Systemic hemodynamics during sleep in young or middle-aged and elderly patients with essential hypertension.

Minamisawa, Kohsuke; Tochikubo, Osamu; Ishii, Masao

doi:10.1161/01.hyp.23.2.167

Cited by 23 publications

(10 citation statements)

References 31 publications

(21 reference statements)

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“…1 Applying this concept to ABPM measured values, we have specified minimum sleep-time BP (base BP) and have repeatedly studied its significance. [2][3][4][5][6][7] Instead of manifesting a gaussian distribution, intra-arterial BP and HR values obtained during nighttime and daytime are distributed asymmetrically with a levopositional mode (modeϽmean) in a manner approximating a gamma distribution that has a minimum value (location parameter). 8,9 We found that base BP was almost the same as the location (L) parameter of the BP frequency distribution, which approximated a gamma distribution.…”

Section: Discussionmentioning

confidence: 99%

“…3,6,21 The base BP waveform manifesting itself at this time takes the most efficient pulse interval (RR) for producing a maximum per-minute waveform area, which indicates a maximum per-minute blood flow in relation to BP value. 5 Moreover, at this time, base BP demonstrates a higher correlation with total peripheral vascular resistance and arterial elastic modulus than MBP W .…”

Section: Discussionmentioning

confidence: 99%

“…Although it has been reported previously, 6,10 we here briefly outline the procedure whereby direct BP measurements were made. Using a system developed in our laboratory, we used the telemetric method to perform continuous 24-hour monitoring of intra-arterial pressure and ECG under almost unrestricted conditions.…”

Section: Direct Bp Measurementmentioning

confidence: 99%

“…Applying the same line of thought to 24-hour intra-arterial BP values, we reported base BP (that is, minimum BP occurring during nighttime sleep) to be a physiologically and stochastically important BP value. [2][3][4][5][6][7] However, because base BP can be measured only with a large number of samples by the direct method, we found it necessary to devise a method of calculating statistical base BP with a small number of samples obtained indirectly by means of ABPM, and we have investigated the extent to which values obtained in this way satisfy the first 4 of the conditions set forth above.…”

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confidence: 99%

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Statistical Base Value of 24-Hour Blood Pressure Distribution in Patients With Essential Hypertension

et al. 1998

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Direct Bp Measurementmentioning

confidence: 99%

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confidence: 99%

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Statistical Base Value of 24-Hour Blood Pressure Distribution in Patients With Essential Hypertension

et al. 1998

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“…26 Stroke patients often exhibit hypertension, which is related to the occurrence of atherosclerosis, and therefore must be assessed and managed carefully during physical rehabilitation. 25 Frequent repetition of short-duration physical therapy is appropriate for stroke patients with a lesion of the thalamus or brain stem in order to avoid large fluctuations of BP.…”

Section: Discussionmentioning

confidence: 99%

Relation Between 24-h Heart Rate Variability and Blood Pressure Fluctuation During Exercise in Stroke Patients

Nishioka

Sashika

Andho

et al. 2005

Circ J

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lood pressure (BP) and heart rate (HR) often fluctuate extensively in stroke patients during the acute to subacute phase. 1 In addition, cerebral blood flow is dependent on systemic BP during these phases because of the disturbance of autoregulation of cerebral blood flow. 2 Therefore it is important to consider the risk of stroke relapse or progression caused by fluctuating BP, such as an increase or decrease of BP and BP variability (BPV). 3,4 Some clinical studies have shown that an abnormal pattern of variability of diurnal BP, evaluated by 24-h ambulatory BP monitoring, 5 is associated with target organ damage. 6 Currently, the Holter ECG is used to monitor spontaneous heart rate variability (HRV) to assess the function of the cardiac autonomic nervous system in stroke patients. [7][8][9][10][11] Singh et al reported that autonomic nervous system activity, monitored by HRV, was related to 24-h BPV. 12 Clinical and experimental studies have examined how the localization of stroke affects autonomic function and prognosis. [13][14][15] Stroke patients with a lesion in the thalamus or brain stem often show high BP and other cardiovascular dysfunction. We assumed that stroke patients with a thalamic lesion would exhibit autonomic nervous dysfunction.The purpose of this study was to clarify the autonomic nervous system dysfunction and evaluate the risk during medical rehabilitation in stroke patients with a thalamic Circulation Journal Vol.69, June 2005 lesion, using 24-h HRV and 24-h BPV. The relationship between HRV, as well as 24-h BPV, and the change in BP during exercise was also investigated. Methods SubjectsThe subjects were patients who were admitted to the Stroke Medical Center within 2 weeks of the onset of their first stroke. The stroke group (Table 1) Relation Between 24-h Heart Rate Variability and Blood Pressure Fluctuation During Exercise in Stroke PatientsYasuko Nishioka, MD; Hironobu Sashika, MD*; Norihiko Andho, MD*; Osamu Tochikubo, MD** Background In some stroke patients blood pressure (BP) fluctuates extensively during medical rehabilitation, so the present study investigated the influence of autonomic nervous dysfunction on the change in BP during exercise. Methods and ResultsThe subjects consisted of 55 stroke inpatients (males, 29; mean age, 58.8 years old; ischemic/hemorrhagic etiology, 30/25) who were admitted to the Stroke Center within 2 weeks of their first stroke. The control group consisted of 15 age-matched healthy volunteers. The 24-h heart rate (HR) variability (HRV) and BP variability (BPV) were examined, and then the increase and recovery of BP and HR were measured during bicycle ergometer exercise at 4 METs. Components of 24-h HRV (low-frequency power (LF), highfrequency power (HF), LF/HF, and asleep -awake ratio of LF/HF (LF/HFd-n)) were lower (p<0.01) and BPV was greater in the stroke group (p<0.05) than in the control group. There was a negative correlation between BP change during exercise and LF/HF or LF/HFd-n (r=-0.43 or r=-0.58, p<0.01), and a greater increase in sy...

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Changes of Circadian Blood Pressure Patterns Are Associated With the Occurrence of Lacunar Infarction

Kukla¹,

Sander²,

Schwarze³

et al. 1998

Arch Neurol

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Systemic hemodynamics during sleep in young or middle-aged and elderly patients with essential hypertension.

Abstract: Age-related changes in cardiovascular regulatory mechanisms may affect blood pressure homeostasis during sleep and in the daytime. This study compared systemic hemodynamics during the daytime and sleep between 12 young or middle-aged patients (young, 42

Cited by 23 publications

References 31 publications

Statistical Base Value of 24-Hour Blood Pressure Distribution in Patients With Essential Hypertension

Statistical Base Value of 24-Hour Blood Pressure Distribution in Patients With Essential Hypertension

Relation Between 24-h Heart Rate Variability and Blood Pressure Fluctuation During Exercise in Stroke Patients

Changes of Circadian Blood Pressure Patterns Are Associated With the Occurrence of Lacunar Infarction

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