (β = 0.1758; P = 0.0108). Adjusted Cox regression analyses demonstrated that CV of SBP was associated with an increased hazard of development of albuminuria; hazard ratio was 1.143 (95% CI 1.008–1.302). CONCLUSIONS Visit-to-visit variability in SBP could be a novel risk factor for the development and progression of diabetic nephropathy in patients with type 2 diabetes. PMID:23340892

  11. Long-Term Visit-to-Visit Blood Pressure Variability and Renal Function Decline in Patients With Hypertension Over 15 Years.

    PubMed

    Chia, Yook Chin; Lim, Hooi Min; Ching, Siew Mooi

    2016-11-07

    Visit-to-visit variability of systolic blood pressure (SBP) has been shown to contribute to cardiovascular events and all-cause mortality. However, little is known about its long-term effect on renal function. We aim to examine the relationship between visit-to-visit blood pressure variability (BPV) and decline in renal function in patients with hypertension and to determine the level of systolic BPV that is associated with significant renal function decline. This is a 15-year retrospective cohort study of 825 hypertensive patients. Blood pressure readings every 3 months were retrieved from the 15 years of clinic visits. We used SD and coefficient of variation as a measure of systolic BPV. Serum creatinine was captured and estimated glomerular filtration rate was calculated at baseline, 5, 10, and 15 years. The mean SD of SBP was 14.2±3.1 mm Hg and coefficient of variation of SBP was 10.2±2%. Mean for estimated glomerular filtration rate slope was -1.0±1.5 mL/min per 1.73 m(2) per year. There was a significant relationship between BPV and slope of estimated glomerular filtration rate (SD: r=-0.16, P<0.001; coefficient of variation: r=-0.14, P<0.001, Pearson's correlation). BPV of SBP for each individual was significantly associated with slope of estimated glomerular filtration rate after adjustment for mean SBP and other confounders. The cutoff values estimated by the receiver operating characteristic curve for the onset of chronic kidney disease for SD of SBP was 13.5 mm Hg and coefficient of variation of SBP was 9.74%. Long-term visit-to-visit variability of SBP is an independent determinant of renal deterioration in patients with hypertension. Hence, every effort should be made to reduce BPV in order to slow down the decline of renal function. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  12. Short-term effects of espresso coffee on heart rate variability and blood pressure in habitual and non-habitual coffee consumers--a randomized crossover study.

    PubMed

    Zimmermann-Viehoff, Frank; Thayer, Julian; Koenig, Julian; Herrmann, Christian; Weber, Cora S; Deter, Hans-Christian

    2016-05-01

    Coffee is one of the most widely consumed beverages worldwide. Aim of this study was to investigate short-term effects of espresso coffee on heart rate variability (HRV), a marker of vagal activity, in healthy habitual and non-habitual coffee consumers. Seventy-seven healthy subjects (38 habitual and 39 non-habitual coffee consumers, 74% women, mean age 26.97 ± 6.88 years) took part in three laboratory sessions in a randomized order. In condition 1, subjects consumed espresso; in condition 2, subjects consumed decaffeinated espresso; and in condition 3, subjects consumed warm water. HRV and blood pressure were assessed at rest before and after ingestion of the respective beverage. HRV was significantly increased after consumption of caffeinated espresso, decaffeinated espresso, or water, indicating increased vagal activity in the course of the experiments. In the habitual coffee consumers, the increase in vagally mediated HRV was significantly lower after consumption of decaffeinated espresso compared to caffeinated espresso. Increases of systolic blood pressure were only found in the non-habitual consumers. We found no evidence for specific short-term effects of caffeinated espresso on vagal activity in healthy subjects. Instead, consumption of decaffeinated espresso inhibited vagal activity in habitual consumers. This may be explained by an attempt of the organism to establish a sympathovagal equilibrium comparable to that after caffeine consumption. In the absence of caffeine-induced sympathetic activation, this may have been achieved by relative vagal withdrawal.

  13. Anxiety: A Cause of High Blood Pressure?

    MedlinePlus

    ... Conditions High blood pressure (hypertension) Can anxiety cause high blood pressure? Answers from Sheldon G. Sheps, M.D. Anxiety doesn't cause long-term high blood pressure (hypertension). But episodes of anxiety can cause dramatic, ...

  14. High Blood Pressure: Medicines to Help You

    MedlinePlus

    ... For Consumers Consumer Information by Audience For Women High Blood Pressure--Medicines to Help You Share Tweet Linkedin Pin ... Click here for the Color Version (PDF 533KB) High blood pressure is a serious illness. High blood pressure is ...

  15. Wrist Blood Pressure Monitors: Are They Accurate?

    MedlinePlus

    ... be at heart level. Even then, blood pressure measurements taken at the wrist are usually higher and ... a very large arm or find blood pressure measurements painful. In these cases, measuring blood pressure at ...

  16. Night time blood pressure dip

    PubMed Central

    Bloomfield, Dennis; Park, Alex

    2015-01-01

    The advent of ambulatory blood pressure monitoring permitted examination of blood pressures during sleep and recognition of the associated circadian fall in pressure during this period. The fall in pressure, called the “dip”, is defined as the difference between daytime mean systolic pressure and nighttime mean systolic pressure expressed as a percentage of the day value. Ten percent to 20% is considered normal. Dips less than 10%, referred to as blunted or absent, have been considered as predicting an adverse cardiovascular event. This view and the broader concept that white coat hypertension itself is a forerunner of essential hypertension is disputable. This editorial questions whether mean arterial pressures over many hours accurately represent the systolic load, whether nighttime dipping varies from measure to measure or is a fixed phenomenon, whether the abrupt morning pressure rise is a risk factor or whether none of these issues are as important as the actual night time systolic blood pressure itself. The paper discusses the difference between medicated and nonmedicated white coat hypertensives in regard to the cardiovascular risk and suggests that further work is necessary to consider whether the quality and duration of sleep are important factors. PMID:26225196

  17. Night time blood pressure dip.

    PubMed

    Bloomfield, Dennis; Park, Alex

    2015-07-26

    The advent of ambulatory blood pressure monitoring permitted examination of blood pressures during sleep and recognition of the associated circadian fall in pressure during this period. The fall in pressure, called the "dip", is defined as the difference between daytime mean systolic pressure and nighttime mean systolic pressure expressed as a percentage of the day value. Ten percent to 20% is considered normal. Dips less than 10%, referred to as blunted or absent, have been considered as predicting an adverse cardiovascular event. This view and the broader concept that white coat hypertension itself is a forerunner of essential hypertension is disputable. This editorial questions whether mean arterial pressures over many hours accurately represent the systolic load, whether nighttime dipping varies from measure to measure or is a fixed phenomenon, whether the abrupt morning pressure rise is a risk factor or whether none of these issues are as important as the actual night time systolic blood pressure itself. The paper discusses the difference between medicated and nonmedicated white coat hypertensives in regard to the cardiovascular risk and suggests that further work is necessary to consider whether the quality and duration of sleep are important factors.

  18. Vegetarian diet and blood pressure.

    PubMed

    Beilin, L J; Armstrong, B K; Margetts, B M; Rouse, I L; Vandongen, R

    1987-01-01

    There is now convincing evidence from epidemiological studies and randomized controlled trials that adoption of an ovo-lacto vegetarian diet leads to blood pressure reduction in both normotensive and hypertensive subjects. This effect appears to be independent of both dietary sodium and weight loss but additive to effects of weight reduction. Long-term adherence to a vegetarian diet is associated with less of a rise of blood pressure with age and a decreased prevalence of hypertension. The nutrients responsible for these effects have not been clearly identified and the mechanisms involved are unknown. Resolution of these questions is needed to enable more widespread adoption of dietary changes which may reduce the prevalence of hypertension, reduce antihypertensive drug dependence and by effects on blood pressure and blood lipids ameliorate the natural history of hypertensive cardiovascular disease.

  19. Blood pressure variability on antihypertensive therapy in acute intracerebral hemorrhage: the Stroke Acute Management with Urgent Risk-factor Assessment and Improvement-intracerebral hemorrhage study.

    PubMed

    Tanaka, Eijirou; Koga, Masatoshi; Kobayashi, Junpei; Kario, Kazuomi; Kamiyama, Kenji; Furui, Eisuke; Shiokawa, Yoshiaki; Hasegawa, Yasuhiro; Okuda, Satoshi; Todo, Kenichi; Kimura, Kazumi; Okada, Yasushi; Okata, Takuya; Arihiro, Shoji; Sato, Shoichiro; Yamagami, Hiroshi; Nagatsuka, Kazuyuki; Minematsu, Kazuo; Toyoda, Kazunori

    2014-08-01

    The associations between early blood pressure (BP) variability and clinical outcomes in patients with intracerebral hemorrhage after antihypertensive therapy, recently clarified by a post hoc analysis of Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial 2 (INTERACT2), were confirmed using the Stroke Acute Management with Urgent Risk-factor Assessment and Improvement (SAMURAI)-intracerebral hemorrhage study cohort. Patients with hyperacute (<3 hours from onset) intracerebral hemorrhage with initial systolic BP (SBP) >180 mm Hg were registered in a prospective, multicenter, observational study. All patients received antihypertensive therapy based on a predefined standardized protocol to lower and maintain SBP between 120 and 160 mm Hg using intravenous nicardipine. BPs were measured hourly during the initial 24 hours. BP variability was determined as SD and successive variation. The associations between BP variability and hematoma expansion (>33%), neurological deterioration within 72 hours, and unfavorable outcome (modified Rankin Scale, 4-6) at 3 months were assessed. Of the 205 patients, 33 (16%) showed hematoma expansion, 14 (7%) showed neurological deterioration, and 81 (39%) had unfavorable outcomes. The SD and successive variation of SBP were 13.8 (interquartile range, 11.5-16.8) and 14.9 (11.7-17.7) mm Hg, respectively, and those of diastolic BP were 9.4 (7.5-11.2) and 13.1 (11.2-15.9) mm Hg, respectively. On multivariate regression analyses, neurological deterioration was associated with the SD of SBP (odds ratio, 2.75; 95% confidence interval, 1.45-6.12 per quartile) and the successive variation of SBP (2.37; 1.32-4.83), and unfavorable outcome was associated with successive variation of SBP (1.42; 1.04-1.97). Hematoma expansion was not associated with any BP variability. SBP variability during the initial 24 hours of acute intracerebral hemorrhage was independently associated with neurological deterioration and unfavorable outcomes

  20. Implanted Blood-Pressure-Measuring Device

    NASA Technical Reports Server (NTRS)

    Fischell, Robert E.

    1988-01-01

    Arterial pressure compared with ambient bodily-fluid pressure. Implanted apparatus, capable of measuring blood pressure of patient, includes differential-pressure transducer connected to pressure sensor positioned in major artery. Electrical signal is function of differential pressure between blood-pressure sensor and reference-pressure sensor transmitted through skin of patient to recorder or indicator.

  1. Blood pressure regulation: basic concepts.

    PubMed

    Guyton, A C; Hall, J E; Lohmeier, T E; Jackson, T E; Kastner, P R

    1981-06-01

    In this paper we have attempted to explain the difference between proportional pressure control systems and the renal-blood volume-pressure control mechanism, which is an infinite gain pressure control system. Because of this infinite gain of the kidney mechanism, this mechanism has the capability of returning arterial pressure all the way back to the control leve. Furthermore, this mechanism can override the other pressure control mechanisms because of its extreme control capability. On the other hand, the renal-blood volume mechanism for pressure control itself be controlled by many other factors. These other factors are said to change the pressure "set-point" level of the renal system, and then the renal system automatically brings the pressure to the set-point level. It is especially noteworthy, however, that some of the factors that play extreme roles in short-term pressure control-such as heart strength, vascular capacity, and total peripheral resistance-will not alter the long-term arterial pressure level (unless they in some way concurrently alter the set-point of the kidney mechanism).

  2. Effects of calcium channel blocker-based combinations on intra-individual blood pressure variability: post hoc analysis of the COPE trial

    PubMed Central

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Nishida, Y; Sakamoto, T; Yanagi, S; Hirota, K; Majima, T; Ota, T; Tanaka, T; Nohara, R; Funauchi, T; Isogai, O; Takashima, S; Koike, H; Nishimoto, M; Kawase, Y; Tojo, O; Chimori, Y; Harada, H; Takeoka, H; Kishi, S; Yokoyama, M; Hirata, K; Ejiri, J; Emoto, R; Furuta, Y; Hattori, K; Kuroda, R; Maehashi, N; Monnaka, H; Ohashi, Y; Okada, T; Suzuki, H; Takeuchi, M; Ohyanagi, M; Masai, M; Masuyama, T; Kawabata, M; Kajiya, T; Daito, N; Fujisawa, T; Fujita, S; Hasegawa, M; Hirakoba, M; Hirano, T; Ikeda, Y; Imai, N; Marumoto, K; Masuda, S; Miki, T; Mitsunaga, M; Mitsuoka, H; Miyachi, Y; Mukohara, N; Nagao, T; Nakada, K; Nishian, K; Nishioka, S; Ogura, T; Onishi, Y; Sakaguchi, K; Sano, I; Sano, W; Shigenobu, M; Tabuchi, A; Takashima, J; Taniguchi, Y; Uchida, H; Ueda, T; Urabe, N; Makino, H; Harada, S; Hirakawa, S; Hirata, H; Ishii, J; Koten, K; Nagake, Y; Nakajima, T; Nakamura, Y; Terami, T; Mitsudo, K; Fujii, M; Fujita, K; Iwano, E; Kadota, K; Nishihara, Y; Takaya, Y; Yamamoto, H; Yamamoto, T; Shigemasa, C; Hisatome, I; Kato, T; Miyakoda, H; Sakamoto, M; Shimoyama, M; Shimada, T; Tanabe, K; Goto, Y; Hanada, Y; Kawakami, K; Kitamura, J; Kitamura, K; Nakata, H; Oyake, N; Sugiura, H; Tsukihashi, H; Matsuzaki, M; Umemoto, S; Aoyagi, S; Aoyama, H; Fujino, T; Fukuta, S; Hiroyama, N; Ikeda, Y; Inamoto, Y; Kametani, R; Kamiya, A; Kanamaru, Y; Kotoku, S; Matsushima, A; Morita, J; Murano, Y; Nakatsuka, M; Nishimura, S; Nisnimura, Y; Okamura, T; Okuda, F; Onaka, U; Ozaki, M; Shimizu, A; Takata, C; Tamitani, M; Watada, T; Watada, T; Yamamoto, K; Yamauchi, M; Yorozu, T; Yoshikane, H; Yoshino, F; Higaki, J; Doiuchi, J; Fukuoka, T; Hashimoto, H; Igase, M; Kadota, H; Kaneko, H; Komatsu, S; Matsubara, Y; Miyoshi, K; Murakami, K; Murao, S; Niiya, T; Ochi, T; Satoh, A; Seki, T; Takahashi, H; Yamashita, T; Yoshino, T; Kohno, M; Fujita, N; Fukui, T; Hamamoto, T; Hasegawa, K; Hitomi, H; Ihara, K; Kiyomoto, H; Masugata, H; Matsumoto, I; Takahashi, N; Yoshikawa, K; Doi, Y; Arisawa, M; Egawa, T; Fukuda, M; Kawada, Y; Kusunose, H; Maeda, T; Minami, N; Nishinaga, M; Noguchi, T; Okabayashi, K; Sato, K; Satomi, T; Takada, J; Tamura, S; Usui, T; Yamada, M; Irahara, M; Azuma, H; Fujimura, M; Fujino, H; Fujino, M; Harada, E; Harada, S; Hiasa, Y; Hosokawa, S; Kawahara, K; Koshiba, K; Murakami, M; Nakaya, Y; Nii, H; Nozaki, S; Ota, A; Ozaki, T; Sone, K; Tsutsui, Y; Ueta, S; Nobuyoshi, M; Fujishima, Y; Hisano, K; Ikezono, H; Imawatari, R; Izumi, Y; Kanai, H; Nakamura, T; Nakamura, T; Noda, T; Ono, E; Tanaka, S; Tsuiki, T; Yanai, T; Sasaguri, T; Akimitsu, S; Dohmen, K; Fujisawa, K; Fukuyo, K; Harashima, S; Hayashi, T; Hirata, M; Hirata, Y; Ikeda, N; Ikematsu, H; Ikematsu, W; Kajiyama, W; Kawakami, Y; Kawasaki, I; Kondo, H; Kusuhara, H; Maeda, N; Miyahara, H; Motomura, A; Nakamura, K; Noguchi, T; Okinaga, T; Sato, M; Shimada, I; Shin, H; Soejima, K; Sugi, K; Taniguchi, T; Uwatoku, T; Yamaga, S; Yamaji, K; Yanagi, J; Yano, H; Saku, K; Enomoto, M; Hiratsuka, T; Imoto, K; Kamei, R; Kanaya, H; Kohara, M; Kusuda, M; Nishikawa, H; Sako, H; Imaizumi, T; Yano, K; Maemura, K; Ashizawa, N; Hazama, M; Ishida, Y; Ito, T; Kanda, M; Kimura, M; Noguchi, T; Oku, Y; Seto, S; Suzuki, S; Ogawa, H; Goto, K; Honjio, K; Horio, Y; Jinnouchi, H; Kaku, Y; Kawano, S; Kimura, T; Kiyohara, Y; Maki, A; Matsumoto, N; Misumi, K; Sakamoto, T; Sasaki, K; Sugiyama, S; Tanaka, E; Uemura, S; Tei, C; Arima, K; Daitoku, Y; Eto, H; Hashino, T; Ichinari, K; Ikeda, Y; Iriki, A; Kiyonaga, K; Kubota, K; Makise, Y; Masuzaki, S; Miyata, M; Mizoguchi, H; Niiyama, T; Samejima, Y; Yonezawa, S

    2016-01-01

    Visit-to-visit blood pressure (BP) variability is an important predictor of stroke. However, which antihypertensive drug combination is better at reducing visit-to-visit BP variability and therefore at reducing stroke incidence remains uncertain. We have previously reported that the dihydropyridine calcium channel blocker benidipine combined with a β-blocker appeared to be less beneficial in reducing the risk of stroke than a combination of benidipine and thiazide. Here, we further compare the visit-to-visit BP variability among three benidipine-based regimens, namely angiotensin receptor blocker (ARB), β-blocker and thiazide combinations. The present post hoc analysis included 2983 patients without cardiovascular events or death during the first 18 months after randomization. We compared the BP variability (defined as the s.d. and the coefficient of variation (CV)), maximum systolic BP (SBP) and diastolic BP (DBP) of the clinic mean on-treatment BPs obtained at 6-month intervals, starting 6 months after the treatment initiation, among the 3 treatments (ARB, n=1026; β-blocker, n=966; thiazide, n=991). During the first 6–36 months after randomization, both the s.d. and CV-BPs were lower in the benidipine–thiazide group than in the benidipine–β-blocker group (s.d.-SBP, P=0.019; s.d.-DBP, P=0.030; CV-SBP, P=0.012; CV-DBP, P=0.022). The s.d. and CV in the ARB group did not reach statistical significance compared with the other two groups. The maximum BPs did not differ among the three treatments. These findings suggest that the benidipine–thiazide combination may reduce visit-to-visit BP variability more than the benidipine–β-blocker combination. PMID:26490089

  3. Systolic Blood Pressure Visit-to-Visit Variability and Major Adverse Outcomes in Atrial Fibrillation: The AFFIRM Study (Atrial Fibrillation Follow-Up Investigation of Rhythm Management).

    PubMed

    Proietti, Marco; Romiti, Giulio Francesco; Olshansky, Brian; Lip, Gregory Y H

    2017-11-01

    Hypertension and atrial fibrillation predict major adverse events independently. Visit-to-visit variability (VVV) in systolic blood pressure (SBP) predicts outcomes beyond SBP itself, but risk associated with SBP-VVV in atrial fibrillation remains uncertain. We evaluated relationships between SBP-VVV, quality of oral anticoagulation control, and outcomes in patients with atrial fibrillation. Data from the AFFIRM trial (atrial fibrillation follow-up investigation of rhythm management) were analyzed. SBP-VVV was defined according to SD of SBP (SBP-SD) during follow-up. SBP-VVV was categorized by quartiles (1st, <10.09; 2nd, 10.09-13.85; 3rd, 13.86-17.33; and 4th, ≥17.34 mm Hg) and as a continuous variable. Among the original cohort, 3843 (94.7%) patients were eligible. Time in therapeutic range and percentage of international normalized ratio in range were progressively lower by quartiles (both P<0.001). An inverse linear association existed between SBP-SD and time in therapeutic range/percentage of international normalized ratio in range (P<0.001). After a median (interquartile range) follow-up of 3.6 (2.7-4.6) years, stroke and major bleeding rates progressively increased by SBP-VVV quartile (both P<0.001). Patients in the 4th quartile had the highest rate of cardiovascular and all-cause death (P=0.005 and P<0.001). A Cox multivariate analysis confirmed that 3rd and 4th quartiles were associated independently with a higher risk for stroke (P=0.042 and P=0.004) and major bleeding (P=0.009 and P<0.001). Patients in 4th quartile had also a higher risk for all-cause death (P=0.048). SBP-SD as a continuous variable was associated with increased risk for all outcomes. In conclusion, SBP-VVV is inversely associated with quality of anticoagulation control and independently predicts major adverse outcomes. Management of blood pressure variability may improve outcomes in atrial fibrillation. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000556. © 2017

  4. Maternal Blood Pressure During Pregnancy and Early Childhood Blood Pressures in the Offspring

    PubMed Central

    Lim, Wai-Yee; Lee, Yung-Seng; Yap, Fabian Kok-Peng; Aris, Izzudin Mohd; Ngee, Lek; Meaney, Michael; Gluckman, Peter D.; Godfrey, Keith M.; Kwek, Kenneth; Chong, Yap-Seng; Saw, Seang-Mei; Pan, An

    2015-01-01

    Abstract Although epidemiological studies suggest that offspring of women with preeclampsia are at increased risk to higher blood pressures and cardiovascular disease, little is known about the nature of blood pressures between the mother and her offspring. As blood pressures comprise of both pulsatile (systolic blood pressure [SBP] and pulse pressure [PP]) and stable (diastolic blood pressure [DBP]) components, and they differ between central and peripheral sites, we sought to examine maternal peripheral and central blood pressure components in relation to offspring early childhood blood pressures. A prospective birth cohort of 567 Chinese, Malay, and Indian mother–offspring with complete blood pressure information were studied. Maternal brachial artery SBP, DBP, and PP were measured at 26 to 28 weeks gestation; and central SBP and PP were estimated from radial artery waveforms. Offspring brachial artery SBP, DBP, and PP were measured at 3 years of age. Associations between continuous variables of maternal blood pressures (peripheral SBP, DBP, PP, central SBP, and PP) and offspring blood pressures (peripheral SBP, DBP, and PP) were examined using multiple linear regression with adjustment for maternal characteristics (age, education level, parity, smoking status, alcohol consumption and physical activity during pregnancy, and pre-pregnancy BMI) and offspring characteristics (sex, ethnicity, BMI, and height at 3 years of age). In the multivariate models, offspring peripheral SBP increased by 0.08 (95% confidence interval 0.00–0.17, P = 0.06) mmHg with every 1-mmHg increase in maternal central SBP, and offspring peripheral PP increased by 0.10 (0.01–0.18, P = 0.03) mmHg for every 1-mmHg increase in maternal central PP. The relations of maternal-offspring peripheral blood pressures (SBP, DBP, and PP) were positive but not statistically significant, and the corresponding values were 0.05 (−0.03 to 0.13; P = 0.21), 0.03 (−0.04 to 0.10; P = 0

  5. Prognostic Value of Variability in Systolic Blood Pressure Related to Vascular Events and Premature Death in Type 2 Diabetes Mellitus: The ADVANCE-ON Study.

    PubMed

    Ohkuma, Toshiaki; Woodward, Mark; Jun, Min; Muntner, Paul; Hata, Jun; Colagiuri, Stephen; Harrap, Stephen; Mancia, Giuseppe; Poulter, Neil; Williams, Bryan; Rothwell, Peter; Chalmers, John

    2017-08-01

    Visit-to-visit variability in systolic blood pressure (SBP) is a risk factor for cardiovascular events. However, whether it provides additional predictive information beyond traditional risk factors, including mean SBP, in the long term is unclear. The ADVANCE trial (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation) was a randomized controlled trial in patients with type 2 diabetes mellitus; ADVANCE-ON (ADVANCE-Observational) followed-up patients subsequently. In these analyses, 9114 patients without major macrovascular or renal events or death during the first 24 months were included. Data on SBP from 6 visits during the first 24 months after randomization were used to estimate visit-to-visit variability in several ways: the primary measure was the standard deviation. Events accrued during the following 7.6 years. The primary outcome was a composite of major macrovascular and renal events and all-cause mortality. Standard deviation of SBP was log-linearly associated with an increased risk of the primary outcome (P<0.001) after adjustment for mean SBP and other cardiovascular risk factors. The hazard ratio (HR; 95% confidence interval [CI]) in the highest, compared with the lowest, tenth of the standard deviation was 1.39 (1.15-1.69). Results were similar for major macrovascular events alone and all-cause mortality alone (both P<0.01). Addition of standard deviation of SBP significantly improved 8-year risk classification (continuous net reclassification improvement, 5.3%). Results were similar for other measures of visit-to-visit variability, except maximum SBP. Visit-to-visit variability in SBP is an independent predictor of vascular complications and death, which improves risk prediction beyond that provided by traditional risk factors, including mean SBP. © 2017 American Heart Association, Inc.

  6. Long-term blood pressure variability throughout young adulthood and cognitive function in midlife: the Coronary Artery Risk Development in Young Adults (CARDIA) study.

    PubMed

    Yano, Yuichiro; Ning, Hongyan; Allen, Norrina; Reis, Jared P; Launer, Lenore J; Liu, Kiang; Yaffe, Kristine; Greenland, Philip; Lloyd-Jones, Donald M

    2014-11-01

    Whether long-term blood pressure (BP) variability throughout young adulthood is associated with cognitive function in midlife remains uncertain. Using data from the Coronary Artery Risk Development in Young Adults (CARDIA), which recruited healthy young adults aged 18 to 30 years (mean age, 25 years) at baseline (Y(0)), we assessed BP variability by SD and average real variability (ARV) for 25 years (8 visits). Cognitive function was assessed with the Digit Symbol Substitution Test (psychomotor speed test), the Rey Auditory Verbal Learning Test (verbal memory test), and the modified Stroop test (executive function test) at follow-up (Y(25)). At the Y(25) examination, participants (n=2326) had a mean age of 50.4 years, 43% were men, and 40% were black. In multivariable-adjusted linear regression models, higher ARV(SBP), ARV(DBP), and SD(DBP) were significantly associated with lower scores of Digit Symbol Substitution Test (β [SE]: -0.025 [0.006], -0.029 [0.007], and -0.029 [0.007], respectively; all P<0.001) and Rey Auditory Verbal Learning Test (β [SE]: -0.016 [0.006], -0.021 [0.007], and -0.019 [0.007], respectively; all P<0.05) after adjustment for demographic and clinical characteristics and with cumulative exposure to BP through Y(0) to Y(25). Neither SDBP nor ARV(BP) was associated with the Stroop score. The associations between ARV(BP) or SD(BP) and each cognitive function test were similar between blacks and whites except for 1 significant interaction between race and SDS(BP) on the Digit Symbol Substitution Test (P<0.05). Long-term BP variability for 25 years beginning in young adulthood was associated with worse psychomotor speed and verbal memory tests in midlife, independent of cumulative exposure to BP during follow-up.

  7. Clinical relevance of central blood pressure - a critical review.

    PubMed

    Kostapanos, Michael; McEniery, Carmel M; Wilkinson, Ian B

    2016-11-01

    Vital organs are exposed to the central rather than the brachial blood pressure. To date, central blood pressure can be assessed noninvasively through the use of several devices. In this review, we critically discuss the clinical relevance of central blood pressure assessment. Considerable evidence suggests that central blood pressure is a better predictor of end-organ damage than brachial blood pressure. However, there is still uncertainty concerning the value of central pressure for predicting cardiovascular outcomes, as the existing studies are underpowered to address this issue. A full synthesis of the available data is needed in this regard. Among the different antihypertensive drug classes, beta-blockers appear to lower central blood pressure less than brachial blood pressure. This difference may, at least in part, explain the reduced efficacy of beta-blockers in the prevention of cardiovascular outcomes compared with the other antihypertensive drug classes, which may lower central and brachial blood pressure to a similar extent. Nevertheless, this differential effect might not be relevant to the newer beta-blockers with vasodilating properties, including nebivolol, celliprolol and carvedilol. However, whether a preferential reduction of central blood pressure results in better outcomes should be further assessed by appropriately powered clinical trials. Other emerging challenges include the assessment of the potential predictive value of central blood pressure variability and the development of new antihypertensive medications based on central blood pressure rather than brachial blood pressure.

  8. Circadian rhythm and blood pressure control: physiological and pathophysiological factors.

    PubMed

    Coca, A

    1994-07-01

    To review current knowledge on blood pressure variability. Blood pressure variability has a time-course ranging from a few seconds or minutes (short-term variability) to 24 h (long-term variability) or 1 year (seasonal variations). The variability is influenced by physiological factors such as physical and mental activity (posture, exercise, talking) or behavioral and environmental factors (salt, caffeine, alcohol), and by pathological conditions. In patients with essential hypertension, the day-night pattern of blood pressure change is generally similar to that of normotensives, with a significant nocturnal blood pressure fall (dippers), except that the entire profile is shifted upwards. Nevertheless, in some essential hypertensives the nocturnal fall in blood pressure is absent or reversed (non-dippers), in spite of a decrease in the nocturnal heart rate. In several forms of secondary hypertension (pheochromocytoma, renal failure) and other clinical conditions (sleep apnea syndrome, diabetes mellitus, cardiac transplantation) the nocturnal fall in blood pressure is also absent or reversed. Blood pressure variability and the blunted nocturnal fall in blood pressure may be clinically relevant. Several studies have demonstrated that subjects whose 24-h variability was higher than the group average were more likely to have target-organ damage. Moreover, hypertensive women with a blunted nocturnal fall in blood pressure (non-dippers) are more likely to suffer morbid cardiovascular events than dippers. On theoretical grounds, therefore, antihypertensive treatment that reduces blood pressure variability and preserves the nocturnal fall in blood pressure will help to protect target organs in hypertension. So far, this has not been demonstrated in clinical trials.

  9. High Blood Pressure (Hypertension) (For Parents)

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old High Blood Pressure (Hypertension) KidsHealth > For Parents > High Blood Pressure (Hypertension) A ... posture, and medications. continue Long-Term Effects of High Blood Pressure When someone has high blood pressure, the heart ...

  10. Development of an Experimental Model to Study the Relationship Between Day-to-Day Variability in Blood Pressure and Aortic Stiffness

    PubMed Central

    Bouissou-Schurtz, Camille; Lindesay, Georges; Regnault, Véronique; Renet, Sophie; Safar, Michel E.; Molinie, Vincent; Dabire, Hubert; Bezie, Yvonnick

    2015-01-01

    We aimed to develop an animal model of long-term blood pressure variability (BPV) and to investigate its consequences on aortic damage. We hypothesized that day-to-day BPV produced by discontinuous treatment of spontaneously hypertensive rats (SHR) by valsartan may increase arterial stiffness. For that purpose, rats were discontinuously treated, 2 days a week, or continuously treated by valsartan (30 mg/kg/d in chow) or placebo. Telemetered BP was recorded during 2 min every 15 min, 3 days a week during 8 weeks to cover the full BP variations in response to the treatment schedule. Pulse wave velocity (PWV) and aortic structure evaluated by immunohistochemistry were investigated in a second set of rats treated under the same conditions. Continuous treatment with valsartan reduced systolic BP (SBP) and reversed the aortic structural alterations observed in placebo treated SHR (decrease of medial cross-sectional area). Discontinuous treatment with valsartan decreased SBP to a similar extent but increased the day-to-day BPV, short term BPV, diastolic blood pressure (DBP), and PWV as compared with continuous treatment. Despite no modifications in the elastin/collagen ratio and aortic thickness, an increase in PWV was observed following discontinuous treatment and was associated with a specific accumulation of fibronectin and its αv-integrin receptor compared with both groups of rats. Taken together the present results indicate that a discontinuous treatment with valsartan is able to induce a significant increase in day-to-day BPV coupled to an aortic phenotype close to that observed in hypertension. This experimental model should pave the way for future experimental and clinical studies aimed at assessing how long-term BPV increases aortic stiffness. PMID:26696902

  11. Development of an Experimental Model to Study the Relationship Between Day-to-Day Variability in Blood Pressure and Aortic Stiffness.

    PubMed

    Bouissou-Schurtz, Camille; Lindesay, Georges; Regnault, Véronique; Renet, Sophie; Safar, Michel E; Molinie, Vincent; Dabire, Hubert; Bezie, Yvonnick

    2015-01-01

    We aimed to develop an animal model of long-term blood pressure variability (BPV) and to investigate its consequences on aortic damage. We hypothesized that day-to-day BPV produced by discontinuous treatment of spontaneously hypertensive rats (SHR) by valsartan may increase arterial stiffness. For that purpose, rats were discontinuously treated, 2 days a week, or continuously treated by valsartan (30 mg/kg/d in chow) or placebo. Telemetered BP was recorded during 2 min every 15 min, 3 days a week during 8 weeks to cover the full BP variations in response to the treatment schedule. Pulse wave velocity (PWV) and aortic structure evaluated by immunohistochemistry were investigated in a second set of rats treated under the same conditions. Continuous treatment with valsartan reduced systolic BP (SBP) and reversed the aortic structural alterations observed in placebo treated SHR (decrease of medial cross-sectional area). Discontinuous treatment with valsartan decreased SBP to a similar extent but increased the day-to-day BPV, short term BPV, diastolic blood pressure (DBP), and PWV as compared with continuous treatment. Despite no modifications in the elastin/collagen ratio and aortic thickness, an increase in PWV was observed following discontinuous treatment and was associated with a specific accumulation of fibronectin and its αv-integrin receptor compared with both groups of rats. Taken together the present results indicate that a discontinuous treatment with valsartan is able to induce a significant increase in day-to-day BPV coupled to an aortic phenotype close to that observed in hypertension. This experimental model should pave the way for future experimental and clinical studies aimed at assessing how long-term BPV increases aortic stiffness.

  12. Blood Pressure Regulation: Every Adaptation is an Integration?

    PubMed Central

    Joyner, Michael J.; Limberg, Jacqueline K.

    2013-01-01

    This focused review serves to explore relevant issues in regard to blood pressure regulation and by doing so, provides the initial stimulus paper for the Thematic Review series “Blood Pressure Regulation” to be published in the European Journal of Applied Physiology over the coming months. In this introduction, we highlight how variable normal blood pressure can be and challenge the reader to take another look at some key concepts related to blood pressure regulation. We point out that there is frequently an underappreciated balance between peripheral vasodilation and systemic blood pressure regulation and ask the question: Are changes in blood pressure, in effect, reasonable and integrated adaptations to the physiological challenge at hand? We conclude with the idea that blood pressure regulatory systems are both flexible and redundant; ensuring a wide variety of activities associated with life can be accompanied by a perfusion pressure that can serve multiple masters. PMID:23558925

  13. Long-Term Blood Pressure Variability, New-Onset Diabetes Mellitus, and New-Onset Chronic Kidney Disease in the Japanese General Population.

    PubMed

    Yano, Yuichiro; Fujimoto, Shouichi; Kramer, Holly; Sato, Yuji; Konta, Tsuneo; Iseki, Kunitoshi; Iseki, Chiho; Moriyama, Toshiki; Yamagata, Kunihiro; Tsuruya, Kazuhiko; Narita, Ichiei; Kondo, Masahide; Kimura, Kenjiro; Asahi, Koichi; Kurahashi, Issei; Ohashi, Yasuo; Watanabe, Tsuyoshi

    2015-07-01

    Whether long-term blood pressure (BP) variability among individuals without diabetes mellitus is associated with new-onset chronic kidney disease (CKD) risk, independently of other BP parameters (eg, mean BP, cumulative exposure to BP) and metabolic profile changes during follow-up, remains uncertain. We used data from a nationwide study of 48 587 Japanese adults aged 40 to 74 years (mean age, 61.7 years; 39% men) without diabetes mellitus or CKD (estimated glomerular filtration rate <60 mL/min per 1.73 m2 or proteinuria by dipstick). BP was measured at baseline and during 3 annual follow-up visits (4 visits). BP variability was defined as standard deviation (SD) and average real variability during the 4 visits. At the year 3 follow-up visit, 6.3% of the population had developed CKD. In multivariable-adjusted logistic regression models, 1 SD increases in SDSBP (per 5 mmHg), SDDBP (per 3 mmHg), average real variabilitySBP (per 6 mmHg), and average real variabilityDBP (per 4 mmHg) were associated with new-onset CKD (odds ratios [ORs] and 95% confidence intervals, 1.15 [1.11-1.20], 1.08 [1.04-1.12], 1.13 [1.09-1.17], 1.06 [1.02-1.10], respectively; all P<0.01) after adjustment for clinical characteristics, and with mean BP from year 0 to year 3. The associations of SDBP and average real variabilityBP with CKD remained significant after additional adjustments for metabolic parameter changes during follow-up (ORs, 1.06-1.15; all P<0.01). Sensitivity analyses by sex, antihypertensive medication use, and the presence of hypertension showed similar conclusions. Among those in the middle-aged and elderly general population without diabetes mellitus, long-term BP variability during 3 years was associated with new-onset CKD risk, independently of mean or cumulative exposure to BP and metabolic profile changes during follow-up. © 2015 American Heart Association, Inc.

  14. High blood pressure and eye disease

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000999.htm High blood pressure and eye disease To use the sharing features on this page, please enable JavaScript. High blood pressure can damage blood vessels in the retina . The ...

  15. Effects of short-term hypocaloric diet on sympatho-vagal interaction assessed by spectral analysis of heart rate and blood pressure variability during stress tests in obese hypertensive patients.

    PubMed

    Ashida, Terunao; Ono, Chikako; Sugiyama, Takao

    2007-12-01

    We examined the effects of a short-term low-calorie diet on the activity of the autonomic nervous system during stress tests in obese patients with hypertension by analysis of heart rate and blood pressure variability. Eighteen obese inpatients with essential hypertension were given a regular-calorie diet (1,600 kcal, NaCl 7 g) for 4 days, and then a low-calorie diet (1,100 kcal, NaCl 7 g) for 11 days. During both the regular-calorie diet and low-calorie diet, power spectral analysis of heart rate and blood pressure variability at rest and during mental arithmetic test, deep breathing test, isometric handgrip test or cold pressor test was performed. Body weight and 24-h ambulatory blood pressure were significantly lower during the low-calorie diet than during the regular-calorie diet. Systolic and diastolic blood pressure significantly increased over the handgrip test and cold pressor test during both diets. The low frequency component (LF) of systolic blood pressure, a marker of sympathetic activity to the vasculature, during the deep breathing test and cold pressor test were significantly lower on the low-calorie diet than the regular-calorie diet. The blood leptin concentration was also significantly lower on the low-calorie diet than the regular-calorie diet. The decrease in body weight was positively correlated with the decrease in blood leptin concentration. The LF/high frequency component (HF) ratio of the RR interval at rest on the regular-calorie diet was negatively correlated with the decrease in blood leptin concentration. These results suggest that the autonomic nervous function assessed by analysis of heart rate and blood pressure variability during stress tests may be improved by weight loss due to a short-term low-calorie diet in obese patients with hypertension.

  16. Alcohol: Does It Affect Blood Pressure?

    MedlinePlus

    ... pressure (hypertension) Does drinking alcohol affect your blood pressure? Answers from Sheldon G. Sheps, M.D. Drinking too much alcohol can raise blood pressure to unhealthy levels. Having more than three drinks ...

  17. Automatic blood pressure measuring system (M092)

    NASA Technical Reports Server (NTRS)

    Nolte, R. W.

    1977-01-01

    The Blood Pressure Measuring System is described. It measures blood pressure by the noninvasive Korotkoff sound technique on a continual basis as physical stress is imposed during experiment M092, Lower Body Negative Pressure, and experiment M171, Metabolic Activity.

  18. Automatic blood pressure measuring system (M092)

    NASA Technical Reports Server (NTRS)

    Nolte, R. W.

    1977-01-01

    The Blood Pressure Measuring System is described. It measures blood pressure by the noninvasive Korotkoff sound technique on a continual basis as physical stress is imposed during experiment M092, Lower Body Negative Pressure, and experiment M171, Metabolic Activity.

  19. Pistachio Nut Consumption Modifies Systemic Hemodynamics, Increases Heart Rate Variability, and Reduces Ambulatory Blood Pressure in Well‐Controlled Type 2 Diabetes: a Randomized Trial

    PubMed Central

    Sauder, Katherine A.; McCrea, Cindy E.; Ulbrecht, Jan S.; Kris‐Etherton, Penny M.; West, Sheila G.

    2014-01-01

    Background Managing cardiovascular risk factors is important for reducing vascular complications in type 2 diabetes, even in individuals who have achieved glycemic control. Nut consumption is associated with reduced cardiovascular risk; however, there is mixed evidence about the effect of nuts on blood pressure (BP), and limited research on the underlying hemodynamics. This study assessed the effect of pistachio consumption on BP, systemic hemodynamics, and heart rate variability in adults with well‐controlled type 2 diabetes. Methods and Results We enrolled 30 adults (40 to 74 years) with type 2 diabetes in a randomized, crossover, controlled feeding study. After a 2‐week run‐in period, participants consumed a low‐fat control diet (27% fat) containing low‐fat/high‐carbohydrate snacks and a moderate‐fat diet (33% fat) containing pistachios (20% of total energy) for 4 weeks each, separated by a 2‐week washout. Following each diet period, we assessed BP, systemic hemodynamics, and heart rate variability at rest and during acute mental stress, and, in a subset of participants (n=21), 24‐hour ambulatory BP. BP at rest and during stress did not differ between treatments. The pistachio diet significantly reduced total peripheral resistance (−3.7±2.9%, P=0.004), increased cardiac output (3.1±2.3%, P=0.002), and improved some measures of heart rate variability (all P<0.05). Systolic ambulatory BP was significantly reduced by 3.5±2.2 mm Hg (P=0.046) following the pistachio diet, with the greatest reduction observed during sleep (−5.7±2.6 mm Hg, P=0.052). Conclusions A moderate‐fat diet containing pistachios modestly improves some cardiovascular risk factors in adults with well‐controlled type 2 diabetes. Clinical Trial Registration URL: www.clinicaltrials.gov. Unique identifier: NCT00956735. PMID:24980134

  20. Visit-to-visit variability of blood pressure and cardiovascular outcomes in patients with stable coronary heart disease. Insights from the STABILITY trial.

    PubMed

    Vidal-Petiot, Emmanuelle; Stebbins, Amanda; Chiswell, Karen; Ardissino, Diego; Aylward, Philip E; Cannon, Christopher P; Ramos Corrales, Marco A; Held, Claes; López-Sendón, José Luis; Stewart, Ralph A H; Wallentin, Lars; White, Harvey D; Steg, Philippe Gabriel

    2017-05-27

    To study the relation between visit-to-visit variability of blood pressure (BP) and cardiovascular risk in patients with stable coronary heart disease. In 15 828 patients from the STABILITY trial (darapladib vs. placebo in patients with established coronary heart disease), BP variability was assessed by the standard deviation (SD) of systolic BP, the SD of diastolic BP, maximum BP, and minimum BP, from 5 measurements (baseline and months 1, 3, 6, and 12) during the first year after randomisation. Mean (SD) average BP during the first year of study was 131.0 (13.7) mmHg over 78.3 (8.3) mmHg. Mean (SD) of the visit-to-visit SD was 9.8 (4.8) mmHg for systolic and 6.3 (3.0) mmHg for diastolic BP. During the subsequent median follow-up of 2.6 years, 1010 patients met the primary endpoint, a composite of time to cardiovascular death, myocardial infarction, or stroke. In Cox regression models adjusted for average BP during first year of study, baseline vascular disease, treatment, renal function and cardiovascular risk factors, the primary endpoint was associated with SD of systolic BP (hazard ratio for highest vs. lowest tertile, 1.30, 95% CI 1.10-1.53, P = 0.007), and with SD of diastolic BP (hazard ratio for highest vs. lowest tertile, 1.38, 95% CI 1.18-1.62, P < 0.001). Peaks and troughs in BP were also independently associated with adverse events. In patients with stable coronary heart disease, higher visit-to-visit variabilities of both systolic and diastolic BP are strong predictors of increased risk of cardiovascular events, independently of mean BP.

  1. Association between beat-to-beat blood pressure variability and vascular elasticity in normal young adults during the cold pressor test

    PubMed Central

    Xia, Yufa; Wu, Dan; Gao, Zhifan; Liu, Xin; Chen, Qian; Ren, Lijie; Wu, Wanqing

    2017-01-01

    Abstract The beat-to-beat blood pressure (BP) monitoring parameters, such as average beat-to-beat BP, BP variability (BPV), could have an influence on the vascular elasticity. This study hypothesized that the elevated beat-to-beat BPV could evoke the reduction of the vascular elasticity independent of BP levels. We measured the beat-to-beat BP recordings and total arterial compliance (TAC), which was used to assess the vascular elasticity, in 80 young healthy adults during the cold pressor test (CPT). The CPT included 3 phases: baseline phase, cold stimulus phase, recovery phase. Six parameters were used to estimate BPV. In bivariate correlation analysis, TAC showed a significant correlation with systolic BP (SBP) and diastolic BP (DBP) in the cold stimulus phase; and 4 indices of SBP variability (SBPV) were associated with TAC (r = 0.271∼0.331, P ≤ 0.015) in the recovery phase; similarly, 2 indices of DBP variability (DBPV) were also correlated with TAC (r = 0.221∼0.285, P ≤ 0.048) in the recovery phase. In multivariate regression analysis, DBPV (β = 0.229, P = 0.001) was a determinant of TAC independent of average DBP, sex, and weight. In addition, both beat-to-beat BP and BPV values increased in the cold stimulus phase (P < 0.01); whereas, the TAC decreased in the cold stimulus phase (P < 0.01). In conclusion, these data suggest that the beat-to-beat DBPV shows an independent association with the vascular elasticity in young normal adults during the CPT. PMID:28225488

  2. Influence of Rest Interval Length Between Sets on Blood Pressure and Heart Rate Variability After a Strength Training Session Performed By Prehypertensive Men.

    PubMed

    Figueiredo, Tiago; Willardson, Jeffrey M; Miranda, Humberto; Bentes, Claudio M; Machado Reis, Victor; Freitas de Salles, Belmiro; Simão, Roberto

    2016-07-01

    Figueiredo, T, Willardson, JM, Miranda, H, Bentes, CM, Machado Reis, V, Freitas de Salles, B, and Simão, R. Influence of rest interval length between sets on blood pressure and heart rate variability after a strength training session performed by prehypertensive men. J Strength Cond Res 30(7): 1813-1824, 2016-The purposes of this study were to compare the effects of 2 different rest interval lengths between sets and exercises during strength training (ST) on blood pressure (BP) and heart rate variability (HRV) in prehypertensive trained men, and to verify how HRV influences BP. Eleven volunteer subjects (age: 26.1 ± 3.6 years; body mass: 74.1 ± 7.9 kg; height: 172.1 ± 4.1 cm; % body fat: 18.3 ± 6.3; ST experience: 1.7 ± 0.8 years) participated in this study. After assessing one repetition maximum (1RM) loads for the free weight bench press, lat pull-down, shoulder press, biceps curl, triceps extension, leg press, leg extension, and leg curl exercises; subjects performed 2 sessions with different rest intervals between sets and exercises in random order and 72 hours apart. Each ST session consisted of performing 3 sets of eight to 10 repetitions at 70% of a 1RM for each exercise, with either 1-minute (sequence 1 [SEQ1]) or 2-minute (sequence 2 [SEQ2]) rest intervals between sets and exercises, respectively. Before and after each session, BP and HRV (low frequency band, high frequency [HF] band, and square root of the mean squared difference of successive RR-interval index) were tracked for 60 minutes. The results demonstrated a postexercise hypotensive response (PEH) after both rest interval conditions (p ≤ 0.05). Additionally, increases in cardiac stress were noted after SEQ1, with a greater withdrawal in parasympathetic activity vs. baseline as noted in the HF band at 1-, 10-, and 20-minute postexercise (p ≤ 0.05). These results indicate that both sequences provided an effective stimulus for a PEH. Therefore, strength and conditioning professionals may

  3. Prolonged (48-hour) modest hyperinsulinemia decreases nocturnal heart rate variability and attenuates the nocturnal decrease in blood pressure in lean, normotensive humans.

    PubMed

    Petrova, Maja; Townsend, Raymond; Teff, Karen L

    2006-03-01

    Heart rate variability (HRV), an index of cardiac vagal activity, is decreased in individuals with metabolic disease. The relationship between decreased HRV and metabolic disease is unclear. The objective of this study was to determine whether experimentally induced glucose intolerance decreases HRV in a circadian relevant manner in healthy individuals. This was a within-subject, randomized design study with subjects infused for 48 h with saline (50 ml/h) or 15% glucose (200 mg/m2.min). HRV was evaluated using time domain measurements taken over the 48-h period. Blood pressure and heart rate were monitored, and blood samples were taken. This study was performed at the General Clinical Research Center of the Hospital of the University of Pennsylvania. Sixteen healthy subjects (eight men and eight women; 18-30 yr old; mean body mass index, 21.7 +/- 1.6 kg/m2) were studied. After glucose infusion, mean plasma glucose was increased by 16.8% (P < 0.0001), and plasma insulin was increased by 99.4% (P < 0.0001) compared with after saline infusion. Significant decreases in homeostasis model assessment indicated a decrease in insulin sensitivity (saline, 0.52 + 0.13; glucose, 0.34 + 0.12; P < 0.0001). The nocturnal root mean square successive difference, an index of cardiac vagal activity, was significantly decreased (P < 0.01), and nocturnal HR (P < 0.001) and blood pressure were significantly elevated (saline, 107.4 +/- 2.7; glucose, 112.5 +/- 3.3 mm Hg; P < 0.05) compared with the saline control. The change in homeostasis model assessment due to glucose infusion was significantly correlated with the change in root mean square successive difference (r = 0.48; P < 0.01). Prolonged mild hyperinsulinemia disrupts the circadian rhythm of cardiac autonomic activity. Early changes in the neural control of cardiac activity may provide a potential mechanism mediating the pathophysiological link between impaired glucose tolerance and cardiovascular disease.

  4. Quantile Regression Analysis of the Distributional Effects of Air Pollution on Blood Pressure, Heart Rate Variability, Blood Lipids, and Biomarkers of Inflammation in Elderly American Men: The Normative Aging Study.

    PubMed

    Bind, Marie-Abele; Peters, Annette; Koutrakis, Petros; Coull, Brent; Vokonas, Pantel; Schwartz, Joel

    2016-08-01

    Previous studies have observed associations between air pollution and heart disease. Susceptibility to air pollution effects has been examined mostly with a test of effect modification, but little evidence is available whether air pollution distorts cardiovascular risk factor distribution. This paper aims to examine distributional and heterogeneous effects of air pollution on known cardiovascular biomarkers. A total of 1,112 men from the Normative Aging Study and residents of the greater Boston, Massachusetts, area with mean age of 69 years at baseline were included in this study during the period 1995-2013. We used quantile regression and random slope models to investigate distributional effects and heterogeneity in the traffic-related responses on blood pressure, heart rate variability, repolarization, lipids, and inflammation. We considered 28-day averaged exposure to particle number, PM2.5 black carbon, and PM2.5 mass concentrations (measured at a single monitor near the site of the study visits). We observed some evidence suggesting distributional effects of traffic-related pollutants on systolic blood pressure, heart rate variability, corrected QT interval, low density lipoprotein (LDL) cholesterol, triglyceride, and intercellular adhesion molecule-1 (ICAM-1). For example, among participants with LDL cholesterol below 80 mg/dL, an interquartile range increase in PM2.5 black carbon exposure was associated with a 7-mg/dL (95% CI: 5, 10) increase in LDL cholesterol, while among subjects with LDL cholesterol levels close to 160 mg/dL, the same exposure was related to a 16-mg/dL (95% CI: 13, 20) increase in LDL cholesterol. We observed similar heterogeneous associations across low versus high percentiles of the LDL distribution for PM2.5 mass and particle number. These results suggest that air pollution distorts the distribution of cardiovascular risk factors, and that, for several outcomes, effects may be greatest among individuals who are already at high risk

  5. Quantile Regression Analysis of the Distributional Effects of Air Pollution on Blood Pressure, Heart Rate Variability, Blood Lipids, and Biomarkers of Inflammation in Elderly American Men: The Normative Aging Study

    PubMed Central

    Bind, Marie-Abele; Peters, Annette; Koutrakis, Petros; Coull, Brent; Vokonas, Pantel; Schwartz, Joel

    2016-01-01

    Background: Previous studies have observed associations between air pollution and heart disease. Susceptibility to air pollution effects has been examined mostly with a test of effect modification, but little evidence is available whether air pollution distorts cardiovascular risk factor distribution. Objectives: This paper aims to examine distributional and heterogeneous effects of air pollution on known cardiovascular biomarkers. Methods: A total of 1,112 men from the Normative Aging Study and residents of the greater Boston, Massachusetts, area with mean age of 69 years at baseline were included in this study during the period 1995–2013. We used quantile regression and random slope models to investigate distributional effects and heterogeneity in the traffic-related responses on blood pressure, heart rate variability, repolarization, lipids, and inflammation. We considered 28-day averaged exposure to particle number, PM2.5 black carbon, and PM2.5 mass concentrations (measured at a single monitor near the site of the study visits). Results: We observed some evidence suggesting distributional effects of traffic-related pollutants on systolic blood pressure, heart rate variability, corrected QT interval, low density lipoprotein (LDL) cholesterol, triglyceride, and intercellular adhesion molecule-1 (ICAM-1). For example, among participants with LDL cholesterol below 80 mg/dL, an interquartile range increase in PM2.5 black carbon exposure was associated with a 7-mg/dL (95% CI: 5, 10) increase in LDL cholesterol, while among subjects with LDL cholesterol levels close to 160 mg/dL, the same exposure was related to a 16-mg/dL (95% CI: 13, 20) increase in LDL cholesterol. We observed similar heterogeneous associations across low versus high percentiles of the LDL distribution for PM2.5 mass and particle number. Conclusions: These results suggest that air pollution distorts the distribution of cardiovascular risk factors, and that, for several outcomes, effects may be

  6. Correlation of 24-Hour Blood Pressure and Heart Rate Variability to Renal Function Parameters in Hypertensive Patients. The Effect of Smoking.

    PubMed

    Liakos, Charalampos I; Karpanou, Eva A; Markou, Maria I; Grassos, Charalampos A; Vyssoulis, Gregory P

    2015-12-01

    Intrarenal hemodynamics depend on blood pressure (BP), heart rate (HR), and smoking. Although BP levels have been associated with kidney function, the effect of HR levels, BP, and HR variability on renal function are less well clarified. This cross-sectional study sought to determine the association of 24-hour BP and HR variability with kidney function in hypertensive patients, stratified by smoking. The study comprised 9600 nondiabetic, never-treated hypertensive individuals without evident renal impairment examined from 1985 to 2014 (aged 53.3±13.4 years, 55.3% males). The 24-hour systolic BP (SBP) and HR variability were estimated via their coefficient of variation (CV =standard deviation×100/mean value) derived from ambulatory recording. The CV SBP-to-CV HR ratio (CV R) was used as a marker of the interplay between 24-hour SBP and HR variability. Renal function was estimated via 24-hour urine creatinine clearance (CrCl), estimated glomerular filtration rate (eGFR), albumin-to-creatinine ratio (ACR), and 24-hour urine α1 -microglobulin. After adjustment for age, sex, and smoking, CV SBP was found to be weakly correlated to eGFR (r=-0.017, P=.1) and somewhat more strongly to CrCl, ACR, and α1 -microglobulin (r=-0.032, 0.072, and 0.065; P=.002, <.001 and <.001, respectively). CV HR was much better related to renal function, with stronger adjusted correlations to CrCl, eGFR, ACR, and α1 -microglobulin (r=0.185, 0.134, -0.306, -0.247; all P<.001, respectively). CV R also showed equally good adjusted correlations (r=-0.175, -0.125, 0.336, 0.262; all P<.001, respectively). Most adjusted correlations for CV HR and CV R were even better in smokers (r=0.213, 0.158, -0.332, -0.272 and -0.183, -0.118, 0.351, 0.275, respectively; all P<.001). CV HR and CV R emerge as better related to kidney function than CV SBP, especially in smokers. The correlation of CV HR and CV SBP to renal function is inverse to each other. ACR and α1 -microglobulin are better related to

  7. Interchangeability of Electrocardiography and Blood Pressure Measurement for Determining Heart Rate and Heart Rate Variability in Free-Moving Domestic Pigs in Various Behavioral Contexts

    PubMed Central

    Krause, Annika; Tuchscherer, Armin; Puppe, Birger; Langbein, Jan

    2015-01-01

    This study assessed the interchangeability between heart rate (HR) and heart rate variability (HRV) measures derived from a series of interbeat intervals (IBIs) recorded via electrocardiogram (ECG) and intra-arterial blood pressure (BP) in various behavioral contexts. Five minutes of simultaneously recorded IBIs from ECG and BP signals in 11 female domestic pigs during resting, feeding, and active behavior were analyzed. Comparisons were made for measures of HR, the standard deviation of IBIs, and the root mean of the squared distances of subsequent IBIs derived from ECG and BP signals for each behavior category using statistical procedures with different explanatory power [linear regression, intraclass correlation coefficient (ICC), Bland and Altman plots, and analysis of variance (ANOVA)]. Linear regression showed a strong relationship for HR during all behaviors and for HRV during resting. Excellent ICCs [lower 95% confidence intervals (CI) >0.75] and narrow limits of agreement in all behavior categories were found for HR. ICCs for HRV reached the critical lower 95% CI value of 0.75 only during resting. Using Bland and Altman plots, HRV agreement was unacceptable for all of the behavior categories. ANOVA showed significant differences between the methods in terms of HRV. BP systematically overestimated HRV compared with ECG. Our findings reveal that HR data recorded via BP agree well those recorded using ECG independently of the activity of the subject, whereas ECG and BP cannot be used interchangeably in the context of HRV in free-moving domestic pigs. PMID:26664979

  8. CHRONOBIOLOGY OF HIGH BLOOD PRESSURE

    PubMed Central

    Cornélissen, G.; Halberg, F.; Bakken, E. E.; Wang, Z.; Tarquini, R.; Perfetto, F.; Laffi, G.; Maggioni, C.; Kumagai, Y.; Homolka, P.; Havelková, A.; Dušek, J.; Svačinová, H.; Siegelová, J.; Fišer, B.

    2008-01-01

    BIOCOS, the project aimed at studying BIOlogical systems in their COSmos, has obtained a great deal of expertise in the fields of blood pressure (BP) and heart rate (HR) monitoring and of marker rhythmometry for the purposes of screening, diagnosis, treatment, and prognosis. Prolonging the monitoring reduces the uncertainty in the estimation of circadian parameters; the current recommendation of BIOCOS requires monitoring for at least 7 days. The BIOCOS approach consists of a parametric and a non-parametric analysis of the data, in which the results from the individual subject are being compared with gender- and age-specified reference values in health. Chronobiological designs can offer important new information regarding the optimization of treatment by timing its administration as a function of circadian and other rhythms. New technological developments are needed to close the loop between the monitoring of blood pressure and the administration of antihypertensive drugs. PMID:19122770

  9. Birth weight, infant growth, and adolescent blood pressure using twin status as an instrumental variable in a Chinese birth cohort: "Children of 1997".

    PubMed

    Kwok, Man Ki; Au Yeung, Shiu Lun; Leung, Gabriel M; Schooling, C Mary

    2014-07-01

    To evaluate the credibility of twin status as an instrumental variable for birth weight and infant growth and to obtain less-confounded estimates of the associations of birth weight or infant growth with adolescent blood pressure (BP). Prospective population-based "Children of 1997" birth cohort of all surviving infants born in Hong Kong, China, from April to May 1997 with sex-, age-, and height-specific BP z-score at approximately 11 years (n = 6276) and approximately 13 years (n = 5305). In instrumental variable analyses, birth weight-for-gestational age z-score was not associated with z-score for systolic BP (0.01; 95% confidence interval [CI], -0.22 to 0.25) or diastolic BP (0.04; 95% CI, -0.09 to 0.18) at approximately 11 years adjusted for maternal age and migrant status (F = 38.6). Change in weight z-score at 0 to 12 months was not associated with z-score for systolic BP (-0.003; 95% CI, -0.15 to 0.15) or diastolic BP (-0.02; 95% CI, -0.10 to 0.07) at approximately 11 years (F = 54.4). Estimates were similar for BP at approximately 13 years, although the F-statistic was lower. Birth weight and infant growth may make little contribution to adolescent BP. Extending consideration of the effects of early life to other growth periods, such as puberty, on BP might yield public health benefits. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Medication adherence and visit-to-visit variability of systolic blood pressure in African Americans with chronic kidney disease in the AASK trial.

    PubMed

    Hong, K; Muntner, P; Kronish, I; Shilane, D; Chang, T I

    2016-01-01

    Lower adherence to antihypertensive medications may increase visit-to-visit variability of blood pressure (VVV of BP), a risk factor for cardiovascular events and death. We used data from the African American Study of Kidney Disease and Hypertension (AASK) trial to examine whether lower medication adherence is associated with higher systolic VVV of BP in African Americans with hypertensive chronic kidney disease (CKD). Determinants of VVV of BP were also explored. AASK participants (n=988) were categorized by self-report or pill count as having perfect (100%), moderately high (75-99%), moderately low (50-74%) or low (<50%) proportion of study visits with high medication adherence over a 1-year follow-up period. We used multinomial logistic regression to examine determinants of medication adherence, and multivariable-adjusted linear regression to examine the association between medication adherence and systolic VVV of BP, defined as the coefficient of variation or the average real variability (ARV). Participants with lower self-reported adherence were generally younger and had a higher prevalence of comorbid conditions. Compared with perfect adherence, moderately high, moderately low and low adherence was associated with 0.65% (±0.31%), 0.99% (±0.31%) and 1.29% (±0.32%) higher systolic VVV of BP (defined as the coefficient of variation) in fully adjusted models. Results were qualitatively similar when using ARV or when using pill counts as the measure of adherence. Lower medication adherence is associated with higher systolic VVV of BP in African Americans with hypertensive CKD; efforts to improve medication adherence in this population may reduce systolic VVV of BP.

  11. Association of left ventricular structural and functional abnormalities with aortic and brachial blood pressure variability in hypertensive patients: the SAFAR study.

    PubMed

    Chi, C; Yu, S-K; Auckle, R; Argyris, A A; Nasothimiou, E; Tountas, C; Aissopou, E; Blacher, J; Safar, M E; Sfikakis, P P; Zhang, Y; Protogerou, A D

    2017-10-01

    Both brachial blood pressure (BP) level and its variability (BPV) significantly associate with left ventricular (LV) structure and function. Recent studies indicate that aortic BP is superior to brachial BP in the association with LV abnormalities. However, it remains unknown whether aortic BPV better associate with LV structural and functional abnormalities. We therefore aimed to investigate and compare aortic versus brachial BPV, in terms of the identification of LV abnormalities. Two hundred and three participants who underwent echocardiography were included in this study. Twenty-four-hour aortic and brachial ambulatory BP was measured simultaneously by a validated BP monitor (Mobil-O-Graph, Stolberg, Germany) and BPV was calculated with validated formulae. LV mass and LV diastolic dysfunction (LVDD) were evaluated by echocardiography. The prevalence of LV hypertrophy (LVH) and LVDD increased significantly with BPV indices (P⩽0.04) in trend tests. After adjustment to potential confounders, only aortic average real variability (ARV), but not brachial ARV or weighted s.d. (wSD, neither aortic nor brachial) significantly associated with LV mass index (P=0.02). Similar results were observed in logistic regression. After adjustment, only aortic ARV significantly associated with LVH (odds ratio (OR) and 95% confidence interval (CI): 2.28 (1.08, 4.82)). As for LVDD, neither the brachial nor the aortic 24-hour wSD, but the aortic and brachial ARV, associated with LVDD significantly, with OR=2.28 (95% CI: (1.03, 5.02)) and OR=2.36 (95% CI: (1.10, 5.05)), respectively. In summary, aortic BPV, especially aortic ARV, seems to be superior to brachial BPV in the association of LV structural and functional abnormalities.

  12. Short-term blood pressure variability - variation between arm side, body position and successive measurements: a population-based cohort study.

    PubMed

    Lacruz, Maria Elena; Kluttig, Alexander; Kuss, Oliver; Tiller, Daniel; Medenwald, Daniel; Nuding, Sebastian; Greiser, Karin Halina; Frantz, Stefan; Haerting, Johannes

    2017-01-18

    Precise blood pressure (BP) measurements are central for the diagnosis of hypertension in clinical and epidemiological studies. The purpose of this study was to quantify the variability in BP associated with arm side, body position, and successive measurements in the setting of a population-based observational study. Additionally, we aimed to evaluate the influence of different measurement conditions on prevalence of hypertension. The sample included 967 men and 812 women aged 45 to 83 years at baseline. BP was measured according to a standardized protocol with oscillometric devices including three sitting measurements at left arm, one simultaneous supine measurement at both arms, and four supine measurements at the arm with the higher BP. Hypertension was defined as systolic BP (SBP) ≥140 mmHg and/or diastolic BP (DBP) ≥90 mmHg. Variability in SBP and DBP were analysed with sex-stratified linear covariance pattern models. We found that overall, no mean BP differences were measured according to arm-side, but substantial higher DBP and for men also higher SBP was observed in sitting than in supine position and there was a clear BP decline by consecutive measurement. Accordingly, the prevalence of hypertension depends strongly on the number and scheme of BP measurements taken to calculate the index values. Thus, BP measurements should only be compared between studies applying equal measurement conditions and index calculation. Moreover, the first BP measurement should not be used to define hypertension since it overestimates BP. The mean of second and third measurement offers the advantage of better reproducibility over single measurements.

  13. The Environment and Blood Pressure.

    PubMed

    Brook, Robert D

    2017-05-01

    A host of environmental factors can significantly increase arterial blood pressure (BP) including cold temperature, high altitude, loud noises, and ambient air pollutants. Although brief exposures acutely elevate BP, over the long term, chronic exposures may be capable of promoting the development of sustained hypertension. Given their omnipresent nature, environmental factors may play a role in worsening BP control and heightening overall cardiovascular risk at the global public health level. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. High Blood Pressure and Kidney Disease

    MedlinePlus

    ... Kidney disease is diagnosed with urine and blood tests. Health care providers measure blood pressure with a blood pressure ... the sample to a lab for analysis. A health care provider may order a blood test to estimate how much blood the kidneys filter ...

  15. Electronically Variable Pressure Regulator (EVPR)

    NASA Technical Reports Server (NTRS)

    Reinicke, R. H.; Nelson, R. O.; Hurlbert, E.

    1989-01-01

    A new programmable electronically variable pressure regulator (EVPR) concept accurately controls the local outlet or remote system pressure. It uses an integral pulse width modulated rare earth permanent magnet motor operating in response to redundant pressure transducer feedback signals. The EVPR is a simple single stage device that does not use dynamic seals or pilot valving. Conversion of partial revolution motor torque to poppet lifting force is accomplished by pure flexure action to avoid using bearings. The flexure drive (called the ROTAX) has a variable lead to minimize motor weight and power consumption. Breadboard tests were completed successfully on two critical design elements of the EVPR: the ROTAX and the motor. The ROTAX cable system was tested for 250,000 cycles without failure. The breadboard motor met the basic design requirements including the design torque and power consumption. Prototype parts were fabricated, and testing of the prototype EVPR has started. It is PC computer controlled to facilitate programming, data acquisition and analysis. A lightweight dedicated microprocessor is planned for the flightweight EVPR.

  16. Electronically Variable Pressure Regulator (EVPR)

    NASA Astrophysics Data System (ADS)

    Reinicke, R. H.; Nelson, R. O.; Hurlbert, E.

    1989-05-01

    A new programmable electronically variable pressure regulator (EVPR) concept accurately controls the local outlet or remote system pressure. It uses an integral pulse width modulated rare earth permanent magnet motor operating in response to redundant pressure transducer feedback signals. The EVPR is a simple single stage device that does not use dynamic seals or pilot valving. Conversion of partial revolution motor torque to poppet lifting force is accomplished by pure flexure action to avoid using bearings. The flexure drive (called the ROTAX) has a variable lead to minimize motor weight and power consumption. Breadboard tests were completed successfully on two critical design elements of the EVPR: the ROTAX and the motor. The ROTAX cable system was tested for 250,000 cycles without failure. The breadboard motor met the basic design requirements including the design torque and power consumption. Prototype parts were fabricated, and testing of the prototype EVPR has started. It is PC computer controlled to facilitate programming, data acquisition and analysis. A lightweight dedicated microprocessor is planned for the flightweight EVPR.

  17. Risk Factors for High Blood Pressure

    MedlinePlus

    ... to achieve target blood pressure goals with treatment. Overweight You are more likely to develop prehypertension or high blood pressure if you’re overweight or obese . The terms “overweight” and “obese” refer ...

  18. Control Blood Pressure, Protect Your Kidneys

    MedlinePlus

    ... Bar Home Current Issue Past Issues Health Lines Control Blood Pressure, Protect Your Kidneys Past Issues / Fall ... Not Alone / Keep Weight Off / Facts About Fat / Control Blood Pressure, Protect Your Kidneys Fall 2008 Issue: ...

  19. Taking your blood pressure at home (image)

    MedlinePlus

    ... sure you are taking your blood pressure correctly. Compare your home machine with the one at your ... sure you are taking your blood pressure correctly. Compare your home machine with the one at your ...

  20. Avoid the Consequences of High Blood Pressure

    MedlinePlus

    ... Aneurysm More Avoid the Consequences of High Blood Pressure Infographic Updated:Oct 31,2016 View a downloadable version of this infographic High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  1. Cuff for Blood-Vessel Pressure Measurements

    NASA Technical Reports Server (NTRS)

    Shimizu, M.

    1982-01-01

    Pressure within blood vessel is measured by new cufflike device without penetration of vessel. Device continuously monitors blood pressure for up to 6 months or longer without harming vessel. Is especially useful for vessels smaller than 4 or 5 millimeters in diameter. Invasive methods damage vessel wall, disturb blood flow, and cause clotting. They do not always give reliable pressure measurements over prolonged periods.

  2. Cuff for Blood-Vessel Pressure Measurements

    NASA Technical Reports Server (NTRS)

    Shimizu, M.

    1982-01-01

    Pressure within blood vessel is measured by new cufflike device without penetration of vessel. Device continuously monitors blood pressure for up to 6 months or longer without harming vessel. Is especially useful for vessels smaller than 4 or 5 millimeters in diameter. Invasive methods damage vessel wall, disturb blood flow, and cause clotting. They do not always give reliable pressure measurements over prolonged periods.

  3. Reliability of nocturnal blood pressure dipping.

    PubMed

    Dimsdale, J E; von Känel, R; Profant, J; Nelesen, R; Ancoli-Israel, S; Ziegler, M

    2000-08-01

    Increasing evidence documents the fact that individuals whose blood pressure drops or 'dips' relatively little at night have a higher risk of numerous cardiovascular illnesses. To examine the reliability of various measures of nocturnal blood pressure dipping. This study examined 17 individuals with ambulatory blood pressure monitoring on three 24 h recordings while they pursued a schedule similar to that of in-patients on a clinical research unit. Nocturnal dipping of blood pressure was scored three ways: as the drop in blood pressure between 10 p.m. and 6 a.m. ('clocktime'), as the drop in blood pressure tailored to each individual's reported bedtime ('bedtime'), and as the drop in blood pressure accompanying polysomnographically verified sleep ('sleeptime'). Adequate reliability was obtained for all three measures of dipping. There was, in general, a significant correlation across testing occasions (P<0.05). The correlation coefficient ranged from 0.5 to 0.8, depending on which criterion of dipping was selected and whether the endpoint was systolic blood pressure, diastolic blood pressure, or mean arterial blood pressure. The reliability of systolic blood pressure dipping was somewhat lower than that of diastolic or mean arterial blood pressure dipping. Dipping appears to be a reliable construct. While no one definition of dipping was demonstrably better than another, the most sensible definition of dipping would allow some adjustment for defining 'night' on the basis of each individual's idiosyncratic bed time.

  4. Preferable effects of olmesartan/calcium channel blocker to olmesartan/diuretic on blood pressure variability in very elderly hypertension: COLM study subanalysis

    PubMed Central

    Rakugi, Hiromi; Ogihara, Toshio; Saruta, Takao; Kawai, Tatsuo; Saito, Ikuo; Teramukai, Satoshi; Shimada, Kazuyuki; Katayama, Shigehiro; Higaki, Jitsuo; Odawara, Masato; Tanahashi, Norio; Kimura, Genjiroh

    2015-01-01

    Objective: The aims of this subanalysis of the COLM trial [NCT00454662] were to compare visit-to-visit variability (VVV) of blood pressure (BP) between age groups and between two treatment combinations, that is, the angiotensin II receptor blocker, olmesartan combined with a calcium channel blocker (CCB), or a diuretic and to investigate the effect of VVV of BP on cardiovascular events in elderly hypertensive patients. Methods: Hypertensive patients ages 65–84 years with a history of and/or risk factors for cardiovascular disease were randomized to receive treatment with olmesartan along with either a CCB or a diuretic for at least 3 years. This subanalysis comprised 4876 patients who had their office BP measured at least three occasions (median nine occasions) during the follow-up period. VVV of BP was defined by several metrics including the within-individual standard deviation of every visit during the follow-up period. Results: VVV of SBP was larger in the very elderly group (75–84 years) than in the elderly group (65–74 years). VVV of SBP was smaller in the olmesartan along with CCB group than in the olmesartan along with diuretic group, especially in very elderly patients and also isolated systolic hypertensive patients. The incidence rate of primary endpoint increased along with an increment in the SD of SBP in all of the age and treatment groups. Conclusion: VVV of SBP may mediate the preferable effect of combination of angiotensin II receptor blocker along with CCB on cardiovascular events in the very elderly and also isolated systolic hypertensive patients. PMID:26066644

  5. Preferable effects of olmesartan/calcium channel blocker to olmesartan/diuretic on blood pressure variability in very elderly hypertension: COLM study subanalysis.

    PubMed

    Rakugi, Hiromi; Ogihara, Toshio; Saruta, Takao; Kawai, Tatsuo; Saito, Ikuo; Teramukai, Satoshi; Shimada, Kazuyuki; Katayama, Shigehiro; Higaki, Jitsuo; Odawara, Masato; Tanahashi, Norio; Kimura, Genjiroh

    2015-10-01

    The aims of this subanalysis of the COLM trial [NCT00454662] were to compare visit-to-visit variability (VVV) of blood pressure (BP) between age groups and between two treatment combinations, that is, the angiotensin II receptor blocker, olmesartan combined with a calcium channel blocker (CCB), or a diuretic and to investigate the effect of VVV of BP on cardiovascular events in elderly hypertensive patients. Hypertensive patients ages 65-84 years with a history of and/or risk factors for cardiovascular disease were randomized to receive treatment with olmesartan along with either a CCB or a diuretic for at least 3 years. This subanalysis comprised 4876 patients who had their office BP measured at least three occasions (median nine occasions) during the follow-up period. VVV of BP was defined by several metrics including the within-individual standard deviation of every visit during the follow-up period. VVV of SBP was larger in the very elderly group (75-84 years) than in the elderly group (65-74 years). VVV of SBP was smaller in the olmesartan along with CCB group than in the olmesartan along with diuretic group, especially in very elderly patients and also isolated systolic hypertensive patients. The incidence rate of primary endpoint increased along with an increment in the SD of SBP in all of the age and treatment groups. VVV of SBP may mediate the preferable effect of combination of angiotensin II receptor blocker along with CCB on cardiovascular events in the very elderly and also isolated systolic hypertensive patients.

  6. The effects of weight loss and salt reduction on visit-to-visit blood pressure variability: results from a multicenter randomized controlled trial.

    PubMed

    Diaz, Keith M; Muntner, Paul; Levitan, Emily B; Brown, Michael D; Babbitt, Dianne M; Shimbo, Daichi

    2014-04-01

    As evidence suggests visit-to-visit variability (VVV) of blood pressure (BP) is associated with cardiovascular events and mortality, there is increasing interest in identifying interventions that reduce VVV of BP. We investigated the effects of weight loss and sodium reduction, alone or in combination, on VVV of BP in participants enrolled in phase II of the Trials of Hypertension Prevention. BP readings were taken at 6-month intervals for 36 months in 1820 participants with high-normal DBP who were randomized to weight loss, sodium reduction, combination (weight loss and sodium reduction), or usual care groups. VVV of BP was defined as the SD of BP across six follow-up visits. VVV of SBP was not significantly different between participants randomized to the weight loss (7.2 ± 3.1  mmHg), sodium reduction (7.1 ± 3.0  mmHg), or combined (6.9 ± 2.9  mmHg) intervention groups vs. the usual care group (6.9 ± 2.9  mmHg). In a fully adjusted model, no difference (0.0 ± 0.2  mmHg) in VVV of SBP was present between individuals who successfully maintained their weight loss vs. individuals who did not lose weight during follow-up (P = 0.93). Also, those who maintained a reduced sodium intake throughout follow-up did not have lower VVV of SBP compared to those who did not reduce their sodium intake (0.1 ± 0.3  mmHg; P = 0.77). Results were similar for VVV of DBP. These findings suggest that weight loss and sodium reduction may not be effective interventions for lowering VVV of BP in individuals with high-normal DBP.

  7. Significance of Cardiac Rehabilitation on Visit-to-Visit Variability of Blood Pressure in Patients With Cardiovascular Disease in a 12-Month Follow-Up

    PubMed Central

    Ishida, Toshihisa; Miura, Shin-ichiro; Fujimi, Kanta; Futami, Makito; Ueda, Yoko; Ueda, Takashi; Arimura, Tadaaki; Koyoshi, Rie; Shiga, Yuhei; Kitajima, Ken; Saku, Keijiro

    2017-01-01

    Background Visit-to-visit variability (VVV) in blood pressure (BP) has been shown to be a strong predictor of cardiovascular disease (CVD). However, the long-term effect of comprehensive cardiac rehabilitation (CR) with exercise training on VVV in BP has not yet been established. Therefore, we evaluated the long-term effects of CR on VVV in BP in patients with CVD. Methods Twenty-two CVD patients in a 12-month CR program who had at least six clinic visits per month to measure BP were enrolled. We determined VVV in BP expressed as the standard deviation of average BP every month for 12 months. Results The mean age was 70 ± 8 years and the body mass index was 24.4 ± 4.9 kg/m2. In addition, the percentage (%) of males, % heart failure and % ischemic heart disease were 77%, 55% and 27%, respectively. Patients who had uncontrolled BP at baseline showed a significant reduction of both systolic BP (SBP) and diastolic BP (DBP). VVV in SBP in the first month was significantly less than that in the last month, although there was no difference in VVV in DBP. Patients were divided into larger (L-) and smaller (S-) VVV in SBP groups according to the average value of VVV in SBP as a cut-off. The L-VVV in SBP group, but not the S-VVV in SBP group, showed a significant reduction of VVV in SBP. Conclusion Comprehensive CR may improve VVV in SBP in CVD patients who have larger VVV in SBP. PMID:28270895

  8. Effects of aerobic exercise training and irbesartan on blood pressure and heart rate variability in patients with chronic obstructive pulmonary disease.

    PubMed

    Marquis, Karine; Maltais, Fracois; Lacasse, Yves; Lacourciere, Yves; Fortin, Claudette; Poirier, Paul

    2008-10-01

    The present pilot study was undertaken to evaluate the efficacy of an aerobic exercise training (AET) program alone or combined with an antihypertensive agent (irbesartan) to reduce blood pressure (BP) and enhance heart rate variability (HRV) in chronic obstructive pulmonary disease patients. Twenty-one patients were randomly assigned to a double-blind treatment with exercise and placebo (n=11) or exercise and irbesartan (n=10). Subjects underwent 24 h BP monitoring and 24 h electrocardiographic recording before and after the 12-week AET. HRV was investigated using three indexes from the power spectral analysis and three indexes calculated from the time domain. The AET program consisted of exercising on a calibrated ergocycle for 30 min three times per week. Five patients in the placebo group were excluded during follow-up because they were not compliant. There was no change in 24 h systolic and diastolic BP before (130+/-14 mmHg and 70+/-3 mmHg, respectively) and after (128+/-8 mmHg and 70+/-8 mmHg, respectively) exercise training in the placebo group, whereas in the irbesartan group systolic and diastolic BP decreased from 135+/-9 mmHg and 76+/-9 mmHg to 126+/-12 mmHg and 72+/-8 mmHg, respectively (P<0.02). There were no changes in HRV parameters in either group. The present study suggests that a 12-week AET program is not associated with a significant reduction in BP or enhancement in HRV, whereas an AET program combined with irbesartan is associated with a reduction in 24 h BP.

  9. Effects of aerobic training intensity on resting, exercise and post-exercise blood pressure, heart rate and heart-rate variability.

    PubMed

    Cornelissen, V A; Verheyden, B; Aubert, A E; Fagard, R H

    2010-03-01

    We aimed to investigate the effects of endurance training intensity (1) on systolic blood pressure (SBP) and heart rate (HR) at rest before exercise, and during and after a maximal exercise test; and (2) on measures of HR variability at rest before exercise and during recovery from the exercise test, in at least 55-year-old healthy sedentary men and women. A randomized crossover study comprising three 10-week periods was performed. In the first and third period, participants exercised at lower or higher intensity (33% or 66% of HR reserve) in random order, with a sedentary period in between. Training programmes were identical except for intensity, and were performed under supervision thrice for 1 h per week. The results show that in the three conditions, that is, at rest before exercise, during exercise and during recovery, we found endurance training at lower and higher intensity to reduce SBP significantly (P<0.05) and to a similar extent. Further, SBP during recovery was, on average, not lower than at rest before exercise, and chronic endurance training did not affect the response of SBP after an acute bout of exercise. The effect of training on HR at rest, during exercise and recovery was more pronounced (P<0.05) with higher intensity. Finally, endurance training had no significant effect on sympathovagal balance. In conclusion, in participants at higher age, both training programmes exert similar effects on SBP at rest, during exercise and during post-exercise recovery, whereas the effects on HR are more pronounced after higher intensity training.

  10. Cutaneous control of blood pressure.

    PubMed

    Johnson, Randall S; Titze, Jens; Weller, Richard

    2016-01-01

    Textbook theory holds that blood pressure (BP) is regulated by the brain, by blood vessels, or by the kidney. Recent evidence suggests that BP could be regulated in the skin. The skin holds a complex capillary counter current system, which controls body temperature, skin perfusion, and apparently systemic BP. Epidemiological data suggest that sunlight exposure plays a role in controlling BP. Ultraviolet A radiation produces vasodilation and a fall in BP. Keratinocytes and immune cells control blood flow in the extensive countercurrent loop system of the skin by producing nitric oxide, a key regulator of vascular tone. The balance between hypoxia-inducible factor-1α and hypoxia-inducible factor-2α activity in keratinocytes controls skin perfusion, systemic thermoregulation, and systemic BP by nitric oxide-dependent mechanisms. Furthermore, the skin accumulates Na which generates a barrier to promote immunological host defense. Immune cells control skin Na metabolism and the clearance of Na via the lymphatic system. Reduced lymphatic clearance increases BP. Apart from the well-known role of the brain, blood vessels, and the kidney, the skin is important for systemic BP control in humans and in experimental animals.

  11. Blood pressure reprogramming adapter assists signal recording

    NASA Technical Reports Server (NTRS)

    Vick, H. A.

    1967-01-01

    Blood pressure reprogramming adapter separates the two components of a blood pressure signal, a dc pressure signal and an ac Korotkoff sounds signal, so that the Korotkoff sounds are recorded on one channel as received while the dc pressure signal is converted to FM and recorded on a second channel.

  12. Searching for baseline blood pressure: A comparison of blood pressure at three different care points.

    PubMed

    Ard, John L; Kendale, Samir

    2016-12-01

    A common approach to blood pressure management in the operating room is to keep the intraoperative, pressures within 20% of baseline blood pressure. One question that arises from this recommendation is; what is a patient's true baseline blood pressure? In order to get a more precise definition of baseline blood pressure, a comparison of the first operating room blood pressure was made with the blood pressure taken in a preoperative holding area before surgery, and the blood pressure taken in pre-surgical testing. (before day of surgery). A database of 2087 adult general anesthesia cases was generated, which contained the blood pressure (BP) in the pre-surgical testing clinic, the first BP in preoperative holding on the day of surgery, and the first BP in the operating room. Comparisons were made between the blood pressures taken at each phase of care. All components of BP taken in the OR were statistically significantly higher (p<0.001 for all comparisons) than in either PST or the holding area, while the BP in the latter locations were not significantly different. This blood pressure difference persists whether or not the patient is taking antihypertensive medications. The higher blood pressure measured in the operating rooms precludes using this measurement to determine baseline blood pressure. Blood pressures taken prior to arrival in the operating room are similar to blood pressures taken before the day of surgery. Blood pressure measurements taken prior to entrance in the operating room can be used to determine baseline blood pressure.

  13. Calf blood pressure: clinical implications and correlations with arm blood pressure in infants and young children.

    PubMed

    Crapanzano, M S; Strong, W B; Newman, I R; Hixon, R L; Casal, D; Linder, C W

    1996-02-01

    Indirect measurement of lower extremity blood pressure is often used in the clinical setting, although normative data after the newborn period are not readily available. Indirect blood pressure (BP) measurement was obtained in the right arms and right calves of 148 healthy infants and young children 2 weeks to 3 years of age. All measurements were made using an oscillometric device. The infants and children are quiet or asleep and in the supine position. A BP cuff of proper size was chosen. Three measurements were made in both extremities; the average of the second and third measurements was used for all analyses. Age correlated better with calf systolic blood pressure (SBPc) than with arm SBP (SBPa) (r = .52 vs .17). Calf diastolic blood pressure (DBPc) and calf mean blood pressure (MBPc) correlated moderately poorly with age (r = .37 and .39, respectively). There was no order effect. SBPc correlated best with height (r = .53), then age (r = .52), and, finally, weight (r = .51). The correlation between BPc and BPa was moderately low. The correlation of SBPc with SBPa was r = .46; that of DBPc with DBPa was r = .37; and that of MBPc with MBPa was r = .41. From birth to 6 months, SBPc was slightly lower than SBPa (1 to 3 mm Hg). SBPc increased linearly relative to SBPa and began to exceed SBPa at 6 months of age. The pattern of DBP and MBP was similar. Wide variability of blood pressure parameters was noted between the infants and children at all ages. Reference data are presented for BPc and the difference between BPc and BPa in healthy infants and children from 2 weeks to 3 years of age. BPc is not equivalent to BPa and should not be arbitrarily substituted. Because of the wide variability among healthy infants and children, SBPc measurements should be interpreted with caution when evaluating for coarctation of the aorta.

  14. Acute and chronic effects of a hypocaloric diet on 24-hour blood pressure, heart rate and heart-rate variability in mildly-to-moderately obese patients with essential hypertension.

    PubMed

    Minami, J; Kawano, Y; Ishimitsu, T; Matsuoka, H; Takishita, S

    1999-11-01

    We examined the acute and chronic effects of a nutritionally balanced, moderately hypocaloric diet on 24-hour ambulatory blood pressure, heart rate and heart-rate variability in mildly-to-moderately obese patients with essential hypertension. We enrolled 16 obese patients with essential hypertension [age: 51-76 years, body mass index (BMI): 26-32 kg/m2]. For the initial week, a standard diet of 2,000 kcal/day was given, followed by a 3-week of a hypocaloric diet of 850 kcal/day. In the last period of the standard diet and in the first and the last periods of the hypocaloric diet, each subject's 24-hour ambulatory blood pressure, heart rate and R-R intervals of the electrocardiogram were recorded, and electrolytes and catecholamines in 24-hour urine samples were also measured. A power spectral analysis of the heart-rate variability was performed over a 24-hour period based on the autoregressive method. The subjects lost 3.7+/-0.3 kg (mean +/- s.e.m.) of body weight during the 3-week hypocaloric diet period. The 24-hour blood pressure did not differ between the last period of the standard diet and the first period of the hypocaloric diet; however, it showed a significant reduction after 3 weeks of the hypocaloric diet. The decrease in the 24-hour blood pressure during the study period was 10.5+/-1.5 mm Hg systole and 4.3+/-1.8 mm Hg diastole. In contrast, the 24-hour heart rate was significantly reduced in the first period of the hypocaloric diet, although the body weight and blood pressure did not change, and the rate was maintained even in the last period of the hypocaloric diet. The decrease in the 24-hour heart rate during the study period was 2.8+/-0.9 beats per minute. The hypocaloric diet did not change any autonomic indices obtained from a power spectral analysis of the heart-rate variability. In conclusion, different responses to a hypocaloric diet were observed between the blood pressure and the heart rate in obese hypertensive patients. The changes in

  15. Central blood pressure and chronic kidney disease

    PubMed Central

    Ohno, Yoichi; Kanno, Yoshihiko; Takenaka, Tsuneo

    2016-01-01

    In this review, we focused on the relationship between central blood pressure and chronic kidney diseases (CKD). Wave reflection is a major mechanism that determines central blood pressure in patients with CKD. Recent medical technology advances have enabled non-invasive central blood pressure measurements. Clinical trials have demonstrated that compared with brachial blood pressure, central blood pressure is a stronger risk factor for cardiovascular (CV) and renal diseases. CKD is characterized by a diminished renal autoregulatory ability, an augmented direct transmission of systemic blood pressure to glomeruli, and an increase in proteinuria. Any elevation in central blood pressure accelerates CKD progression. In the kidney, interstitial inflammation induces oxidative stress to handle proteinuria. Oxidative stress facilitates atherogenesis, increases arterial stiffness and central blood pressure, and worsens the CV prognosis in patients with CKD. A vicious cycle exists between CKD and central blood pressure. To stop this cycle, vasodilator antihypertensive drugs and statins can reduce central blood pressure and oxidative stress. Even in early-stage CKD, mineral and bone disorders (MBD) may develop. MBD promotes oxidative stress, arteriosclerosis, and elevated central blood pressure in patients with CKD. Early intervention or prevention seems necessary to maintain vascular health in patients with CKD. PMID:26788468

  16. Cardiac and Arterial Contribution to Blood Pressure

    DTIC Science & Technology

    2007-11-02

    heart to the blood pressure . We conclude that when the heart hypertrophies, as a result of the hypertension , the changed cardiac behavior, in turn...Plenary Talks Cardiac and Arterial Contribution to Blood Pressure N.Westerhof, Lab. for Physiology, Institute for Cardiovascular Research...Vrije Universiteit of Amsterdam Blood pressure and blood flow result from the interaction of the heart, the pump, and the arterial system, the load

  17. Dietary potassium and blood pressure in a population.

    PubMed

    Khaw, K T; Barrett-Connor, E

    1984-06-01

    A population based study of 685 men and women aged 20 to 79 yr in a predominantly Caucasian community in Southern California found dietary potassium intake estimated from 24-h recall dietary history to be significantly and negatively correlated with age-adjusted systolic pressure in both men and women and with age-adjusted diastolic blood pressure in men. These correlations remained after exclusion of persons taking antihypertension medication or those with categorical hypertension (blood pressure greater than 160/95), and also persisted after adjusting for other dietary variables including alcohol and calcium intake. In women, correlations with blood pressure increased after excluding those taking sex hormones, suggesting that hormonal status may be an important determinant of blood pressure in women and may obscure other relationships. These findings support the etiological relationship of dietary potassium with blood pressure in populations.

  18. Relation of blood volume and blood pressure in orthostatic intolerance

    NASA Technical Reports Server (NTRS)

    Jacob, G.; Biaggioni, I.; Mosqueda-Garcia, R.; Robertson, R. M.; Robertson, D.

    1998-01-01

    A complex but crucial relationship exists between blood volume and blood pressure in human subjects; it has been recognized that in essential hypertension, renovascular hypertension, and pheochromocytoma, the relationship between plasma volume and diastolic blood pressure is an inverse one. This phenomenon has not been studied in individuals with low normal and reduced blood pressures. Orthostatic intolerance is a commonly encountered abnormality in blood pressure regulation often associated with tachycardia in the standing position. Most of these patients have varying degrees of reduced blood volume. We tested the hypothesis that the relationship previously found between plasma volume and diastolic blood pressure in pressor states would also hold in orthostatic intolerance. We studied 16 patients with a history of symptomatic orthostatic intolerance associated with an elevation in plasma norepinephrine in the upright posture and hypovolemia in 9 patients and normovolemia in 7 patients. Our studies demonstrate an inverse relationship between plasma volume and diastolic blood pressure in patients with orthostatic intolerance. This finding also holds for the change in diastolic blood pressure in response to upright posture. In this relationship, patients with orthostatic intolerance with high plasma norepinephrine resemble those with essential hypertension, renovascular hypertension, and pheochromocytoma. We conclude that in a variety of conditions at both ends of the blood pressure spectrum, the seemingly paradoxical association of hypovolemia and diastolic blood pressure is preserved.

  19. Relation of blood volume and blood pressure in orthostatic intolerance

    NASA Technical Reports Server (NTRS)

    Jacob, G.; Biaggioni, I.; Mosqueda-Garcia, R.; Robertson, R. M.; Robertson, D.

    1998-01-01

    A complex but crucial relationship exists between blood volume and blood pressure in human subjects; it has been recognized that in essential hypertension, renovascular hypertension, and pheochromocytoma, the relationship between plasma volume and diastolic blood pressure is an inverse one. This phenomenon has not been studied in individuals with low normal and reduced blood pressures. Orthostatic intolerance is a commonly encountered abnormality in blood pressure regulation often associated with tachycardia in the standing position. Most of these patients have varying degrees of reduced blood volume. We tested the hypothesis that the relationship previously found between plasma volume and diastolic blood pressure in pressor states would also hold in orthostatic intolerance. We studied 16 patients with a history of symptomatic orthostatic intolerance associated with an elevation in plasma norepinephrine in the upright posture and hypovolemia in 9 patients and normovolemia in 7 patients. Our studies demonstrate an inverse relationship between plasma volume and diastolic blood pressure in patients with orthostatic intolerance. This finding also holds for the change in diastolic blood pressure in response to upright posture. In this relationship, patients with orthostatic intolerance with high plasma norepinephrine resemble those with essential hypertension, renovascular hypertension, and pheochromocytoma. We conclude that in a variety of conditions at both ends of the blood pressure spectrum, the seemingly paradoxical association of hypovolemia and diastolic blood pressure is preserved.

  20. Religiosity and its relation to blood pressure among selected Kuwaitis.

    PubMed

    Al-Kandari, Yagoub Yousif

    2003-07-01

    This study examines the relationship between blood pressure and the religious practices of Kuwaitis as members of a Muslim society. Religious variables were measured via a sociocultural questionnaire. Blood pressure measurements were taken with a sphygmomanometer. Non-opportunistic samples were taken from 223 Kuwaitis. The difference in religious commitment between Muslim Sunnis and Muslim Shiites was examined using a t-test. Matrix correlation was used to examine the relationship between religious commitment and some other variables. Multiple regression was conducted to determine the effect of religiosity on blood pressure, as well as statistically controlling for other variables such as body mass index, socioeconomic status, smoking, gender and age. It was found that both systolic and diastolic blood pressure were affected by religious commitment and religious activities

  1. Continuous Blood Pressure Monitoring in Daily Life

    NASA Astrophysics Data System (ADS)

    Lopez, Guillaume; Shuzo, Masaki; Ushida, Hiroyuki; Hidaka, Keita; Yanagimoto, Shintaro; Imai, Yasushi; Kosaka, Akio; Delaunay, Jean-Jacques; Yamada, Ichiro

    Continuous monitoring of blood pressure in daily life could improve early detection of cardiovascular disorders, as well as promoting healthcare. Conventional ambulatory blood pressure monitoring (ABPM) equipment can measure blood pressure at regular intervals for 24 hours, but is limited by long measuring time, low sampling rate, and constrained measuring posture. In this paper, we demonstrate a new method for continuous real-time measurement of blood pressure during daily activities. Our method is based on blood pressure estimation from pulse wave velocity (PWV) calculation, which formula we improved to take into account changes in the inner diameter of blood vessels. Blood pressure estimation results using our new method showed a greater precision of measured data during exercise, and a better accuracy than the conventional PWV method.

  2. Noninvasive continuous blood pressure monitoring

    NASA Astrophysics Data System (ADS)

    Poghosyan, Armen; Mouradian, Vahram; Hovhannisyan, Levon

    2015-03-01

    We are presenting a novel photoplethysmographic (PPG) optical sensor and device with ambient optical, electrical and electromagnetic noises cancellation, thus allowing only the useful optical signals to be received by the health monitoring device. We are also presenting a new processing technique for canceling the ambient noises contributed by optical, electrical and electromagnetic artifacts in the measured PPG signals. Such a device and method allow the enhancement of the performance of the PPG sensors compared to conventional apparatus and methods. The presented sensor and methodology have been integrated into a prototype standalone device for noninvasive, continuous, wearable, remote and mobile monitoring of blood pressure and other human vital signs, such as heart rate, oxygen saturation, respiration rate, etc This small device allows the user to read, store, process and transmit all the measurements made using the PPG optical sensor and the electronic unit to a remote location.

  3. Timing of blood pressure measurement related to caffeine consumption.

    PubMed

    Mort, Jane R; Kruse, Heather R

    2008-01-01

    To determine whether patients should wait 30 minutes after caffeine consumption to have their blood pressure measured. Literature was obtained by searching MEDLINE (1980-September 2007), International Pharmaceutical Abstracts (1980-September 2007), and the Cochrane Database of Systematic Reviews (1994-September 2007). Search terms included caffeine and blood pressure. Literature was also obtained from citations in relevant articles. Articles that examined caffeine's acute effect on blood pressure were reviewed, with additional focus on caffeine tolerance and hypertensive status. Caffeine appears to affect blood pressure through adenosine receptor inhibition and an increased release of select neurotransmitters. Caffeine levels peak 30-120 minutes after oral intake and caffeine's half-life is 3-6 hours. The effect of caffeine on blood pressure has been examined for decades, with variable results depending on factors such as population examined (eg, hypertensive status, physical stressors, age) and study design (eg, acute effects, chronic ingestion, retrospective epidemiologic review). Caffeine tolerance diminishes the acute effect of caffeine on blood pressure, and hypertensive individuals are more susceptible to blood pressure changes. Reviews of caffeine's acute effect on blood pressure indicate changes of 3-15 mm Hg systolic and 4-13 mm Hg diastolic. Typically, blood pressure changes occur within 30 minutes, peak in 1-2 hours, and may persist for more than 4 hours. Having a patient abstain from caffeine for 30 minutes prior to blood pressure monitoring is not adequate to avoid caffeine's potential effects. An alternative approach to blood pressure monitoring would be to ask the patient about recent caffeine consumption and interpret the blood pressure reading based on this information. In addition, healthcare practitioners should provide education regarding caffeine's effects.

  4. Effect of nocturnal blood pressure measurement on sleep and blood pressure during sleep.

    PubMed

    Middeke, M

    1996-01-01

    Nocturnal hypertension is of diagnostic interest and has important prognostic and therapeutic implications. Nighttime blood pressure can easily be measured using ambulatory blood pressure monitoring (ABPM). However, during nocturnal ambulatory blood pressure measurement pump noise, tactile stimuli and pressure produced by cuff inflation may alter the quality of sleep and subsequently influence the physiological fall of night time blood pressure. Eight studies were performed to determine whether non-invasive automated blood pressure monitoring during day and/or night provokes alert reaction, arousal, sleep disturbances and changes in blood pressure and/or heart rate. From these studies it can be concluded: 1) Nighttime blood pressure can be evaluated properly using ABPM. 2) Nocturnal blood pressure is not overestimated by ABPM. 3) ABPM does not induce an alarm reaction and a blood pressure rise when monitored with a silently operating recorder. 4) Sleep is often disturbed by blood pressure measurement without provoking a blood pressure increase. 5) In older patients blood pressure measurement and age-related alterations in sleep quality may influence each other. A patient's protocol has to be carried out and sleep quality should be recorded to provide a proper interpretation of nocturnal blood pressure behavior. ABPM is an important and valuable method to record nocturnal blood pressure for diagnostic and therapeutic purposes.

  5. Pressure natriuresis and the renal control of arterial blood pressure

    PubMed Central

    Ivy, Jessica R; Bailey, Matthew A

    2014-01-01

    The regulation of extracellular fluid volume by renal sodium excretion lies at the centre of blood pressure homeostasis. Renal perfusion pressure can directly regulate sodium reabsorption in the proximal tubule. This acute pressure natriuresis response is a uniquely powerful means of stabilizing long-term blood pressure around a set point. By logical extension, deviation from the set point can only be sustained if the pressure natriuresis mechanism is impaired, suggesting that hypertension is caused or sustained by a defect in the relationship between renal perfusion pressure and sodium excretion. Here we describe the role of pressure natriuresis in blood pressure control and outline the cascade of biophysical and paracrine events in the renal medulla that integrate the vascular and tubular response to altered perfusion pressure. Pressure natriuresis is impaired in hypertension and mechanistic insight into dysfunction comes from genetic analysis of blood pressure disorders. Transplantation studies in rats show that blood pressure is determined by the genotype of the kidney and Mendelian hypertension indicates that the distal nephron influences the overall natriuretic efficiency. These approaches and the outcomes of genome-wide-association studies broaden our view of blood pressure control, suggesting that renal sympathetic nerve activity and local inflammation can impair pressure natriuresis to cause hypertension. Understanding how these systems interact is necessary to tackle the global burden of hypertension. PMID:25107929

  6. Pressure natriuresis and the renal control of arterial blood pressure.

    PubMed

    Ivy, Jessica R; Bailey, Matthew A

    2014-09-15

    The regulation of extracellular fluid volume by renal sodium excretion lies at the centre of blood pressure homeostasis. Renal perfusion pressure can directly regulate sodium reabsorption in the proximal tubule. This acute pressure natriuresis response is a uniquely powerful means of stabilizing long-term blood pressure around a set point. By logical extension, deviation from the set point can only be sustained if the pressure natriuresis mechanism is impaired, suggesting that hypertension is caused or sustained by a defect in the relationship between renal perfusion pressure and sodium excretion. Here we describe the role of pressure natriuresis in blood pressure control and outline the cascade of biophysical and paracrine events in the renal medulla that integrate the vascular and tubular response to altered perfusion pressure. Pressure natriuresis is impaired in hypertension and mechanistic insight into dysfunction comes from genetic analysis of blood pressure disorders. Transplantation studies in rats show that blood pressure is determined by the genotype of the kidney and Mendelian hypertension indicates that the distal nephron influences the overall natriuretic efficiency. These approaches and the outcomes of genome-wide-association studies broaden our view of blood pressure control, suggesting that renal sympathetic nerve activity and local inflammation can impair pressure natriuresis to cause hypertension. Understanding how these systems interact is necessary to tackle the global burden of hypertension.

  7. Measuring Time-Averaged Blood Pressure

    NASA Technical Reports Server (NTRS)

    Rothman, Neil S.

    1988-01-01

    Device measures time-averaged component of absolute blood pressure in artery. Includes compliant cuff around artery and external monitoring unit. Ceramic construction in monitoring unit suppresses ebb and flow of pressure-transmitting fluid in sensor chamber. Transducer measures only static component of blood pressure.

  8. Measuring Time-Averaged Blood Pressure

    NASA Technical Reports Server (NTRS)

    Rothman, Neil S.

    1988-01-01

    Device measures time-averaged component of absolute blood pressure in artery. Includes compliant cuff around artery and external monitoring unit. Ceramic construction in monitoring unit suppresses ebb and flow of pressure-transmitting fluid in sensor chamber. Transducer measures only static component of blood pressure.

  9. Prevalence, Awareness, Treatment and Influence of Socioeconomic Variables on Control of High Blood Pressure: Results of the ELSA-Brasil Study

    PubMed Central

    Chor, Dóra; Pinho Ribeiro, Antonio Luiz; Sá Carvalho, Marilia; Duncan, Bruce Bartholow; Andrade Lotufo, Paulo; Araújo Nobre, Aline; de Aquino, Estela Mota Lima Leão; Schmidt, Maria Inês; Griep, Rosane Härter; Molina, Maria Del Carmen Bisi; Barreto, Sandhi Maria; Passos, Valéria Maria de Azeredo; Benseñor, Isabela Judith Martins; Matos, Sheila Maria Alvim; Mill, José Geraldo

    2015-01-01

    High blood pressure (HBP) is the leading risk factor for years of life lost in Brazil. Factors associated with HBP awareness, treatment and control need to be understood better. Our aim is to estimate prevalence, awareness, and types of anti-hypertensive treatment and to investigate the association of HBP control with social position. Data of 15,103 (54% female) civil servants in six Brazilian state capitals collected at the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline (2008-2010) were used to estimate prevalence and cross-sectional association of HBP control with education, per capita family income and self-reported race, using multiple logistic regression. Blood pressure was measured by the oscillometric method. 35.8% were classified as presenting HBP; 76.8% of these used anti-hypertensive medication. Women were more aware than men (84.8% v. 75.8%) and more often using medication (83.1% v. 70.7%). Adjusted HBP prevalence was, in ascending order, Whites (30.3%), Browns (38.2%) and Blacks (49.3%). The therapeutic schemes most used were angiotensin-converting enzyme inhibitors, in isolation (12.4%) or combined with diuretics (13.3%). Among those in drug treatment, controlled blood pressure was more likely in the (postgraduate) higher education group than among participants with less than secondary school education (PR = 1.21; 95% CI: 1.14–1.28), and among Asian (PR = 1.21; 95% CI: 1.12–1.32) and ‘Whites (PR = 1.19; 95% CI: 1.12–1.26) compared to Blacks. Socioeconomic and racial inequality—as measured by different indicators—are strongly associated with HBP control, beyond the expected influence of health services access. PMID:26102079

  10. Prevalence, Awareness, Treatment and Influence of Socioeconomic Variables on Control of High Blood Pressure: Results of the ELSA-Brasil Study.

    PubMed

    Chor, Dóra; Pinho Ribeiro, Antonio Luiz; Sá Carvalho, Marilia; Duncan, Bruce Bartholow; Andrade Lotufo, Paulo; Araújo Nobre, Aline; Aquino, Estela Mota Lima Leão de; Schmidt, Maria Inês; Griep, Rosane Härter; Molina, Maria Del Carmen Bisi; Barreto, Sandhi Maria; Passos, Valéria Maria de Azeredo; Benseñor, Isabela Judith Martins; Matos, Sheila Maria Alvim; Mill, José Geraldo

    2015-01-01

    High blood pressure (HBP) is the leading risk factor for years of life lost in Brazil. Factors associated with HBP awareness, treatment and control need to be understood better. Our aim is to estimate prevalence, awareness, and types of anti-hypertensive treatment and to investigate the association of HBP control with social position. Data of 15,103 (54% female) civil servants in six Brazilian state capitals collected at the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline (2008-2010) were used to estimate prevalence and cross-sectional association of HBP control with education, per capita family income and self-reported race, using multiple logistic regression. Blood pressure was measured by the oscillometric method. 35.8% were classified as presenting HBP; 76.8% of these used anti-hypertensive medication. Women were more aware than men (84.8% v. 75.8%) and more often using medication (83.1% v. 70.7%). Adjusted HBP prevalence was, in ascending order, Whites (30.3%), Browns (38.2%) and Blacks (49.3%). The therapeutic schemes most used were angiotensin-converting enzyme inhibitors, in isolation (12.4%) or combined with diuretics (13.3%). Among those in drug treatment, controlled blood pressure was more likely in the (postgraduate) higher education group than among participants with less than secondary school education (PR = 1.21; 95% CI: 1.14-1.28), and among Asian (PR = 1.21; 95% CI: 1.12-1.32) and 'Whites (PR = 1.19; 95% CI: 1.12-1.26) compared to Blacks. Socioeconomic and racial inequality-as measured by different indicators-are strongly associated with HBP control, beyond the expected influence of health services access.

  11. Blood pressure behaviour during physical activity.

    PubMed

    Palatini, P

    1988-06-01

    Aerobic exercise is currently being recommended in addition to pharmacological therapy for lowering blood pressure levels in hypertensive patients, i.e. in subjects whose resting blood pressure levels exceed 145/90 mm Hg. On the other hand competitive sports are generally contraindicated in hypertensives, who are thought to be at increased risk of morbidity or mortality from their blood pressure levels. The present knowledge of blood pressure behaviour during isotonic physical activity is almost wholly based on the results obtained by means of the ergometric tests. Several maximal and submaximal exercise protocols have been introduced, but none has proved to be superior for diagnostic purposes. There is general agreement that the systolic blood pressure increase determined by isotonic exercise usually ranges from 50 to 70 mm Hg in both normotensive or hypertensive subjects. Diastolic blood pressure shows only minor changes in the normotensives, while in the hypertensives it tends to substantially increase because of their inability to adequately reduce their peripheral resistance. This mechanism may also explain the delay shown by the hypertensives in reaching pre-exercise blood pressure values during the recovery. On average diastolic blood pressure increases to a greater extent during bicycle ergometry than during treadmill, while no differences in exertional systolic blood pressure have been observed between the 2 tests. The results of several studies indicate that the blood pressure response to isotonic exercise is a marker for detection of hypertension earlier in the course of the disease, while resting blood pressure is still normal. According to some authors it is also of value in predicting future hypertension in individuals with borderline pressure levels. There are no conclusive data on the effect of training on blood pressure response to exercise. The majority of the published studies report small exertional pressure reductions after conditioning, which

  12. Ambulatory blood pressure monitoring in hypertensive adolescents.

    PubMed

    Fixler, D E; Wallace, J M; Thornton, W E; Dimmitt, P

    1990-04-01

    The purpose of this study was to determine the ability of ambulatory blood pressure monitoring to identify youths with chronic blood pressure elevation. Nineteen adolescent boys were studied, ten had 5-year average systolic or diastolic pressures above the 95th percentile, nine had normal pressure. A Del Mar Avionics Pressurometer III system recorded an average of 121 readings on each subject. The coefficients of variation for pressure were similar for hypertensive and normotensive individuals. During classes, eight of the ten hypertensive youths had elevated pressures in over half of the measurements. Also during these classes eight of ten hypertensive boys had average systolic or diastolic pressure above the 95th percentile, whereas only one of nine normotensive boys had average pressures above this level. We suggest that schooltime ambulatory pressures may be most useful in classifying the blood pressure trend in a youth.

  13. Preeclampsia and High Blood Pressure During Pregnancy

    MedlinePlus

    ... thrombophilia , or lupus • are obese •had in vitro fertilization What are the risks for my baby if ... blood cells. Hypertension: High blood pressure. In Vitro Fertilization: A procedure in which an egg is removed ...

  14. Effects of age on blood pressure (image)

    MedlinePlus

    ... become less elastic with age. The average blood pressure increases from 120/70 to 150/90 and may persist slightly high, even if treated. The blood vessels respond more slowly to a change in body ...

  15. Preeclampsia and High Blood Pressure During Pregnancy

    MedlinePlus

    ... mellitus , thrombophilia , or lupus • are obese •had in vitro fertilization What are the risks for my baby if ... red blood cells. Hypertension: High blood pressure. In Vitro Fertilization: A procedure in which an egg is removed ...

  16. Sustained Blood Pressure Responding during Synthetic Work.

    DTIC Science & Technology

    1982-06-15

    split-half reliabilities of both heart rate and mean * blood pressure were high during task performance. Significant correlations were observed between... blood pressure responses elicited by :1 16 an anagram task showed a high test-retest reliability, even over an interval of 13 months. Examination of the...8217AD-AI5 733 JOHNS HOPKINS UNIV BALTIMORE MO DEPT OF PSYCHIATRY F/6 6/5 SUSTAINED BLOOD PRESSURE RESPONDING DURING SYNTHETIC WORK.(U) JUN A2 R L RAY

  17. Biofeedback With Implanted Blood-Pressure Device

    NASA Technical Reports Server (NTRS)

    Rischell, Robert E.

    1988-01-01

    Additional uses found for equipment described in "Implanted Blood-Pressure-Measuring Device" (GSC-13042). Implanted with device electronic circuitry that measures, interprets, and transmits data via inductive link through patient's skin to external receiver. Receiver includes audible alarm generator activated when patient's blood pressure exceeds predetermined threshold. Also included in receiver a blood-pressure display, recorder, or both, for use by patient or physician.

  18. High blood pressure tests (image)

    MedlinePlus

    ... factors. These lab tests include urinalysis, blood cell count, blood chemistry (potassium, sodium, creatinine, fasting glucose, total cholesterol and HDL cholesterol), and an ECG (electrocardiogram). ...

  19. How to Prevent High Blood Pressure

    MedlinePlus

    ... provider will use a gauge, a stethoscope or electronic sensor, and a blood pressure cuff. For most ... pressure. Stress management techniques include exercising, listening to music, focusing on something calm or peaceful, and meditating. ...

  20. Blood pressure measurement--an overview.

    PubMed

    Dieterle, Thomas

    2012-01-27

    Arterial hypertension continues to represent the leading cause of morbidity and mortality world-wide. Diagnosis and therapy of arterial hypertension require adequate blood pressure measurements. Blood pressure is affected by constitutional and environmental factors as well as the measurement procedure itself, inducing substantial uncertainty with regard to adequate diagnosis and control of arterial hypertension. Therefore, current guidelines recommend that the diagnosis of arterial hypertension should not be solely based on conventional blood pressure measurements in the physician's office or in the hospital, but also on out-of-office ambulatory or home blood pressure measurements using clinically validated semi-automated or automated blood pressure measurement devices. Despite the enormous progress in the field of arterial hypertension, many aspects of blood pressure measurement require further intensive investigation, for example blood pressure measurement in special populations and distinct clinical situations, as well as the applicability and validation of novel measurement approaches and devices. This article provides an overview of current methods and trends in the field of non-invasive blood pressure measurement, an update on current clinical guidelines and an overview of blood pressure measurement in special populations.

  1. Ambulatory blood pressure monitoring in children.

    PubMed

    Sinha, Rajiv; Dionne, Janis

    2011-02-01

    Recently there have been great advances in the use of ambulatory blood pressure monitoring (ABPM) in children. A major boost has been the publication of normative data for blood pressure in children. ABPM has been able to detect significant differences in blood pressure in many disease states including chronic renal failure, polycystic kidney disease and post renal transplantation and has helped in identifying both white coat hypertension and masked hypertension. Current evidence does suggest that sole reliance on clinic blood pressure might not be always appropriate and ABPM has a definite role in pediatric hypertension.

  2. Embedded programmable blood pressure monitoring system

    NASA Astrophysics Data System (ADS)

    Hasan, Md. Mahmud-Ul; Islam, Md. Kafiul; Shawon, Mehedi Azad; Nowrin, Tasnuva Faruk

    2010-02-01

    A more efficient newer algorithm of detecting systolic and diastolic pressure of human body along with a complete package of an effective user-friendly embedded programmable blood pressure monitoring system has been proposed in this paper to reduce the overall workload of medical personals as well as to monitor patient's condition more conveniently and accurately. Available devices for measuring blood pressure have some problems and limitations in case of both analog and digital devices. The sphygmomanometer, being analog device, is still being used widely because of its reliability and accuracy over digital ones. But it requires a skilled person to measure the blood pressure and obviously not being automated as well as time consuming. Our proposed system being a microcontroller based embedded system has the advantages of the available digital blood pressure machines along with a much improved form and has higher accuracy at the same time. This system can also be interfaced with computer through serial port/USB to publish the measured blood pressure data on the LAN or internet. The device can be programmed to determine the patient's blood pressure after each certain interval of time in a graphical form. To sense the pressure of human body, a pressure to voltage transducer is used along with a cuff in our system. During the blood pressure measurement cycle, the output voltage of the transducer is taken by the built-in ADC of microcontroller after an amplifier stage. The recorded data are then processed and analyzed using the effective software routine to determine the blood pressure of the person under test. Our proposed system is thus expected to certainly enhance the existing blood pressure monitoring system by providing accuracy, time efficiency, user-friendliness and at last but not the least the 'better way of monitoring patient's blood pressure under critical care' all together at the same time.

  3. Role of ambulatory blood pressure monitoring in resistant hypertension.

    PubMed

    Grassi, Guido; Bombelli, Michele; Seravalle, Gino; Brambilla, Gianmaria; Dell'oro, Raffaella; Mancia, Giuseppe

    2013-06-01

    Ambulatory blood pressure monitoring has gained growing popularity in the diagnosis and treatment of essential hypertension for several reasons, such as the lack of the so-called white-coat effect, the greater reproducibility as compared with clinic blood pressure, the ability to provide information on blood pressure phenomena of prognostic value and the closer relationship with the risk of cardiovascular morbidity and mortality. All the above-mentioned main features of ambulatory blood pressure monitoring are also true for resistant hypertension. In addition, however, in resistant hypertension, blood pressure monitoring allows one to precisely define the diagnosis of this clinical condition, by excluding the presence of white-coat hypertension, which is responsible for a consistent number of "false" resistant hypertensive cases. The approach also allows one to define the patterns of blood pressure variability in this clinical condition, as well as its relationships with target organ damage. Finally, it allows one to assess the effects of therapeutic interventions, such as renal nerves ablation, aimed at improving blood pressure control in this hypertensive state. The present paper will critically review the main features of ambulatory blood pressure monitoring in resistant hypertension, with particular emphasis on the diagnosis and treatment of this high-risk hypertensive state.

  4. [Breast feeding and systemic blood pressure in infants].

    PubMed

    Hernández-González, Martha A; Díaz-De-León, Luz V; Guízar-Mendoza, Juan M; Amador-Licona, Norma; Cipriano-González, Marisol; Díaz-Pérez, Raúl; Murillo-Ortiz, Blanca O; De-la-Roca-Chiapas, José María; Solorio-Meza, Sergio Eduardo

    2012-01-01

    Blood pressure levels in childhood influence these levels in adulthood, and breastfeeding has been considered such as a cardioprotective. We evaluated the association between blood pressure levels and feeding type in a group of infants. We conducted a comparative cross-sectional study in term infants with appropriate weight at birth, to compare blood pressure levels in those children with exclusively breastfeeding, mixed-feeding and formula feeding. The comparison of groups was performed using ANOVA and multiple regression analysis was used to identify variables associated with mean arterial blood pressure levels. A p value < 0.05 was considered significant. We included 20 men and 24 women per group. Infant Formula Feeding had higher current weight and weight gain compared with the other two groups (p < 0.05). Systolic, diastolic and mean blood pressure levels, as well as respiratory and heart rate were higher in the groups of exclusively formula feeding and mixed-feeding than in those with exclusively breastfeeding (p < 0.05). Multiple regression analysis identified that variables associated with mean blood pressure levels were current body mass index, weight gain and formula feeding. Infants in breastfeeding show lower blood pressure, BMI and weight gain.

  5. A prediction model of blood pressure for telemedicine.

    PubMed

    Kwong, Enid Wai-Yung; Wu, Hao; Pang, Grantham Kwok-Hung

    2016-08-04

    This paper presents a new study based on a machine learning technique, specifically an artificial neural network, for predicting systolic blood pressure through the correlation of variables (age, BMI, exercise level, alcohol consumption level, smoking status, stress level, and salt intake level). The study was carried out using a database containing a variety of variables/factors. Each database of raw data was split into two parts: one part for training the neural network and the remaining part for testing the performance of the network. Two neural network algorithms, back-propagation and radial basis function, were used to construct and validate the prediction system. According to the experiment, the accuracy of our predictions of systolic blood pressure values exceeded 90%. Our experimental results show that artificial neural networks are suitable for modeling and predicting systolic blood pressure. This new method of predicting systolic blood pressure helps to give an early warning to adults, who may not get regular blood pressure measurements that their blood pressure might be at an unhealthy level. Also, because an isolated measurement of blood pressure is not always very accurate due to daily fluctuations, our predictor can provide the predicted value as another figure for medical staff to refer to. © The Author(s) 2016.

  6. Nutraceuticals for blood pressure control.

    PubMed

    Sirtori, Cesare R; Arnoldi, Anna; Cicero, Arrigo F G

    2015-01-01

    Significant effects on blood pressure (BP) have been reported from large nutritional interventions, particularly the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet. In more recent years, numerous studies have investigated the possible BP-lowering effect of different nutraceuticals; these range from specific foods to minerals, lipids, whole proteins, peptides, amino acids, probiotics, and vitamins. While a very large body of evidence supports the use of potassium, L-arginine, vitamins C and D, cocoa flavonoids, beetroot juice, some probiotics, coenzyme Q10, controlled-release melatonin, aged garlic extract, and coffee, the use of other nutraceuticals, such as green tea, flaxseed, and resveratrol, has not as yet been supported by adequate evidence. In some cases, e.g. proteins/peptides, the responsible component needs also to be fully uncovered. Finally, while for most of the products only short-term studies are available, with no specific end-points, an ongoing very large prospective study on chocolate flavanols will answer the question whether this may reduce cardiovascular risk. Thus, in addition to data on long-term safety, further clinical research is advisable in order to identify, among active nutraceuticals, those with the best cost-effectiveness and risk-benefit ratio for a wide use in the general population with a raised cardiovascular risk consequent to uncomplicated hypertension.

  7. The DASH diet and blood pressure.

    PubMed

    Craddick, Shirley R; Elmer, Patricia J; Obarzanek, Eva; Vollmer, William M; Svetkey, Laura P; Swain, Martha C

    2003-11-01

    High blood pressure (also called hypertension) is one of the most important and common risk factors for atherosclerotic cardiovascular disease (CVD) and other chronic diseases. National guidelines recommend that all individuals with blood pressure readings of 120/80 mm Hg or higher adopt healthy lifestyle habits, including the Dietary Approaches to Stop Hypertension (DASH) diet, to manage their blood pressure. The DASH diet, which is high in fruits, vegetables, and low-fat dairy products and reduced in fat, has been shown in large, randomized, controlled trials to reduce blood pressure significantly. The DASH diet also has been shown to reduce blood cholesterol and homocysteine levels and to enhance the benefits of antihypertensive drug therapy. The DASH diet should be promoted, along with maintaining healthy weight, reducing sodium intake, increasing regular physical activity, and limiting alcohol intake, for lowering blood pressure and reducing the risk of CVD.

  8. Determinants of blood pressure in Navajo adolescents.

    PubMed

    Coulehan, J L; Topper, M D; Arena, V C; Welty, T K

    1990-01-01

    Hypertension is becoming more common among Navajo people, especially among young men. In a group of 580 Navajo adolescents, we looked for factors associated with variations in blood pressure level. Using our criteria, 11.1% of adolescent males and 1.6% of females had an elevated screening blood pressure. In males, blood pressure was a function of age only, and not significantly related either to obesity (body mass index) or measures of acculturation and personal adjustment. In females, blood pressure was not related to age, but was associated with body mass index. Systolic pressure in females was also associated with poor personal adjustment. Level of acculturation (by our index) had no bearing on blood pressure level in this population.

  9. Perioperative Blood Pressure Control and Management.

    PubMed

    Duke-Novakovski, Tanya; Carr, Anthony

    2015-09-01

    Blood pressure monitoring and management is a vital part of the perianesthetic period. Disturbances in blood pressure, especially hypotension, can have significant impacts on the well-being of small animal patients. There are a variety of mechanisms present to control blood pressure, including ultra-short-, short-, and long-term mechanisms. Several conditions can contribute to decreased blood pressure, including anesthetics, tension pneumothorax, intermittent positive pressure ventilation, hypoxemia, hypercapnia, surgical positioning, and abdominal distension. If hypotension is encountered, the initial response is to provide appropriate fluid therapy. If this is inadequate, other interventions can be used to increase blood pressure and thereby increase perfusion. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Palpatory Method of Measuring Diastolic Blood Pressure

    PubMed Central

    Sahu, Dinesh; Bhaskaran, M

    2010-01-01

    Background: Most common method for measuring blood pressure is palpatory but only systolic pressure can be measured with this method. In this study we are describing palpatory method of measuring diastolic blood pressure as well. Patients & Methods: We have studied in 200 patients and compared systolic as well as diastolic blood pressures with two methods, auscutatory and palpatory. Systolic and diastolic blood pressure were measured by one of the authors with new palpatory method and noted down. Then an independent observer, who was blinded to the palpatory method's values, measured blood pressure by auscultatory method and noted down. The values were compared in term of range and percentage. Results: The difference were analysed and found that 102 (51%) patients had systolic and diastolic blood pressure measured by palpatory method, within ± 2 mmHg of auscutatory method, 37 (19%) patients had within ± 4 mmHg, 52 (25%) patients had same readings as with auscutatory method, and in 9 (0.5%) patients it could not be measured. Conclusion: The palpatory method would be very useful where frequent blood pressure measurement are being done manually like in wards, in busy OPD, patient on treadmill and also whenever stethoscope is not available. The blood pressure can be measured in noisy environment too. PMID:21547184

  11. Blood pressure and blood lead concentration in bus drivers

    SciTech Connect

    Sharp, D.S.; Osterloh, J.; Becker, C.E.; Bernard, B.; Smith, A.H.; Fisher, J.M.; Syme, S.L.; Holman, B.L.; Johnston, T.

    1988-06-01

    San Francisco bus drivers have an increased prevalence of hypertension. This study examined relationships between blood lead concentration and blood pressure in 342 drivers. The analysis reported in this study was limited to subjects not on treatment for hypertension (n = 288). Systolic and diastolic pressure varied from 102 to 173 mm Hg and from 61 to 105 mm Hg, respectively. The blood lead concentration varied from 2 to 15 ..mu..g/dL. The relationship between blood pressure and the logarithm of blood lead concentration was examined using multiple regression analysis. Covariates included age, body mass index, sex, race, and caffeine intake. The largest regression coefficient relating systolic blood pressure and blood lead concentration was 1.8 mm Hg/ln (..mu..g/dL). The coefficient for diastolic blood pressure was 2.5 mm Hg/ln (..mu..g/dL). These findings suggest effects of lead exposure at lower blood lead concentrations than those concentrations that have previously been linked with increases in blood pressure.

  12. How Is High Blood Pressure Treated?

    MedlinePlus

    ... secondary high blood pressure, he or she will work to treat the other condition or change the medicine suspected of causing your ... when the medications they are taking do not work well for them or another medical condition is leading to uncontrolled blood pressure. Health care ...

  13. The importance of prompt blood pressure control.

    PubMed

    Basile, Jan

    2008-01-01

    Hypertension affects almost one-third of adults in the United States, but blood pressure is adequately controlled in only about 50% to 60% of persons with treated hypertension. Abundant clinical trial evidence has shown that antihypertensive therapy significantly reduces the risk of vascular events, and meta-analyses of observational and clinical trials have shown that greater reductions in blood pressure are associated with greater reductions in risk. Recent trials have also suggested that prompt control of blood pressure is beneficial in high-risk patients with hypertension. A post hoc analysis of a trial comparing an angiotensin II receptor blocker-based program with a calcium channel blocker-based treatment regimen found that the blood pressure response after 1 month (regardless of the drug used) predicted the risk of vascular events and survival. Therapy with > or =2 medications given separately or as a fixed combination is more likely than monotherapy to lower blood pressure to goal in part because drugs from different classes target different mechanisms that regulate blood pressure. Moreover, the likelihood of achieving blood pressure goals is greater if the time to achieve control is shortened, and prompt control of blood pressure is more likely with multiple-drug therapy than with monotherapy.

  14. Dietary sodium intake and arterial blood pressure.

    PubMed

    Dumler, Francis

    2009-01-01

    We sought to summarize major recent studies in the field of dietary sodium intake and arterial blood pressure, and discuss the following trials. INTERSALT: Sodium intake correlates with the rise in blood pressure with age, but not with the prevalence of hypertension. The population study identified a minimal impact of sodium intake on blood pressure (0.9 mm Hg/10 mmol difference in salt intake). DASH: This diet induced significant reductions in blood pressure compared with the control diet. Further decreases were observed with DASH and a 50 mmol/day sodium intake. VANGUARD: Blood pressure was inversely related to urinary potassium, calcium and magnesium but not to sodium excretion. TONE: Cardiovascular events were highest in the usual care group (83%) and lowest in the sodium reduction-plus-weight loss group (56%). META-ANALYSIS: A systematic review of 11 long-term controlled randomized trials reported a small decrease (1.1 mm Hg) in median systolic but not diastolic blood pressure with a reduced dietary sodium intake. In conclusion, (1) sodium restriction in hypertensive patients reduces blood pressure, and (2) the long-term impact of reduced salt intake on blood pressure, mortality, and morbidity remains to be defined.

  15. Blood Pressure. Instructor's Packet. Learning Activity Package.

    ERIC Educational Resources Information Center

    Hime, Kirsten

    This instructor's packet accompanies the learning activity package (LAP) on blood pressure. Contents included in the packet are a time sheet, suggested uses for the LAP, an instruction sheet, final LAP reviews, a final LAP review answer key, a pupil performance checklist, a handout on blood pressure, and student completion cards to issue to…

  16. High Blood Pressure Often Undiagnosed, Untreated

    MedlinePlus

    ... Health, or the U.S. Department of Health and Human Services. More Health News on: Heart Attack High Blood Pressure Stroke Recent Health News Related MedlinePlus Health Topics Heart Attack High Blood Pressure Stroke ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated ...

  17. Determinants of Blood Pressure in Navajo Adolescents.

    ERIC Educational Resources Information Center

    Coulehan, John L.; And Others

    1990-01-01

    Among 580 Navajo adolescents, 11.1 percent of males and 1.6 percent of females had high blood pressure. Blood pressure was related to age in males and to body mass index in females but was not related to level of acculturation or traditionality. Contains 17 references. (SV)

  18. Determinants of Blood Pressure in Navajo Adolescents.

    ERIC Educational Resources Information Center

    Coulehan, John L.; And Others

    1990-01-01

    Among 580 Navajo adolescents, 11.1 percent of males and 1.6 percent of females had high blood pressure. Blood pressure was related to age in males and to body mass index in females but was not related to level of acculturation or traditionality. Contains 17 references. (SV)

  19. Orion Suit Loop Variable Pressure Regulator Development

    NASA Technical Reports Server (NTRS)

    Mosher, Michael; Lewis, John F.; Campbell, Melissa

    2012-01-01

    The Orion Multi Purpose Crew Vehicle (MPCV) integrates the cabin and pressure suits with the core life support systems to provide life support during contingency depressurized cabin operations. To provide the multiple suit pressures between nominal pressurized cabin suited operations, suit leak checks, depressurized cabin suited operations, and elevated suit pressure for denitrification, a variable pressure regulator is needed. This paper documents the development of the suit loop regulator for Orion.

  20. Orion Suit Loop Variable Pressure Regulator Development

    NASA Technical Reports Server (NTRS)

    Mosher, Michael; Vassallo, Andrew; Lewis, John F.; Campbell, Melissa

    2014-01-01

    The Orion Multi Purpose Crew Vehicle (MPCV) integrates the cabin and pressure suits with the core life support systems to provide life support during contingency depressurized cabin operations. To provide the multipule suit pressures between nominal pressurized cabin suited operations, suit leak checks, depressurized cabin suited operations, and elevated suit pressure for denitrification, a variable pressure regulator is needed. This paper documents the development and integrated testing of the suit loop regulator for Orion.

  1. Raised intracranial pressure and cerebral blood flow

    PubMed Central

    Johnston, I. H.; Rowan, J. O.; Harper, A. M.; Jennett, W. B.

    1972-01-01

    Changes in cerebral blood flow during incremental increases of intracranial pressure produced by infusion of fluid into the cisterna magna were studied in anaesthetized baboons. Cerebral blood flow remained constant at intracranial pressure levels up to approximately 50 mm Hg. At intracranial pressure levels between 50-96 mm Hg a marked increase in cerebral blood flow occurred, associated with the development of systemic hypertension and changes in cerebrovascular resistance. Further increases of intracranial pressure led to a progressive fall in cerebral blood flow. Prior section of the cervical cord prevented both the increase in cerebral blood flow and the systemic hypertension. Alteration of cerebral perfusion pressure by bleeding during the hyperaemia in a further group of animals suggested that autoregulation was at least partially preserved during this phase. After maximum hyperaemia had occurred, however, autoregulation appeared to be lost. The clinical implications of these findings are discussed. PMID:4624687

  2. Raised intracranial pressure and cerebral blood flow

    PubMed Central

    Johnston, I. H.; Rowan, J. O.

    1974-01-01

    Pressure changes within the venous outflow tract from the brain were studied in anaesthetized baboons. Segmental vascular resistance changes were also calculated and the results correlated with the changes in cerebral blood flow, measured by the 133Xenon clearance method. Three different methods were used to raise intracranial pressure: cisterna magna infusion, a supratentorial subdural balloon, and an infratentorial subdural balloon. A close correlation was found between the cortical vein pressure and intracranial pressure with all methods of raising intracranial pressure: the overall correlation coefficient was 0·98. In the majority of animals sagittal sinus pressure showed little change through a wide range of intracranial pressure. In three of the six animals in the cisterna magna infusion group, however, sagittal sinus pressure increased to levels approaching the intracranial pressure during the later stages of intracranial hypertension. Jugular venous pressure showed little change with increasing intracranial pressure. The relationship between cerebral prefusion pressure and cerebral blood flow differed according to the method of increasing intracranial pressure. This was due to differing patterns of change in prevenous vascular resistance as venous resistance increased progressively with increasing pressure in all three groups. The present results confirm, therefore, the validity of the current definition of cerebral perfusion pressure—that is, cerebral perfusion pressure is equal to mean arterial pressure minus mean intracranial pressure—by demonstrating that intracranial pressure does represent the effective cerebral venous outflow pressure. Images PMID:4209160

  3. Effect of measuring ambulatory blood pressure on sleep and on blood pressure during sleep.

    PubMed Central

    Davies, R. J.; Jenkins, N. E.; Stradling, J. R.

    1994-01-01

    OBJECTIVE--To assess whether recording of ambulatory blood pressure at night causes arousal from sleep and a change in the continuous blood pressure recorded simultaneously. DESIGN--Repeated measurement of blood pressure with two ambulatory blood pressure machines (Oxford Medical ABP and A&D TM2420) during continuous measurement of beat to beat blood pressure and continuous electroencephalography. SETTING--Sleep research laboratory. SUBJECTS--Six normal subjects. MAIN OUTCOME MEASURES--The duration of electroencephalographic arousal and the beat to beat changes in blood pressure produced by the measurement of ambulatory blood pressure; the size of any changes that this arousal and change in blood pressure produced in the blood pressure recorded by the ambulatory machine. RESULTS--Both ambulatory blood pressure machines caused arousal from sleep: the mean duration of arousal was 16 seconds (95% range 0-202) with the ABP and 8 seconds (0-73) with the TM2420. Both also caused a rise in beat to beat blood pressure. During non-rapid eye movement sleep, this rise led to the ABP machine overestimating the true systolic blood pressure during sleep by a mean of 10 (SD 14.8) mm Hg and the TM2420 by a mean of 6.3 (8.2) mm Hg. On average, diastolic pressure was not changed, but measurements in individual subjects changed by up to 23 mm Hg. These changes varied in size among subjects and stages of sleep and were seen after measurements that did not cause any electroencephalographic arousal. CONCLUSIONS--Ambulatory blood pressure machines cause appreciable arousal from sleep and therefore alter the blood pressure that they are trying to record. This effect should be taken into account when recordings of blood pressure at night are interpreted in clinical work and epidemiological research. PMID:8167489

  4. Maternal Blood Pressure During Pregnancy and Early Childhood Blood Pressures in the Offspring: The GUSTO Birth Cohort Study.

    PubMed

    Lim, Wai-Yee; Lee, Yung-Seng; Yap, Fabian Kok-Peng; Aris, Izzudin Mohd; Lek, Ngee; Meaney, Michael; Gluckman, Peter D; Godfrey, Keith M; Kwek, Kenneth; Chong, Yap-Seng; Saw, Seang-Mei; Pan, An

    2015-11-01

    Although epidemiological studies suggest that offspring of women with preeclampsia are at increased risk to higher blood pressures and cardiovascular disease, little is known about the nature of blood pressures between the mother and her offspring. As blood pressures comprise of both pulsatile (systolic blood pressure [SBP] and pulse pressure [PP]) and stable (diastolic blood pressure [DBP]) components, and they differ between central and peripheral sites, we sought to examine maternal peripheral and central blood pressure components in relation to offspring early childhood blood pressures. A prospective birth cohort of 567 Chinese, Malay, and Indian mother-offspring with complete blood pressure information were studied. Maternal brachial artery SBP, DBP, and PP were measured at 26 to 28 weeks gestation; and central SBP and PP were estimated from radial artery waveforms. Offspring brachial artery SBP, DBP, and PP were measured at 3 years of age. Associations between continuous variables of maternal blood pressures (peripheral SBP, DBP, PP, central SBP, and PP) and offspring blood pressures (peripheral SBP, DBP, and PP) were examined using multiple linear regression with adjustment for maternal characteristics (age, education level, parity, smoking status, alcohol consumption and physical activity during pregnancy, and pre-pregnancy BMI) and offspring characteristics (sex, ethnicity, BMI, and height at 3 years of age). In the multivariate models, offspring peripheral SBP increased by 0.08 (95% confidence interval 0.00-0.17, P = 0.06) mmHg with every 1-mmHg increase in maternal central SBP, and offspring peripheral PP increased by 0.10 (0.01-0.18, P = 0.03) mmHg for every 1-mmHg increase in maternal central PP. The relations of maternal-offspring peripheral blood pressures (SBP, DBP, and PP) were positive but not statistically significant, and the corresponding values were 0.05 (-0.03 to 0.13; P = 0.21), 0.03 (-0.04 to 0.10; P = 0.35), and 0.05 (-0

  5. Relationship between blood lead, blood pressure, stroke, and heart attacks in middle-aged British men

    SciTech Connect

    Pocock, S.J.; Shaper, A.G.; Ashby, D.; Delves, H.T.; Clayton, B.E.

    1988-06-01

    The relationship between blood lead concentration and blood pressure is examined in a survey of 7371 men aged 40 to 59 from 24 British towns. After allowance for relevant confounding variables, including town of residence and alcohol consumption, there exists a very weak but statistically significant positive association between blood lead and both systolic and diastolic blood pressure. After 6 years of follow-up, 316 of these men had major ischemic heart disease, and 66 had a stroke. After allowance for the confounding effects of cigarette smoking and town of residence there is no evidence that blood lead is a risk factor for these cardiovascular events. However, as the blood lead-blood pressure association is so weak, it is unlikely that any consequent association between lead and cardiovascular disease could be demonstrated from prospective epidemiological studies. An overview of data from this and other large epidemiological surveys provides reasonable consistent evidence on lead and blood pressure. While NHANES II data on 2254 US men indicate a slightly stronger association between blood lead and systolic blood pressure, data from two Welsh studies on over 2000 men did not show a statistically significant association. Nevertheless, such statistical association cannot be taken as establishing a causal effect of low-level lead exposure on blood pressure.

  6. Short-term variability and nocturnal decline in ambulatory blood pressure in normotension, white-coat hypertension, masked hypertension and sustained hypertension: a population-based study of older individuals in Spain.

    PubMed

    Gijón-Conde, Teresa; Graciani, Auxiliadora; López-García, Esther; Guallar-Castillón, Pilar; García-Esquinas, Esther; Rodríguez-Artalejo, Fernando; Banegas, José R

    2017-06-01

    Blood pressure (BP) variability and nocturnal decline in blood pressure are associated with cardiovascular outcomes. However, little is known about whether these indexes are associated with white-coat and masked hypertension. We performed a cross-sectional analysis of 1047 community-dwelling individuals aged ⩾60 years in Spain in 2012. Three observer-measured home BPs and 24-h ambulatory blood pressure monitoring (ABPM) were performed under standardized conditions. BP variability was defined as BP s.d. and coefficient of variation. Differences in BP variability and nocturnal BP decrease between groups were adjusted for sociodemographic and clinical covariates using generalized linear models. Of the cohort, 21.7% had white-coat hypertension, 7.0% had masked hypertension, 21.4% had sustained hypertension, and 49.9% were normotensive. Twenty-four hour, daytime and night-time systolic BP s.d. and coefficients of variation were significantly higher in subjects with white-coat hypertension than those with normotension (P<0.05) and were similar to subjects with sustained hypertension. In untreated subjects, 24-h but not daytime or night-time BP variability indexes were significantly higher in subjects with white-coat hypertension than in those with normotension (P<0.05). Percentage decrease in nocturnal systolic and diastolic BP was greatest in the white-coat hypertension group and lowest in the masked hypertension group in all patients and untreated patients (P<0.05). Lack of nocturnal decline in systolic blood pressure was observed in 70.2% of subjects with normotension, 57.8% of subjects with white-coat hypertension, 78.1% of subjects with masked hypertension, and 72.2% of subjects with sustained hypertension (P<0.001). In conclusion, 24-h BP variability was higher in subjects with white-coat hypertension and blunted nocturnal BP decrease was observed more frequently in subjects with masked hypertension. These findings may help to explain the reports of increased

  7. Dark chocolate and blood pressure: a novel study from Jordan.

    PubMed

    Al-Safi, Saafan A; Ayoub, Nehad M; Al-Doghim, Imad; Aboul-Enein, Faisal H

    2011-11-01

    The goal of this study was to assess the effect of dark chocolate intake on cardiovascular parameters like blood pressure and heart rate values in a normotensive population. This is a randomized cross-sectional study involving a total of 14,310 adults that were selected from various regions of Jordan. Well-trained pharmacy students interviewed participants in the outpatient settings. Participants reported their weekly intake of dark chocolate that has been further classified into mild (1-2 bars/week), moderate (3-4 bars/week), and high intake ( > 4 bars/week). For each participant, the systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate were measured three times with (10-15) minute intervals in the sitting position and the resting state. The arterial blood pressure (ABP) was calculated from the measured SBP and DBP values. All measured blood pressure values were significantly decreased for participants who reported higher dark chocolate consumption. Our results showed that heart rate values were not affected by variable intake of dark chocolate. In addition, increasing dark chocolate intake was associated with a significant decrease of blood pressure values in participants irrespective of the family history of hypertension or the age of the individual. However, heart rate values were unaffected. Higher intake of dark chocolate can be associated with lower values of blood pressure, while its effect on heart rate values was not consistent.

  8. Salt, blood pressure, and human health.

    PubMed

    Alderman, M H

    2000-11-01

    The positive relation of sodium intake and blood pressure, first recognized a century ago, has been well established in ecological, epidemiological, and experimental human studies. Equally well established is the association of increasing blood pressure and cardiovascular morbidity and mortality. Indeed, the pharmacological capacity to reduce blood pressure has produced one of the great public health accomplishments of the 20th century. These two facts-the positive relation of blood pressure to strokes and heat attacks and the positive association of sodium intake to blood pressure-underlie the hypothesis that a reduction in sodium intake, by virtue of its hypotensive effect, might prevent strokes and heart attacks. Moreover, even if the effect on blood pressure were in the range of a 1- to 2-mm Hg decline in blood pressure for every 75- to 100-mmol difference in sodium intake, the impact of such a change, applied to the whole population, would be enormous. The problem with this appealing possibility is that a reduction in salt consumption of this magnitude has other-and sometimes adverse-health consequences. The question, therefore, is whether the beneficial hypotensive effects of sodium restriction will outweigh its hazards. Unfortunately, few data link sodium intake to health outcomes, and that which is available is inconsistent. Without knowledge of the sum of the multiple effects of a reduced sodium diet, no single universal prescription for sodium intake can be scientifically justified.

  9. Reproductive hormones and blood pressure during pregnancy.

    PubMed

    Kristiansson, P; Wang, J X

    2001-01-01

    The mechanisms involved in cardiovasular changes during human pregnancy and the complicated aetiology of gestational hypertension are unclear. Reproductive hormones have known effects on the cardiovascular system in the non-pregnant state and in animal systems, but their effects in human pregnancy are uncertain. In this study of pregnant women, the effects of serum concentrations of relaxin, progesterone and oestradiol on arterial blood pressure were studied. Higher serum concentrations of progesterone and relaxin, but not oestradiol, in early pregnancy were related to lower mean systolic blood pressures in the second and third trimesters. No relationship was found between hormonal concentrations and diastolic blood pressures. However, women with a diastolic blood pressure of >90 mmHg in late pregnancy showed statistically significant lower relaxin concentrations in early pregnancy in comparison with women whose diastolic blood pressure was blood pressure (P: < 0.0001) and serum relaxin (P: < 0.01) in early pregnancy, but not progesterone, were independently related to systolic blood pressure in late pregnancy. The results support previous experimental and clinical studies. The effect of relaxin may be explained by a possible vasodilatatory action seen in animal studies and appears to be moderate.

  10. Blood Pressure in Acute Ischemic Stroke

    PubMed Central

    McManus, Michael

    2016-01-01

    Hypertension is present in up to 84% of patients presenting with acute stroke, and a smaller proportion of patients have blood pressures that are below typical values in the context of cerebral ischemia. Outcomes are generally worse in those who present with either low or severely elevated blood pressure. Several studies have provided valuable information about malignant trends in blood pressure during the transition from the acute to the subacute phase of stroke. It is not uncommon for practitioners in clinical practice to identify what appear to be pressure-dependent neurologic deficits. Despite physiologic and clinical data suggesting the importance of blood pressure modulation to support cerebral blood flow to ischemic tissue, randomized controlled trials have not yielded robust evidence for this in acute ischemic stroke. We highlight previous studies involving acute-stroke patients that have defined trends in blood pressure and that have evaluated the safety and efficacy of blood-pressure modulation in acute ischemic stroke. This overview reports the current status of this topic from the perspective of a stroke neurologist and provides a framework for future research. PMID:26833984

  11. Raised intracranial pressure and cerebral blood flow

    PubMed Central

    Johnston, I. H.; Rowan, J. O.

    1974-01-01

    Intracranial pressure was raised by expansion of a supratentorial subdural ballon in anaesthetized baboons. Pressures were measured at several sites, both supratentorial and infratentorial, and cerebral blood flow was measured in each cerebral hemisphere separately. Pressures recorded from the right and left lateral ventricles corresponded closely throughout. Highly significant correlations were also obtained between the pressures in the right and left subdural spaces and the mean intraventricular pressure. There was, thus, no evidence of intracompartmental pressure gradients within the supratentorial space. Pressure gradients did, however, develop between the supratentorial and infratentorial compartments in the majority of experiments, although the level of supratentorial pressure at which this occurred, varied. Despite the presence of a large mass lesion over the right cerebral hemisphere, no significant differences developed between levels of cerebral blood flow in the two hemispheres, although flow in the right hemisphere remained consistently slightly lower than that in the left after the ballon was inserted. PMID:4836754

  12. Beat-to-Beat Blood Pressure Monitor

    NASA Technical Reports Server (NTRS)

    Lee, Yong Jin

    2012-01-01

    This device provides non-invasive beat-to-beat blood pressure measurements and can be worn over the upper arm for prolonged durations. Phase and waveform analyses are performed on filtered proximal and distal photoplethysmographic (PPG) waveforms obtained from the brachial artery. The phase analysis is used primarily for the computation of the mean arterial pressure, while the waveform analysis is used primarily to obtain the pulse pressure. Real-time compliance estimate is used to refine both the mean arterial and pulse pressures to provide the beat-to-beat blood pressure measurement. This wearable physiological monitor can be used to continuously observe the beat-to-beat blood pressure (B3P). It can be used to monitor the effect of prolonged exposures to reduced gravitational environments and the effectiveness of various countermeasures. A number of researchers have used pulse wave velocity (PWV) of blood in the arteries to infer the beat-to-beat blood pressure. There has been documentation of relative success, but a device that is able to provide the required accuracy and repeatability has not yet been developed. It has been demonstrated that an accurate and repeatable blood pressure measurement can be obtained by measuring the phase change (e.g., phase velocity), amplitude change, and distortion of the PPG waveforms along the brachial artery. The approach is based on comparing the full PPG waveform between two points along the artery rather than measuring the time-of-flight. Minimizing the measurement separation and confining the measurement area to a single, well-defined artery allows the waveform to retain the general shape between the two measurement points. This allows signal processing of waveforms to determine the phase and amplitude changes. Photoplethysmography, which measures changes in arterial blood volume, is commonly used to obtain heart rate and blood oxygen saturation. The digitized PPG signals are used as inputs into the beat-to-beat blood

  13. The Birmingham blood pressure school study.

    PubMed Central

    De Giovanni, J. V.; Pentecost, B. L.; Beevers, D. G.; Beevers, M.; Jackson, S. H.; Bannan, L. T.; Osbourne, V. L.; Mathews, K.

    1983-01-01

    Four-hundred and twenty-eight school leavers of 3 ethnic groups (white, black and Asian) were screened for blood pressure, resting pulse rate and general anthropometric characteristics. Asian pupils were both shorter and lighter than the other two groups whilst black males were heavier and taller. There was no significant difference in the mean systolic or diastolic blood pressure between the 3 groups, although the black pupils had a stronger family history of hypertension, particularly on the mother's side. These observations differ in some respects from other ethnic blood pressure studies and establish values for the local population. PMID:6647172

  14. Efficacy of a self-directed behavioral health change program: weight, body composition, cardiovascular fitness, blood pressure, health risk, and psychosocial mediating variables.

    PubMed

    Clifford, P A; Tan, S Y; Gorsuch, R L

    1991-06-01

    This study assessed the efficacy of a comprehensive behavioral health program designed to promote self-initiated change in overweight healthy middle-aged adults (M = 49 years). Three treatment groups (total n = 25) differing in type of social support provided (i.e., group plus professional versus group plus peer versus group only) received 13 treatment sessions and 6 maintenance sessions scheduled over a full year. A self-directed change intervention taught several cognitive-behavioral techniques as they applied to exercise adherence, weight reduction/maintenance, and stress management. Combined treatment groups (n = 25) improved significantly more than an assessment only control group (n = 9) in weight, percentage body fat, cardiovascular fitness, exercise adherence, health-risk appraisal, chronic tension (MBHI, scale A), and systolic and diastolic blood pressure at both post-treatment and 6-month follow-up assessments. Self-motivation, group treatment attendance, and health-risk appraisal significantly related (r's = .30-.56) to several posttreatment and follow-up measures of behavioral health change. No significant differences were found among the three treatment groups on any of the outcome measures.

  15. Raised intracranial pressure and cerebral blood flow

    PubMed Central

    Johnston, I. H.; Rowan, J. O.; Harper, A. M.; Jennett, W. B.

    1973-01-01

    Changes in cerebral blood flow with increasing intracranial pressure were studied in anaesthetized baboons during expansion of a subdural balloon in one of two different sites. With an infratentorial balloon, cerebral blood flow bore no clear relation to intracranial pressure, but was linearly related to cerebral perfusion pressure. Apart from an initial change in some animals, cerebrovascular resistance remained constant with increasing intracranial pressure, and autoregulation appeared to be lost from the outset. With a supratentorial balloon, cerebral blood flow remained constant as intracranial pressure was increased to levels around 60 mm Hg, corresponding to a cerebral perfusion pressure range of approximately 100 to 40 mmHg. Cerebrovascular resistance fell progressively, and autoregulation appeared to be effective during this phase. At higher intracranial pressure levels (lower cerebral perfusion pressure levels), autoregulation was lost and cerebral blood flow became directly dependent on cerebral perfusion pressure. The importance of the cause of the increase in intracranial pressure on the response of the cerebral circulation and the relevance of these findings to the clinical situation are discussed. PMID:4196632

  16. Variable pressure thermal insulating jacket

    DOEpatents

    Nelson, P.A.; Malecha, R.F.; Chilenskas, A.A.

    1994-09-20

    A device for controlled insulation of a thermal device is disclosed. The device includes a thermal jacket with a closed volume able to be evacuated to form an insulating jacket around the thermal source. A getter material is in communication with the closed volume of the thermal jacket. The getter material can absorb and desorb a control gas to control gas pressure in the volume of the thermal jacket to control thermal conductivity in the thermal jacket. 10 figs.

  17. Variable pressure thermal insulating jacket

    DOEpatents

    Nelson, Paul A.; Malecha, Richard F.; Chilenskas, Albert A.

    1994-01-01

    A device for controlled insulation of a thermal device. The device includes a thermal jacket with a closed volume able to be evacuated to form an insulating jacket around the thermal source. A getter material is in communcation with the closed volume of the thermal jacket. The getter material can absorb and desorb a control gas to control gas pressure in the volume of the thermal jacket to control thermal conductivity in the thermal jacket.

  18. Blood pressure and industrial lead exposure.

    PubMed

    Maheswaran, R; Gill, J S; Beevers, D G

    1993-03-15

    The association between environmental lead exposure and raised blood pressure remains controversial. This association was examined in a cross-sectional study in 1981 on 809 male workers who were occupationally exposed to lead in a factory manufacturing car lead accumulator batteries in Birmingham, United Kingdom. Lead exposure was assessed by blood lead levels, blood zinc protoporphyrin levels, and years of industrial exposure to lead. The geometric mean blood lead level was 31.6 micrograms/dl with minimum and maximum values of 0 microgram/dl and 98 micrograms/dl, respectively. Unadjusted systolic blood pressure rose with increasing blood lead levels (analysis of variance, F = 3.3, p < 0.05) from 127 mmHg (95% confidence interval (CI) 123.5-130.5) in men with blood lead levels less than 21 micrograms/dl to 133 mmHg (95% CI 128.7-137.3) in men with levels exceeding 50 micrograms/dl. Following adjustment for the confounding effects of age, body mass index, and alcohol consumption, however, the effect of blood lead on systolic pressure was diminished (analysis of variance, F = 1.3, not significant) to 129 mmHg and 132 mmHg in the respective categories. There was no association between diastolic blood pressure and blood lead. Zinc protoporphyrin levels and years of industrial lead exposure did not raise adjusted systolic or diastolic pressure. In conclusion, subject to the limitations inherent in a cross-sectional survey, the findings are consistent with a weak effect of industrial lead exposure on systolic blood pressure, within the range of exposures observed in this study.

  19. Working meeting on blood pressure measurement: suggestions for measuring blood pressure to use in populations surveys.

    PubMed

    2003-11-01

    As part of the Pan American Hypertension Initiative (PAHI), the Pan American Health Organization and the National Heart, Lung, and Blood Institute of the National Institutes of Health of the United States of America conducted a working meeting to discuss blood pressure (BP) measurement methods used in various hypertension prevalence surveys and clinical trials, with the objective of developing a BP measurement protocol for use in hypertension prevalence surveys in the Americas. No such common protocol has existed in the Americas, so it has been difficult to compare hypertension prevention and intervention strategies. This piece describes a proposed standard method for measuring blood pressure for use in population surveys in the Region of the Americas. The piece covers: considerations for developing a common blood pressure measurement protocol, critical issues in measuring blood pressure in national surveys, minimum procedures for blood pressure measurement during surveillance, and quality assessment of blood pressure.

  20. [Current clinical aspects of ambulatory blood pressure monitoring].

    PubMed

    Sauza-Sosa, Julio César; Cuéllar-Álvarez, José; Villegas-Herrera, Karla Montserrat; Sierra-Galán, Lilia Mercedes

    2016-01-01

    Systemic arterial hypertension is the prevalentest disease worldwide that significantly increases cardiovascular risk. An early diagnosis together to achieve goals decreases the risk of complications significatly. Recently have been updated the diagnostic criteria for hypertension and the introduction of ambulatory blood pressure monitoring. The introduction into clinical practice of ambulatory blood pressure monitoring was to assist the diagnosis of «white coat hypertension» and «masked hypertension». Today has also shown that ambulatory blood pressure monitoring is better than the traditional method of recording blood pressure in the office, to the diagnosis and to adequate control and adjustment of drug treatment. Also there have been introduced important new concepts such as isloted nocturnal hypertension, morning blood pressure elevation altered and altered patterns of nocturnal dip in blood pressure; which have been associated with increased cardiovascular risk. Several studies have shown significant prognostic value in some stocks. There are still other concepts on which further study is needed to properly establish their introduction to clinical practice as hypertensive load variability, pulse pressure and arterial stiffness. In addition to setting values according to further clinical studies in populations such as elderly and children.

  1. What Is High Blood Pressure Medicine?

    MedlinePlus

    ... make the other lifestyle changes that will help reduce blood pressure, including: reaching and maintaining a healthy weight, lowering sodium (salt) intake, eating a heart-healthy diet, being more regularly physically active, and limiting alcohol ...

  2. Caffeine: How Does It Affect Blood Pressure?

    MedlinePlus

    ... M.D. References Zhang Z, et al. Habitual coffee consumption and risk of hypertension: A systematic review and ... 1212. Steffen M, et al. The effect of coffee consumption on blood pressure and the development of hypertension: ...

  3. Principles and techniques of blood pressure measurement

    PubMed Central

    Ogedegbe, Gbenga; Pickering, Thomas

    2013-01-01

    Although the mercury sphygmomanometer is widely regarded as the “gold standard” for office blood pressure measurement, the ban on use of mercury devices continues to diminish their role in office and hospital settings. To date, mercury devices have largely been phased out in US hospitals. This has led to the proliferation of non-mercury devices and has changed (probably for ever) the preferable modality of blood pressure measurement in clinic and hospital settings. In this article, the basic techniques of blood pressure measurement and the technical issues associated with measurements in clinical practice are discussed. The devices currently available for hospital and clinic measurements and their important sources of error are presented. Practical advice is given on how the different devices and measurement techniques should be used. Blood pressure measurements in different circumstances and in special populations such as infants, children, pregnant women, elderly persons, and obese subjects are discussed. PMID:20937442

  4. Automatic blood pressure measuring system (M091)

    NASA Technical Reports Server (NTRS)

    1977-01-01

    The Leg Volume Measuring System is used to measure leg calf girth changes that occur during exposure to lower body negative pressure as a result of pooling of blood and other fluids in the lower extremities.

  5. Alcohol drinking and blood pressure among adolescents.

    PubMed

    Jerez, S J; Coviello, A

    1998-07-01

    The purpose of this study was to evaluate alcohol consumption among adolescents from Tucuman, Argentina, and to determine its possible relationship with increased levels of blood pressure. Three hundred fifty-six students aged 13-18 included in the study were asked to answer questionnaires anonymously. Two blood pressures measures were then taken. Differences between both sexes were found in quantity and frequency of alcohol consumption. Enjoyment was determined to be the main reason for drinking. There was an association between frequency and alcohol-related problems, and smoking habits. There were also differences in blood pressure among males and females. A weak, but significant, relationship between quantity/frequency index and diastolic blood pressure was found. A greater prevalence of hypertension in male heavy drinkers was noted as well. Because this addiction implies multiple social problems and it also accounts for a hypertension risk factor, the importance of aiming at developing prevention strategies for alcohol abuse among adolescents is stressed.

  6. Blood pressure and migration in children.

    PubMed

    Beaglehole, R; Eyles, E; Prior, I

    1979-03-01

    The effect of migration on childhood blood pressure levels has been studied by comparing children before and after migration to New Zealand with children who stayed at home on the Pacific atolls of Tokelau. Data were collected in 1971 on 502 children (97% response rate) aged 5--14 years resident in Tokelau and follow-up data were collected in New Zealand and in Tokelau in 1975--1977 (respknse rate 91%). No selection factors were detected before migration. After migration, the younger migrants had significantly higher blood pressures and were heavier, but not taller, than the non-migrants. Weight differences explained some but not all of the blood pressure differences. There were no differences in body size between the 2 groups of older children although the older non migrant girls had higher blood pressure than the migrant girls.

  7. Automatic blood pressure measuring system (M091)

    NASA Technical Reports Server (NTRS)

    1977-01-01

    The Leg Volume Measuring System is used to measure leg calf girth changes that occur during exposure to lower body negative pressure as a result of pooling of blood and other fluids in the lower extremities.

  8. Weightlifting: Bad for Your Blood Pressure?

    MedlinePlus

    ... Circulation. 2007;116:572. Cornelissen VA, et al. Impact of resistance training on blood pressure and other cardiovascular risk factors: A meta-analysis of randomized, controlled trials. Hypertension. ...

  9. Relationship Between Preoperative Evaluation Blood Pressure and Preinduction Blood Pressure: A Cohort Study in Patients Undergoing General Anesthesia.

    PubMed

    van Klei, Wilton A; van Waes, Judith A R; Pasma, Wietze; Kappen, Teus H; van Wolfswinkel, Leo; Peelen, Linda M; Kalkman, Cor J

    2017-02-01

    For outcomes research where changes in intraoperative blood pressure are a possible causative factor, it is important to determine an appropriate source for a reference value. We studied to what extent preinduction blood pressure values in the operating room differ from those obtained during preoperative evaluation outside the operating room. Cohort study including 4408 patients aged 60 years or older undergoing noncardiac surgery. The outcome was the difference between the preinduction mean blood pressure (MBP) and the MBP obtained during preoperative evaluation. A difference of ≥10 mm Hg was considered clinically relevant. A paired samples t test was used to estimate the difference. Linear regression was used to obtain estimates adjusted for patient characteristics, comorbidity, medications, type of surgery, and preoperative blood pressure. Complete data were available for 3660 (83%) patients. There were 2228 (61%) patients with a difference of ≥10 mm Hg between the preinduction and preoperative MBP. The overall mean difference between both MBPs was 11 mm Hg (95% confidence interval, 10-11) with important variability among individuals. Patients with higher preoperative MBP values had smaller differences. After adjusting for patient characteristics, comorbidity, medications, type of surgery, and preoperative blood pressure, the difference decreased an estimated 5.0 mm Hg (95% confidence interval, 4.7-5.4) for every increase of 10 mm Hg in preoperative MBP. Patient characteristics, comorbidity, type of surgery, or medication were not strongly associated with the difference. The average preinduction blood pressure was higher than the preoperative blood pressure. This difference between the measurements can be explained by stress-induced effects and regression to the mean. To define an optimal reference value for research purposes or to arrive at a clinical perioperative blood pressure target, one should consider that there is important variability both within

  10. Longterm blood pressure variability in patients with rheumatoid arthritis and its effect on cardiovascular events and all-cause mortality in RA: a population-based comparative cohort study.

    PubMed

    Myasoedova, Elena; Crowson, Cynthia S; Green, Abigail B; Matteson, Eric L; Gabriel, Sherine E

    2014-08-01

    To examine longterm visit-to-visit blood pressure (BP) variability in patients with rheumatoid arthritis (RA) versus non-RA subjects and to assess its effect on cardiovascular (CV) events and mortality in RA. Clinic BP measures were collected in a population-based incident cohort of patients with RA (1987 American College of Rheumatology criteria met between January 1, 1995, and January 1, 2008) and non-RA subjects. BP variability was defined as within-subject SD in systolic and diastolic BP. The study included 442 patients with RA (mean age 55.5 yrs, 70% females) and 424 non-RA subjects (mean age 55.7 yrs, 69% females). Patients with RA had higher visit-to-visit variability in systolic BP (13.8 ± 4.7 mm Hg) than did non-RA subjects (13.0 ± 5.2 mm Hg, p = 0.004). Systolic BP variability declined after the index date in RA (p < 0.001) but not in the non-RA cohort (p = 0.73), adjusting for age, sex, and calendar year of RA. During the mean followup of 7.1 years, 33 CV events and 57 deaths occurred in the RA cohort. Visit-to-visit systolic BP variability was associated with increased risk of CV events (HR per 1 mm Hg increase in BP variability 1.12, 95% CI 1.01-1.25). Diastolic BP variability was associated with all-cause mortality in RA (HR 1.14, 95% CI 1.03-1.27), adjusting for systolic and diastolic BP, body mass index, smoking, diabetes, dyslipidemia, and use of antihypertensives. Patients with RA had higher visit-to-visit systolic BP variability than did non-RA subjects. There was a significant decline in systolic BP variability after RA incidence. Higher visit-to-visit BP variability was associated with adverse CV outcomes and all-cause mortality in RA.

  11. The relationship of electronically monitored physical activity to blood pressure, heart rate, and the circadian blood pressure profile.

    PubMed

    Mansoor, G A; White, W B; McCabe, E J; Giacco, S

    2000-03-01

    We studied how closely changes in electronically monitored physical activity are reflected in changes in blood pressure and heart rate in a group of untreated hypertensive subjects. Thirty-nine hypertensive patients (office blood pressure > 140/ 90 mm Hg) of mean age 57 +/- 10 years (mean +/-SD) wore an ambulatory blood pressure monitor and a wrist actigraph simultaneously. Both average and peak activity for 5 min before each valid blood pressure reading were determined, as was average activity for awake and sleep periods, determined by patient kept diaries. For the overall group, awake and 24-h activities were inversely correlated to age (n = 39, r = -0.42; P = 0.01 and n = 39, r = -0.38; P = 0.01, respectively). No correlation was found between group awake activity and group-average blood pressure or heart rate. For individual patients, there was marked variation in the degree of correlation between awake activity measures (both peak and average) and blood pressure and heart rate. The strongest positive correlation was between activity levels and the heart rate-pressure product. Nondipper profile hypertensives had higher sleep activity than dipper hypertensives (44 +/- 28 units/min v 25 +/- 20 units/min, df = 37, t = 2.12; P = 0.04), but awake activity levels were similar. The higher sleep activity remained after adjustment for age. These findings indicate that the relationship between actigraphic activity and hemodynamic parameters is highly variable and that the rate-pressure product is the strongest correlate of short-term activity. Furthermore, hypertensives with the nondipper profile have higher sleep activity than dipper hypertensives. These findings stress the need for further study into the role of day-to-day activity in determining ambulatory blood pressure and heart rate variability.

  12. Salt, blood pressure and cardiovascular disease.

    PubMed

    He, Feng J; MacGregor, Graham A

    2007-07-01

    To review the evidence that relates salt intake to blood pressure and cardiovascular disease. Raised blood pressure throughout the range seen in developed countries is the major cause of cardiovascular disease, responsible for 62% of strokes and 49% of coronary heart disease. There is overwhelming evidence that dietary salt is a major cause of raised blood pressure, and a modest reduction in salt intake lowers blood pressure, which is predicted to reduce cardiovascular disease. Several lines of evidence including ecological, population and prospective cohort studies, as well as follow-up studies of individuals who participated in short-term salt reduction trials, have consistently shown a direct relation between salt intake and cardiovascular risk, and a reduction in population salt intake is associated with a reduction in cardiovascular mortality in the population. The evidence for universal salt reduction is strong, and reducing salt from the current intake of 10-12 g/day to the recommended level of 5-6 g/day will have a major effect on blood pressure and cardiovascular mortality. Additionally, this will result in considerable savings on health expenditure as, not only is raised blood pressure the biggest cause of death, but the second biggest cause of disability worldwide.

  13. Cocoa, blood pressure, and cardiovascular health.

    PubMed

    Ferri, Claudio; Desideri, Giovambattista; Ferri, Livia; Proietti, Ilenia; Di Agostino, Stefania; Martella, Letizia; Mai, Francesca; Di Giosia, Paolo; Grassi, Davide

    2015-11-18

    High blood pressure is an important risk factor for cardiovascular disease and cardiovascular events worldwide. Clinical and epidemiological studies suggest that cocoa-rich products reduce the risk of cardiovascular disease. According to this, cocoa has a high content in polyphenols, especially flavanols. Flavanols have been described to exert favorable effects on endothelium-derived vasodilation via the stimulation of nitric oxide-synthase, the increased availability of l-arginine, and the decreased degradation of NO. Cocoa may also have a beneficial effect by protecting against oxidative stress alterations and via decreased platelet aggregation, decreased lipid oxidation, and insulin resistance. These effects are associated with a decrease of blood pressure and a favorable trend toward a reduction in cardiovascular events and strokes. Previous meta-analyses have shown that cocoa-rich foods may reduce blood pressure. Long-term trials investigating the effect of cocoa products are needed to determine whether or not blood pressure is reduced on a chronic basis by daily ingestion of cocoa. Furthermore, long-term trials investigating the effect of cocoa on clinical outcomes are also needed to assess whether cocoa has an effect on cardiovascular events. A 3 mmHg systolic blood pressure reduction has been estimated to decrease the risk of cardiovascular and all-cause mortality. This paper summarizes new findings concerning cocoa effects on blood pressure and cardiovascular health, focusing on putative mechanisms of action and "nutraceutical " viewpoints.

  14. Menopause and High Blood Pressure: What's the Connection?

    MedlinePlus

    ... blood pressure (hypertension) Is there a connection between menopause and high blood pressure? Answers from Shannon K. ... Tommaso, M.D. Blood pressure generally increases after menopause. Some doctors think this increase suggests that hormonal ...

  15. Sleep Deprivation: A Cause of High Blood Pressure?

    MedlinePlus

    ... High blood pressure (hypertension) Is it true that sleep deprivation can cause high blood pressure? Answers from ... be linked to increased blood pressure. People who sleep five hours or less a night may be ...

  16. Too Many Americans Have High Blood Pressure, Doctors Warn

    MedlinePlus

    ... news/fullstory_163468.html Too Many Americans Have High Blood Pressure, Doctors Warn With February designated National Heart Month, ... physicians warns that too many Americans struggle with high blood pressure. High blood pressure is a major risk factor ...

  17. Failure of the community-based Vita-Stat automated blood pressure device to accurately measure blood pressure.

    PubMed

    Whitcomb, B L; Prochazka, A; LoVerde, M; Byyny, R L

    1995-05-01

    To evaluate the Vita-Stat automated blood pressure computer (a patient-operated blood pressure measuring device available in the community) to determine its value as an instrument to monitor blood pressure in the ambulatory patient. Comparative study using the Vita-Stat vs a gold standard, the mercury sphygmomanometer. Three local grocery stores. Sixty-three passersby who agreed to answer questions and to sit for several measurements of blood pressure. Simultaneous measurement of blood pressure with each subject wearing a Vita-Stat cuff on the left arm and a mercury sphygmomanometer cuff on the right arm. Two pressures were measured sequentially in the same manner. The reproducibility, accuracy, sensitivity, and specificity of the Vita-Stat computer compared with the gold standard. In sequential measurements, the Vita-Stat readings of both systolic and diastolic blood pressure correlated less well with each other than did the mercury readings (intramachine differences). The Vita-Stat readings also correlated poorly with the mercury readings of systolic and diastolic blood pressure (intermachine differences). The variability in readings recorded by the Vita-Stat were striking, with differences of up to 60 mm Hg from the mercury readings. More than half (63.2%) of the subjects had Vita-Stat readings that were more than 5 mm Hg different from the mercury readings. Vita-Stat systolic readings were usually lower than mercury readings and also varied by as much as 60 mm Hg below in one patient to 58 mm Hg above the mercury reading in another. The sensitivity of the Vita-Stat in correctly diagnosing hypertension was 0.26; the negative predictive value was 0.45. Our data suggest that the Vita-Stat is not only inconsistent but inaccurate in measuring blood pressure in the ambulatory patient and is, therefore, not appropriate to use as a monitoring device.

  18. Wavelet-based analysis of blood pressure dynamics in rats

    NASA Astrophysics Data System (ADS)

    Pavlov, A. N.; Anisimov, A. A.; Semyachkina-Glushkovskaya, O. V.; Berdnikova, V. A.; Kuznecova, A. S.; Matasova, E. G.

    2009-02-01

    Using a wavelet-based approach, we study stress-induced reactions in the blood pressure dynamics in rats. Further, we consider how the level of the nitric oxide (NO) influences the heart rate variability. Clear distinctions for male and female rats are reported.

  19. Principles and techniques of blood pressure measurement.

    PubMed

    Pickering, Thomas G

    2002-05-01

    The gold standard for clinical blood pressure measurement continues to be readings taken by a physician using a mercury sphygmomanometer, but this is changing as mercury is gradually being phased out. The oscillometric technique, which primarily detects mean arterial pressure, is increasingly popular for use in electronic devices. Other methods include ultrasound (used mainly to detect systolic pressure) and the finger cuff method of Penaz, which can record beat-to-beat pressure noninvasively from the finger. The preferred location of measurement is the upper arm, but errors may occur because of changes in the position of the arm. Other technical sources of error include inappropriate cuff size and too rapid deflation of the cuff. Clinic readings may be unrepresentative of the patient's true blood pressure because of the white coat effect, which is defined as the difference between the clinic readings and the average daytime blood pressure. Patients with elevated clinic pressure and normal daytime pressure are said to have white coat hypertension. There are three commonly used methods for measuring blood pressure for clinical purposes: clinic readings, self-monitoring by the patient at home, and 24-hour ambulatory readings. Self-monitoring is growing rapidly in popularity and is generally carried out using electronic devices that work on the oscillometric technique. Although standard validation protocols exist, many devices on the market have not been tested for accuracy. Such devices can record blood pressure from the upper arm, wrist, or finger, but the arm is preferred. Twenty-four-hour ambulatory monitoring has been found to be the best predictor of cardiovascular risk in the individual patient and is the only technique that can describe the diurnal rhythm of blood pressure accurately. Ambulatory monitoring is mainly used for diagnosing hypertension, whereas self-monitoring is used for following the response to treatment. Different techniques of blood pressure

  20. Beat-to-Beat Blood Pressure Monitor

    NASA Technical Reports Server (NTRS)

    Lee, Yong Jin

    2012-01-01

    This device provides non-invasive beat-to-beat blood pressure measurements and can be worn over the upper arm for prolonged durations. Phase and waveform analyses are performed on filtered proximal and distal photoplethysmographic (PPG) waveforms obtained from the brachial artery. The phase analysis is used primarily for the computation of the mean arterial pressure, while the waveform analysis is used primarily to obtain the pulse pressure. Real-time compliance estimate is used to refine both the mean arterial and pulse pressures to provide the beat-to-beat blood pressure measurement. This wearable physiological monitor can be used to continuously observe the beat-to-beat blood pressure (B3P). It can be used to monitor the effect of prolonged exposures to reduced gravitational environments and the effectiveness of various countermeasures. A number of researchers have used pulse wave velocity (PWV) of blood in the arteries to infer the beat-to-beat blood pressure. There has been documentation of relative success, but a device that is able to provide the required accuracy and repeatability has not yet been developed. It has been demonstrated that an accurate and repeatable blood pressure measurement can be obtained by measuring the phase change (e.g., phase velocity), amplitude change, and distortion of the PPG waveforms along the brachial artery. The approach is based on comparing the full PPG waveform between two points along the artery rather than measuring the time-of-flight. Minimizing the measurement separation and confining the measurement area to a single, well-defined artery allows the waveform to retain the general shape between the two measurement points. This allows signal processing of waveforms to determine the phase and amplitude changes.

  1. Caffeine raises blood pressure at work.

    PubMed

    Lane, J D; Phillips-Bute, B G; Pieper, C F

    1998-01-01

    The study investigated the effects of moderate doses of caffeine on ambulatory blood pressure and heart rate during workday activities. Healthy, nonsmoking, habitual coffee drinkers (N = 21) received daily doses of 100 mg and 500 mg of caffeine on 2 days in a crossover design. Treatment order was random and counterbalanced, and administration was double-blind. Ambulatory monitoring was conducted for 6 to 9 hours during normal workday activities and diary entries were completed at each measurement. Ambulatory data were analyzed for the effects of caffeine dose, controlling for variations in posture, physical activity, and perceived stress. The average workday blood pressure and heart rate were significantly higher when the higher dose of caffeine was consumed. Controlling for other factors, dose-related differences were 4 mm Hg for systolic and 3 mm Hg for diastolic blood pressure, and were 3 bpm for heart rate. Results support earlier evidence that caffeine raises blood pressure at work, and demonstrate that these pressor effects are independent of changes in posture, physical activity, or stress. Daily blood pressure increases associated with caffeine consumption could increase the risk of developing cardiovascular diseases. In addition, caffeine consumption effects might confound ambulatory investigations of the cardiovascular effects of other psychosocial, personality, or health-behavior factors.

  2. Nighttime blood pressure in cluster headache.

    PubMed

    Santos Lasaosa, Sonia; Navarro Calzada, Jorge; Velázquez Benito, Alba; Pérez Lázaro, Cristina

    2011-10-01

    It has been proposed that desaturation of oxygen during an apnea event is the trigger for cluster headache. Obstructive sleep apnea has been associated with a higher than normal cardiovascular morbidity and mortality. Some obstructive sleep apnea syndrome patients lack the sleep-related, nocturnal decrease, or "dip" in blood pressure, which is seen in normal individuals. The aim of this study is to assess whether this non-dipper pattern is present in cluster headache patients. A total of 30 normotensive cluster headache patients underwent an ambulatory blood pressure monitoring. "Non dippers" were defined as patients with a nighttime mean blood pressure fall <10%. Fifteen cluster headache patients (50%) were non-dippers, a frequency higher than expected. The pattern of nocturnal non-dipping is associated with a higher body mass index. Non-dipper patients displayed higher mean nighttime systolic and diastolic blood pressure. No significant difference was observed in the mean 24-hour and daytime blood pressure. The high incidence (50%) of non-dipper pattern in both processes, cluster headache and obstructive sleep apnea syndrome, provides support for the hypothesis of a relationship between theses 2 disorders. © 2011 American Headache Society.

  3. Visually evoked blood flow responses and interaction with dynamic cerebral autoregulation: correction for blood pressure variation.

    PubMed

    Gommer, Erik D; Bogaarts, Guy; Martens, Esther G H J; Mess, Werner H; Reulen, Jos P H

    2014-05-01

    Visually evoked flow responses recorded using transcranial Doppler ultrasonography are often quantified using a dynamic model of neurovascular coupling. The evoked flow response is seen as the model's response to a visual step input stimulus. However, the continuously active process of dynamic cerebral autoregulation (dCA) compensating cerebral blood flow for blood pressure fluctuations may induce changes of cerebral blood flow velocity (CBFV) as well. The effect of blood pressure variability on the flow response is evaluated by separately modeling the dCA-induced effects of beat-to-beat measured blood pressure related CBFV changes. Parameters of 71 subjects are estimated using an existing, well-known second order dynamic neurovascular coupling model proposed by Rosengarten et al., and a new model extending the existing model with a CBFV contributing component as the output of a dCA model driven by blood pressure as input. Both models were evaluated for mean and systolic CBFV responses. The model-to-data fit errors of mean and systolic blood pressure for the new model were significantly lower compared to the existing model: mean: 0.8%±0.6 vs. 2.4%±2.8, p<0.001; systolic: 1.5%±1.2 vs. 2.2%±2.6, p<0.001. The confidence bounds of all estimated neurovascular coupling model parameters were significantly (p<0.005) narrowed for the new model. In conclusion, blood pressure correction of visual evoked flow responses by including cerebral autoregulation in model fitting of averaged responses results in significantly lower fit errors and by that in more reliable model parameter estimation. Blood pressure correction is more effective when mean instead of systolic CBFV responses are used. Measurement and quantification of neurovascular coupling should include beat-to-beat blood pressure measurement.

  4. Occupational lead exposure and blood pressure.

    PubMed Central

    Parkinson, D K; Hodgson, M J; Bromet, E J; Dew, M A; Connell, M M

    1987-01-01

    Recent community studies have suggested that low level lead exposure is significantly associated with blood pressure in the general population. This finding is inconsistent with the results of recent occupational studies of lead exposed workers, although the occupational studies contained serious methodological weaknesses. The present study examined the relation between occupational lead exposure and diastolic and systolic blood pressure in randomly selected samples of 270 exposed and 158 non-exposed workers. Four exposure indicators were examined: employment at a lead battery plant nu a control plant, current blood lead value, current zinc protoporphyrin value, and time weighted average blood lead value. After controlling for other known risk factors such as age, education, income, cigarette usage, alcohol consumption, and exercise, the associations between exposure and blood pressure were small and non-significant. In the absence of a biologically feasible hypothesis regarding the mechanism by which low level lead exposure would influence blood pressure the present findings challenge the validity of the general population association. PMID:3689706

  5. Confounders of auscultatory blood pressure measurement.

    PubMed

    Baker, R H; Ende, J

    1995-04-01

    The appropriate use of any test requires the clinician to appreciate that test's limitations. By recognizing the potential confounders of the auscultatory assessment of blood pressure, the clinician minimizes the likelihood of enacting therapeutic decisions based on inaccurate data. When approaching the treatment of a hypertensive patient, several points should be kept in mind. First, the measurement of persistent and severe hypertension in a patient receiving treatment who describes symptoms of orthostatic hypotension with apparently adequate standing blood pressure or who lacks corroborating retinal, echocardiographic, or electrocardiographic signs of hypertension should raise the concern of pseudohypertension or a white-coat response. Similarly, when one finds a normal or near-normal systolic blood pressure in a patient with a clinical picture consistent with severe hypertension, one should make a directed effort to look for an unrecognized auscultatory gap. Second, marked discrepancies in measurements as obtained by different operators or in different settings should raise concern of the white-coat response or methodologic errors by one operator, such as undercuffing, excessive pressure on the head of the stethoscope, rapid deflation of the cuff, or use of different arms. In treating hypertension in even the minimally obese patient, a special point must be made that an adequate size cuff be used for all blood pressure determinations. Third, when blood pressure is determined with the patient in any but the satndardized back-and-arm-supported seated position described above, the clinician should acknowledge the possibility that the position may alter the patient's classification. Fourth, the diagnosis and management of hypertension requires multiple measurements of blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Daily exercise attenuates the development of arterial blood pressure related cardiovascular risk factors in hypertensive rats.

    PubMed

    Collins, H L; Rodenbaugh, D W; DiCarlo, S E

    2000-02-01

    This study was designed to test the hypothesis that daily spontaneous running (DSR) attenuates the development of blood pressure-related cardiovascular disease risk factors (BP-related CVD risk factors) in spontaneously hypertensive rats (SHR). After 8 weeks of DSR or sedentary control, rats were chronically instrumented with arterial catheters. Daily exercise attenuated the development of all measures of BP-related CVD risk factors. Specifically DSR attenuated the increase in systolic blood pressure (delta--22 mmHg), systolic blood pressure variability (delta--2.5 mmHg), and systolic blood pressure load (delta--27%). Similarly, DSR attenuated the increase in diastolic blood pressure (delta--15 mmHg), diastolic blood pressure variability (delta--1.19 mmHg), and diastolic blood pressure load (delta--17%). Finally, DSR attenuated the development of tachycardia (delta--63 bpm). These data demonstrate that daily exercise attenuates the development of hypertension and tachycardia in animals predisposed to hypertension.

  7. Experimental intrarenal reflux and blood pressure.

    PubMed Central

    Moffat, D. B.

    1977-01-01

    The effect on the blood pressure of experimental vesico-ureteric reflux was investigated in adult female Wistar rats. In 6 rats, reflux with isotonic saline produced a transient rise in systemic blood pressure followed by a fall, with return to normal within 2 min (mean BP readings: 121-130-93 mmHg). In 6 rats during water diuresis, reflux with distilled water produced similar changes (114-120-79 mmHg). In 6 rats in which the ureters were divided before reflux, no rise in blood pressure occurred although in 2 of these the pressure showed a marked fall. The pattern of blood pressure changes which occurred as a result of reflux was similar to that produced by a rapid i.v. injection of a corresponding volume of saline and it was concluded that the changes accompanying reflux are due to pyelovenous backflow. This was confirmed by producing reflux with 5% lissamine green which appeared in the peripheral capillaries within 4 s of the reflux in 3 rats. Slow dilatation of the pelvis with saline in 9 rats showed that rupture of the pelvic epithelium occurred at a mean pressure of 99 mmHg. PMID:607990

  8. [Blood pressure goals on the test bench].

    PubMed

    Slany, Jörg

    2011-10-01

    There is little evidence from controlled prospective studies to support the low blood pressure goals stipulated for the treatment of hypertension by present guidelines, especially in high-risk patients with diabetes, renal insufficiency or coronary heart disease. Aim of this review is to scrutinize the potential benefit and risk of low blood pressure on the basis of recent studies and secondary analyses of older studies. In patients with coronary heart disease or equivalent or with diabetes lowering systolic blood pressure to 130 to 135 mmHg reduced primary or secondary cardiovascular endpoints in the majority of studies. Between 120 and 129 mmHg some positive effects could be shown in patients with coronary heart disease but not in patients with diabetes or metabolic syndrome. In patients with diabetic or nondiabetic nephropathy including those with proteinurea no convincing data exist which show a better outcome with systolic blood pressure below 130 versus below 140 mmHg. However, several studies suggest that the risk of stroke may decrease by lowering systolic pressure to 120 mmHg or even lower. Below 120 mmHg an increased risk of cardiac and noncardiac events or death was shown in quite a number of studies. In patients between 70 and 80 years, current evidence suggests lowering systolic blood pressure to 135 to 145 mmHg and in those above 80 years to 145 to 155 mmHg. No evidence was found to justify different diastolic pressure goals for different groups of patients; optimal values fall between 70 and 85 mmHg. Limitations of recent studies are short follow-up, few event rates and small differences in achieved pressure between groups leaving uncertainty about long-term effects. Apart from prevention of stroke there is sparse evidence that lowering systolic blood pressure below 130 mmHg may be beneficial. Current evidence suggests that lowering systolic and diastolic pressure into a range of 130 to 140/70 to 85 may be adequate for all patients with the exception

  9. Estimation of central systolic blood pressure using an oscillometric blood pressure monitor.

    PubMed

    Cheng, Hao-Min; Wang, Kang-Ling; Chen, Ying-Hwa; Lin, Shing-Jong; Chen, Lung-Ching; Sung, Shih-Hsien; Ding, Philip Yu-An; Yu, Wen-Chung; Chen, Jaw-Wen; Chen, Chen-Huan

    2010-06-01

    Current noninvasive techniques for assessing central aortic pressure require the recording of an arterial pressure wave using a high-fidelity applanation tonometer. We therefore developed and validated a novel method to estimate the central aortic systolic pressure using an oscillometric blood pressure monitor alone. Invasive high-fidelity right brachial and central aortic pressure waves, and left-brachial pulse volume plethysmography from an oscillometric blood pressure monitor, were obtained at baseline and 3 min after administration of sublingual nitroglycerin in 100 patients during cardiac catheterization. In the initial 50 patients (Generation Group), Central systolic blood pressure was predicted by a multi-variate prediction model generated from the comprehensive analysis of the invasive brachial pressure wave, including brachial late-systolic shoulder pressure value and parameters related to wave reflection and arterial compliance. Another prediction model was similarly constructed from the noninvasively calibrated pulse volume plethysmography. Both models were validated in the subsequent 50 patients (Validation Group) with results: r=0.98 (P<0.001) and mean difference=0.5+/-4.5 (95% confidence interval -8.3 to 9.3) mm Hg for the invasive model, and r=0.93 (P<0.001) and mean difference=-0.1+/-7.6 (95% confidence interval -15.0 to 14.8) mm Hg for the noninvasive model. Thus, our results indicate that central aortic systolic blood pressure could be estimated by analysis of the noninvasive brachial pressure wave alone from an oscillometric blood pressure monitor.

  10. WNK signalling pathways in blood pressure regulation.

    PubMed

    Murthy, Meena; Kurz, Thimo; O'Shaughnessy, Kevin M

    2017-04-01

    Hypertension (high blood pressure) is a major public health problem affecting more than a billion people worldwide with complications, including stroke, heart failure and kidney failure. The regulation of blood pressure is multifactorial reflecting genetic susceptibility, in utero environment and external factors such as obesity and salt intake. In keeping with Arthur Guyton's hypothesis, the kidney plays a key role in blood pressure control and data from clinical studies; physiology and genetics have shown that hypertension is driven a failure of the kidney to excrete excess salt at normal levels of blood pressure. There is a number of rare Mendelian blood pressure syndromes, which have shed light on the molecular mechanisms involved in dysregulated ion transport in the distal kidney. One in particular is Familial hyperkalemic hypertension (FHHt), an autosomal dominant monogenic form of hypertension characterised by high blood pressure, hyperkalemia, hyperchloremic metabolic acidosis, and hypercalciuria. The clinical signs of FHHt are treated by low doses of thiazide diuretic, and it mirrors Gitelman syndrome which features the inverse phenotype of hypotension, hypokalemic metabolic alkalosis, and hypocalciuria. Gitelman syndrome is caused by loss of function mutations in the thiazide-sensitive Na/Cl cotransporter (NCC); however, FHHt patients do not have mutations in the SCL12A3 locus encoding NCC. Instead, mutations have been identified in genes that have revealed a key signalling pathway that regulates NCC and several other key transporters and ion channels in the kidney that are critical for BP regulation. This is the WNK kinase signalling pathway that is the subject of this review.

  11. `Sausage string' patterns in blood vessels at high blood pressures

    NASA Astrophysics Data System (ADS)

    Alstrøm, Preben; Eguíluz, Victor M.; Gustafsson, Finn; Holstein-Rathlou, Niels-Henrik

    A new Rayleigh-type instability is proposed to explain the `sausage-string' pattern of alternating constrictions and dialtations formed in blood vessels at high blood pressure conditions. Our theory involves the nonlinear stress-strain characteristics of the vessel wall, and provides predictions for the conditions under which the normal cylindrical geometry of a blood vessel becomes unstable. The theory explains key features observed experimentally, e.g. the limited occurrence of the sausage-string pattern to small arteries and large arterioles, and only in those with small wall-to-lumen ratios.

  12. Blood Pressure in Infants, Children and Adolescents

    PubMed Central

    Moss, Arthur J.

    1981-01-01

    In infants the flush and Doppler methods of blood pressure measurement are usually used. The flush method measures mean pressure; the Doppler method, systolic and diastolic pressures. Normal flush values from 1 to 12 months of age do not exceed 100 mm of mercury; Doppler systolic levels do not exceed 113 mm of mercury. Data concerning normal limits for children and adolescents are conflicting. For practical purposes, a persistent pressure of 140 mm of mercury systolic or 90 mm of mercury diastolic in patients more than 10 years of age is indicative of hypertension. In those younger than 10 years, systolic pressure does not normally exceed 130 mm of mercury and diastolic pressure does not normally exceed 85 mm of mercury. Primary hypertension is relatively infrequent in pediatric patients and diagnosis should be made with deliberation and caution. Antihypertensive drug therapy is indicated only for severe hypertension and in selected cases of moderate hypertension. PMID:7245735

  13. Body mass index modulates blood pressure heritability: the Family Blood Pressure Program.

    PubMed

    Simino, Jeannette; Shi, Gang; Weder, Alan; Boerwinkle, Eric; Hunt, Steven C; Rao, Dabeeru C

    2014-04-01

    Candidate gene and twin studies suggest that interactions between body mass index (BMI) and genes contribute to the variability of blood pressure (BP). To determine whether there is evidence for gene-BMI interactions, we investigated the modulation of BP heritability by BMI using 4,153 blacks, 1,538 Asians, 4,013 whites, and 2,199 Hispanic Americans from the Family Blood Pressure Program. To capture the BP heritability dependence on BMI, we employed a generalized variance components model incorporating linear and Gaussian interactions between BMI and the genetic component. Within each race and network subgroup, we used the Akaike information criterion and likelihood ratio test to select the appropriate interaction function for each BP trait (systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP)) and determine interaction significance, respectively. BP heritabilities were significantly modified by BMI in the GenNet and SAPPHIRe Networks, which contained the youngest and least-obese participants, respectively. GenNet Whites had unimodal SBP, MAP, and PP heritabilities that peaked between BMI values of 33 and 37kg/m(2). The SBP and MAP heritabilities in GenNet Hispanic Americans, as well as the PP heritability in GenNet blacks, were increasing functions of BMI. The DBP and SBP heritabilities in the SAPPHIRe Chinese and Japanese, respectively, were decreasing functions of BMI. BP heritability differed by BMI in the youngest and least-obese networks, although the shape of this dependence differed by race. Use of nonlinear gene-BMI interactions may enhance BP gene discovery efforts in individuals of European ancestry.

  14. An implantable blood pressure and flow transmitter.

    NASA Technical Reports Server (NTRS)

    Rader, R. D.; Meehan, J. P.; Henriksen, J. K. C.

    1973-01-01

    A miniature totally implantable FM/FM telemetry system has been developed to simultaneously measure blood pressure and blood flow, thus providing an appreciation of the hemodynamics of the circulation to the entire body or to a particular organ. Developed for work with animal subjects, the telemetry system's transmission time is controlled by an RF signal that permits an operating life of several months. Pressure is detected by a miniature intravascular transducer and flow is detected by an extravascular interferometric ultrasonic technique. Both pressure and flow are calibrated prior to implanting. The pressure calibration can be checked after the implanting by cannulation; flow calibration can be verified only at the end of the experiment by determining the voltage output from the implanted sensing system as a function of several measured flow rates. The utility of this device has been established by its use in investigating canine renal circulation during exercise, emotional encounters, administration of drugs, and application of accelerative forces.

  15. Blood pressure measurement using finger cuff.

    PubMed

    Lee, J; Choi, E; Jeong, H; Kim, K; Park, J

    2005-01-01

    Many research groups have studied blood pressure measurement in finger artery because of its convenience. But, low accuracy prohibits many hypertension patients from using this device. So, we suggest measurement algorithm that measure systolic and diastolic blood pressure in finger artery. And we also develop calibration method that decreases the error from difference of finger circumference by subjects. We apply our methods for 90 subjects (age form 20 to 49, 55 male, 35 female) to test feasibility of our method by AAMI SP10 standard. The mean difference of our system is ±4.7mmHg for systolic pressure, ±4.2mmHg for systolic pressure. It proved that the feasibility of our method is clinically acceptable.(under ±5mmHg).

  16. An implantable blood pressure and flow transmitter.

    NASA Technical Reports Server (NTRS)

    Rader, R. D.; Meehan, J. P.; Henriksen, J. K. C.

    1973-01-01

    A miniature totally implantable FM/FM telemetry system has been developed to simultaneously measure blood pressure and blood flow, thus providing an appreciation of the hemodynamics of the circulation to the entire body or to a particular organ. Developed for work with animal subjects, the telemetry system's transmission time is controlled by an RF signal that permits an operating life of several months. Pressure is detected by a miniature intravascular transducer and flow is detected by an extravascular interferometric ultrasonic technique. Both pressure and flow are calibrated prior to implanting. The pressure calibration can be checked after the implanting by cannulation; flow calibration can be verified only at the end of the experiment by determining the voltage output from the implanted sensing system as a function of several measured flow rates. The utility of this device has been established by its use in investigating canine renal circulation during exercise, emotional encounters, administration of drugs, and application of accelerative forces.

  17. [Blood pressure and polycystic ovary syndrome (PCOS)].

    PubMed

    Kiałka, Marta; Milewicz, Tomasz; Klocek, Marek

    2015-01-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder occurring in women of childbearing age. The literature describes the relationship between PCOS and high blood pressure levels and increased risk of arterial hypertension development, which is an important and strong risk factor for adverse cardiovascular events in the future. Among the main causes of hypertension in PCOS women insulin resistance, hyperandrogenism, greater sympathetic nerve activity and concomitance of obesity are stressed. Because PCOS may contribute to earlier development of hypertension, as well as pre-hypertension, therefore it is advisable to monitor blood pressure systematically, to control known risk factors, and to initiate the treatment of hypertension when the disease occur.

  18. Phaeochromocytoma with nocturnal elevation of blood pressure.

    PubMed Central

    Yamamoto, T.; Jo, T.; Ishibashi, T.

    1978-01-01

    A 47-year-old woman with phaeochromocytoma showed blood pressure changes characterized by the regular appearance of hypertension at night. The urinary excretion of catecholamines and their metabolites showed augmentation roughly parallel with the elevation of the blood pressure. During normotensive periods, the urinary excretion of catecholamines and their metabolites was elevated. The findings suggested that the pressor effect of catecholamine hypersecretion was compromised to a certain degree and that the regular nocturnal appearances of hypertensive paroxysm conceivably resulted from a spontaneous cyclic augmentation of the catecholamine secretion from the tumour. PMID:625458

  19. Coping strategies and diastolic blood pressure.

    PubMed

    Wright, T A; Sweeney, D

    1989-10-01

    An organizational field study involving 95 civil service employees examined the ways these individuals coped with the stressful events of their daily living. Lazarus' cognitive-phenomenological analysis of psychological stress provided the theoretical framework. Subjects indicated on Lazarus' Ways of Coping Checklist those coping thoughts and actions used in the specific encounter described as stressful. As hypothesized, individuals experiencing higher diastolic blood pressure were more likely to cope using strategies characterized by wishful thinking, avoidance, and minimization of threat than were individuals exhibiting lower blood pressure. Implications from both an individual and organizational perspective are discussed.

  20. Blood pressure in head‐injured patients

    PubMed Central

    Mitchell, Patrick; Gregson, Barbara A; Piper, Ian; Citerio, Giuseppe; Mendelow, A David; Chambers, Iain R

    2007-01-01

    Objective To determine the statistical characteristics of blood pressure (BP) readings from a large number of head‐injured patients. Methods The BrainIT group has collected high time‐resolution physiological and clinical data from head‐injured patients who require intracranial pressure (ICP) monitoring. The statistical features of this dataset of BP measurements with time resolution of 1 min from 200 patients is examined. The distributions of BP measurements and their relationship with simultaneous ICP measurements are described. Results The distributions of mean, systolic and diastolic readings are close to normal with modest skewing towards higher values. There is a trend towards an increase in blood pressure with advancing age, but this is not significant. Simultaneous blood pressure and ICP values suggest a triphasic relationship with a BP rising at 0.28 mm Hg/mm Hg of ICP, for ICP up to 32 mm Hg, and 0.9 mm Hg/mm Hg of ICP for ICP from 33 to 55 mm Hg, and falling sharply with rising ICP for ICP >55 mm Hg. Conclusions Patients with head injury appear to have a near normal distribution of blood pressure readings that are skewed towards higher values. The relationship between BP and ICP may be triphasic. PMID:17138594

  1. Effects of autogenic training and antihypertensive agents on circadian and circaseptan variation of blood pressure.

    PubMed

    Watanabe, Yoshihiko; Cornélissen, Germaine; Watanabe, Misako; Watanabe, Fumihiko; Otsuka, Kuniaki; Ohkawa, Shi-ichiro; Kikuchi, Takenori; Halberg, Franz

    2003-10-01

    Even when the daily blood pressure mean is acceptable, too large a circadian amplitude of blood pressure largely increases cardiovascular disease risk. Autogenic training (N = 11), a non-pharmacologic intervention capable of lowering an excessive blood pressure variability, may be well-suited for MESOR-normotensive patients diagnosed with circadian-hyper-amplitude-tension (CHAT). Not all anti-hypertensive drugs affect blood pressure variability. Accordingly, long-acting carteolol (N = 11) and/or atenolol (N = 8) may be preferred to captopril retard (N = 13), nilvadipine (N = 8), or amlodipine (N = 7) for midline-estimating statistic of rhythm (MESOR)-hypertensive patients with CHAT. Prospective outcome studies are needed to assess whether the relative merits of these treatments are in keeping with their effects on blood pressure and blood pressure variability.

  2. Dietary phosphorus and blood pressure: international study of macro- and micro-nutrients and blood pressure.

    PubMed

    Elliott, Paul; Kesteloot, Hugo; Appel, Lawrence J; Dyer, Alan R; Ueshima, Hirotsugu; Chan, Queenie; Brown, Ian J; Zhao, Liancheng; Stamler, Jeremiah

    2008-03-01

    Raised blood pressure is a leading cause of morbidity and mortality worldwide; improved nutritional approaches to population-wide prevention are required. Few data are available on dietary phosphorus and blood pressure and none are available on possible combined effects of phosphorus, magnesium, and calcium on blood pressure. The International Study of Macro- and Micro-Nutrients and Blood Pressure is a cross-sectional epidemiologic study of 4680 men and women ages 40 to 59 from 17 population samples in Japan, China, United Kingdom, and United States. Blood pressure was measured 8 times at 4 visits. Dietary intakes were obtained from four 24-hour recalls plus data on supplement use. Dietary phosphorus was inversely associated with blood pressure in a series of predefined multiple regression models, with the successive addition of potential confounders, both nondietary and dietary. Estimated blood pressure differences per 232 mg/1000 kcal (2 SD) of higher dietary phosphorus were -1.1 to -2.3 mm Hg systolic/-0.6 to -1.5 mm Hg diastolic (n=4680) and -1.6 to -3.5 mm Hg systolic/-0.8 to -1.8 mm Hg diastolic for 2238 "nonintervened" individuals, ie, those without special diet/nutritional supplements or diagnosis/treatment for cardiovascular disease or diabetes. Dietary calcium and magnesium, correlated with phosphorus (partial r=0.71 and r=0.68), were inversely associated with blood pressure. Blood pressures were lower by 1.9 to 4.2 mm Hg systolic/1.2 to 2.4 mm Hg diastolic for people with intakes above versus below country-specific medians for all 3 of the minerals. These results indicate the potential for increased phosphorus/mineral intake to lower blood pressure as part of the recommendations for healthier eating patterns for the prevention and control of prehypertension and hypertension.

  3. Variable pressure power cycle and control system

    DOEpatents

    Goldsberry, Fred L.

    1984-11-27

    A variable pressure power cycle and control system that is adjustable to a variable heat source is disclosed. The power cycle adjusts itself to the heat source so that a minimal temperature difference is maintained between the heat source fluid and the power cycle working fluid, thereby substantially matching the thermodynamic envelope of the power cycle to the thermodynamic envelope of the heat source. Adjustments are made by sensing the inlet temperature of the heat source fluid and then setting a superheated vapor temperature and pressure to achieve a minimum temperature difference between the heat source fluid and the working fluid.

  4. 21 CFR 870.2850 - Extravascular blood pressure transducer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Extravascular blood pressure transducer. 870.2850... blood pressure transducer. (a) Identification. An extravascular blood pressure transducer is a device used to measure blood pressure by changes in the mechanical or electrical properties of the device....

  5. 21 CFR 870.2850 - Extravascular blood pressure transducer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Extravascular blood pressure transducer. 870.2850... blood pressure transducer. (a) Identification. An extravascular blood pressure transducer is a device used to measure blood pressure by changes in the mechanical or electrical properties of the device....

  6. 21 CFR 870.2850 - Extravascular blood pressure transducer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Extravascular blood pressure transducer. 870.2850... blood pressure transducer. (a) Identification. An extravascular blood pressure transducer is a device used to measure blood pressure by changes in the mechanical or electrical properties of the device....

  7. 21 CFR 870.2850 - Extravascular blood pressure transducer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Extravascular blood pressure transducer. 870.2850... blood pressure transducer. (a) Identification. An extravascular blood pressure transducer is a device used to measure blood pressure by changes in the mechanical or electrical properties of the device....

  8. 21 CFR 870.2850 - Extravascular blood pressure transducer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Extravascular blood pressure transducer. 870.2850... blood pressure transducer. (a) Identification. An extravascular blood pressure transducer is a device used to measure blood pressure by changes in the mechanical or electrical properties of the device....

  9. Utility of ambulatory blood pressure monitoring in children and adolescents.

    PubMed

    Graves, John W; Althaf, Mohammed Mahdi

    2006-11-01

    Diagnosis of hypertension is critically dependent on accurate blood pressure measurement. "Accurate" refers to carefully following the guidelines for blood pressure measurement laid out for children and adults to minimize observer and subject errors