A Case of Vertebral Artery Dissection Associated with Morning Blood Pressure Surge

Eguchi, Katsumi; Tachikawa, Yuichi; Kashima, Ryuichi; Shinohara, Michi M.; Fukushima, Fumiya; Sato, Takashi; Takeda, Atsushi; Numao, Toshiro; Kario, Kazuomi; Shimada, Kazuyuki

doi:10.1291/hypres.28.847

Cited by 9 publications

(4 citation statements)

References 23 publications

(19 reference statements)

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“…In the present study, a high morning SBP, but not morning DBP or other BP variables, was significantly associated with impaired Valsalva-BRS. That may be because morning SBP has been reported to carry the strongest cardiovascular risk among ambulatory BP parameters (35,36,39). On the other hand, the morning BP surge, consisting of both high morning BP and low nighttime BP, was not associated with BRS in our study.…”

Section: Morning Hypertensioncontrasting

confidence: 53%

Factors Associated with Baroreflex Sensitivity: Association with Morning Blood Pressure

et al. 2007

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Baroreflex sensitivity (BRS) is a primary mechanism for acute and chronic control of blood pressure (BP).However, there are few data showing the relationship between BRS and ambulatory BP (ABP). We assessed the hypothesis that BRS specifically contributes to some specific parameters of ABP in never-treated hypertensive/normotensive subjects. We studied 128 subjects (mean age: 54.5 ± 13 years, 60% male) consisting of 92 untreated hypertensive and 36 normotensive subjects. Radial tonometric BP and simultaneous RR interval were recorded for 10 min, and the Valsalva maneuver was performed 3 times for each subject. BRS was calculated in two ways: the spontaneous-BRS by the spectral method, and the Valsalva-BRS by the slope method, using commercial software. ABP monitoring was performed on the same day as the BRS test.

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Section: Morning Hypertensioncontrasting

confidence: 53%

Factors Associated with Baroreflex Sensitivity: Association with Morning Blood Pressure

et al. 2007

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“…Abnormal morning BP profiles have been proved to increase risk of cardiovascular events or hypertensive target organ damages (3)(4)(5)(6)(7), as well as ambulatory BP level itself (8,9). Given that various cardiovascular accidents have their peak in frequency in the morning (10,11), it is reasonable to speculate that morning BP makes a contribution to them.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Morning Blood Pressure Elevation and Autonomic Nervous Activity in Hypertensive Patients Using Wavelet Transform of Heart Rate Variability

et al. 2006

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To evaluate morning autonomic nervous activity and blood pressure profiles in hypertensive patients by analyzing heart rate variability and ambulatory blood pressure. Data from 82 patients with untreated essential hypertension were analyzed. We evaluated the 24-h profile of blood pressure and that of indices of autonomic nervous activity, i.e., the high frequency component (HF) and low frequency component/HF (LF/HF), which were obtained by wavelet transform of heart rate variability. Patients were classified by dipping status (nondippers, n =28; dippers, n =32; extreme-dippers, n =8; and risers, n =14) and morning blood pressure profile (large, n =9; small, n =60; and inverted, n =13). Nocturnal systolic blood pressure in extreme-dippers was significantly lower than that in the other groups; that in the risers was significantly higher (p <0.05). There were no significant group differences in daytime systolic blood pressure. Daytime and 24-h HF levels

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“…[4] Genetic predisposition has also been documented to be an intrinsic factor in the development of a VAD. [2] Other contributory factors mentioned in case reports on VAD include high blood pressure surges [5] and neck manipulation. [6] However fewer cases were deemed to be spontaneous [7,8] with some authors suggesting there may have been minor or trivial injury around the neck preceding spontaneous cases.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Vertebral Artery Dissection Presenting with Crescendo TIAs and Headache

Idehen¹,

Awad²

2019

GJMR

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We present the case of a man in his thirties who had attended the emergency department with complaint of a distressing headache and associated intermittent facial droop with occasional slurred speech. The patient’s symptoms were bizarre in their nature as they were random, not sustained and he had long intervals when he was asymptomatic and was his normal self. During the course of admission his symptoms evolved resulting in neurological deficits which were more sustained, prompting the need for further imaging beyond the initial plain CT brain which showed no abnormality. This led to the diagnosis of vertebral artery dissection (VAD) complicated with an ischaemic stroke in the posterior inferior cerebellar artery distribution (PICA) on MRI/MRA. Dual anti-platelet treatment was commenced with the patient attaining gradual symptomatic improvement prior to discharge. He has reported some degree of neurological sequelae which he described as intermittent poor coordination on follow up visit in clinic after discharge.

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A Case of Vertebral Artery Dissection Associated with Morning Blood Pressure Surge

Cited by 9 publications

References 23 publications

Factors Associated with Baroreflex Sensitivity: Association with Morning Blood Pressure

Factors Associated with Baroreflex Sensitivity: Association with Morning Blood Pressure

Evaluation of Morning Blood Pressure Elevation and Autonomic Nervous Activity in Hypertensive Patients Using Wavelet Transform of Heart Rate Variability

Spontaneous Vertebral Artery Dissection Presenting with Crescendo TIAs and Headache

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