The Changes in the Intra-Arterial Pressure during Immersion of the Hand in Ice-Cold Water

Godden, John O.; Roth, Grace M.; Hines, Edgar A.; Schlegel, J.U.

doi:10.1161/01.cir.12.6.963

Cited by 57 publications

(21 citation statements)

References 15 publications

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“…It is important to stress that, if a 12-cm cuff is used for obese subjects, over estimation of arm blood pressure (cuff hypertension) may occur. 5 Our study shows a similar average difference and interindividual scatter in the hypertensive group, with a normal dimension of the upper arm, compared with the data for the obese group where a wider cuff was used. We therefore recommend a 15-cm cuff for obese subjects with an arm circumference exceeding 35 cm.…”

Section: Discussionsupporting

confidence: 76%

Accuracy of auscultatory blood pressure measurements in hypertensive and obese subjects.

Nielsen¹,

Larsen²,

Holstein³

et al. 1983

Hypertension

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SUMMARY In 59 treated or untreated hypertensive subjects and 52 obese subjects (normotensive or hypertensive), intraarterial blood pressure (BP) was compared to simultaneous auscultatory measurements. In the hypertensive group, arm circumference was less than 35 cm compared to over 35 cm in the obese subjects. The occluding cuffs were 12 x 35 cm and 15 x 43 cm respectively. Mean difference between auscultatory and intraarterial systolic BP (SBP) was among the hypertensive -8.8 mm Hg (SD D[FF 9.0 mm Hg, range + 13/ -28) and among the obese -3.1 mm Hg (SD D(FF 13.8 mm Hg, range + 19/-49). Mean difference auscultatory-intraarterial diastolic BP (DBP) Phase V was among the hypertensive patients + 10.8 mm Hg(SD D1FF 6.8 mm Hg, range + 29/-8), and among the obese + 5.5 mm Hg (SD DIFF 7.3 mm Hg, range + 20/-10). Thus, a 15 x 43 cm cuff used in obese subjects with an arm circumference exceeding 35 cm gave quite as reliable measurements as a 12 x 35 cm cuff used in hypertensive subjects with "normal" dimension of the upper arm (< 35 cm). It is emphasized that there is a wide scatter in the interindividual differences, and it is argued that a comparison between auscultatory and intraarterial BP should be performed in patients with poorly controlled hypertension. (Hypertension 5: 122-127, 1983) KEY WORDS • blood pressure • measurement of blood pressure • hypertension • obesity S EVERAL studies have been published concerning the difference between direct (intraarterial) and indirect (auscultatory) measurement of brachial artery blood pressure (BP). 1 " 13 In these studies nearly all the subjects have been normotensive controls, and only a few have been treated or untreated hypertensives. In both obese and nonobese hypertensive subjects, we have compared the auscultatory measurements with simultaneous short-lasting intraarterial values in order to evaluate whether there is an artifact using the conventional cuff technique. The aims of the present study were to compare auscultatory and intraarterial readings in a group of consecutively referred hypertensive subjects, and to evaluate similar comparisons performed among obese subjects (hypertensive and normotensive). Material and MethodsA total of 59 treated or untreated hypertensive patients were investigated (table 1). Before treatment,

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Section: Discussionsupporting

confidence: 76%

Accuracy of auscultatory blood pressure measurements in hypertensive and obese subjects.

Nielsen¹,

Larsen²,

Holstein³

et al. 1983

Hypertension

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“…demonstrated that the different never fibers for this response are the pain fibers, which are stimulated by placing the hand in cold water and these are the sympathetic fibers. 23 The response of 15mmHg increase in blood pressure is considered as normal response to cold pressor test in normal individuals. Gherghel et al performed a modified cold pressor response test in 24 patients with POAG and 22 controls and found a differing blood pressure and ocular blood flow response in patients with POAG suggestive of systemic autonomic failure and ocular vascular dysregulation.…”

Section: Discussionmentioning

confidence: 99%

Study of Autonomic Activities in Primary Open Angle Glaucoma

Khan¹,

Ghosh²,

Bera³

2015

jemds

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In the late nineteenth century authors established the concept of involvement of Automatic Nervous System (ANS), including both sympathetic and parasympathetic division in the various systemic disorders. ANS help to maintain the ocular blood flow at a suitable level during sudden increments in blood pressure and also influence the steady state level of Intraocular Pressure (IOP) by altering the rate of aqueous production in eye. Glaucoma is characterized by a progressive optic neuropathy resulting in irreversible damage to the optic nerve and visual field leading to blindness. Glaucoma has also been associated with ANS, which affects aqueous dynamics and therefore IOP. The diagnosis of autonomic neuropathy may be based on clinical symptoms on nerve biopsies or on attenuation of reflexes. In India the most common form of glaucoma is the Primary Open-Angle Glaucoma (POAG). The present study is undertaken with similar objectives to provide a further insight to this common and preventable disorder. AIMSTo compare the autonomic functions of POAG and normal subjects (Control). MATERIALS AND METHODSThe various autonomic function tests including Resting Heart Rate, Postural Pressor Response, Valsalva Ratio, Cold Pressor Response, Corrected QT Interval, T-Wave Amplitude of EKG were performed in 30 normal healthy subjects (Control) and 30 Primary Open Angle Glaucoma (POAG) patients in Gold Field Hospital, Faridabad. STATISTICAL ANALYSISIntergroup mean differences were tested for significance by Stusent standard 't' tests by using SPSS software version-17.0. RESULTSThere is significant (p<0.05) decrease in both sympathetic and parasympathetic activity in POAG in comparison to normal subject. CONCLUSIONPOAG showed decrease in both sympathetic and parasympathetic activity.

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“…Blood pressure and heart rate responses to sustained handgrip for 3 min at 30% of maximum voluntary con traction (measured in newtons) were measured [18]. During the cold pressor test one hand was immersed up to the wrist in ice water slush for 3 min, and heart rate and blood pressure response measured [19,20].…”

Section: Methodsmentioning

confidence: 99%

Effect of Haemodialysis on the Control of the Circulation in Patients with Chronic Renal Failure

1985

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The mechanisms of hypotension during haemodialysis were investigated by studying cardiovascular reflexes, body fluid volumes, and osmolality in 11 patients with renal failure before and after haemodialysis and in 17 normal subjects before and after furosemide diuresis. Blood pressure and heart rate responses to tests of autonomic nervous function were unaffected in either group except that in the patients, head-up tilt after haemodialysis caused a fall in blood pressure. This was associated with a greater fall in cardiac output than before haemodialysis but with a similar rise in peripheral vascular resistance. Resting plasma noradrenaline levels were higher than normal, and the rise in plasma noradrenaline levels in response to tilt was unaffected by haemodialysis. Plasma renin activity rose in response to head-up tilt in normal subjects, but not in patients either before or after haemodialysis. Our studies indicate that changes in plasma potassium and osmolality or the possible peripheral circulatory effects of acetate do not impair the regulation of the circulation in response to haemodialysis. Haemodialysis does not reduce plasma noradrenaline levels. Impaired myocardial function in response to fluid depletion or unresponsiveness of the renin-angiotensin system may contribute to haemodialysis hypotension.

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The Changes in the Intra-Arterial Pressure during Immersion of the Hand in Ice-Cold Water

Cited by 57 publications

References 15 publications

Accuracy of auscultatory blood pressure measurements in hypertensive and obese subjects.

Accuracy of auscultatory blood pressure measurements in hypertensive and obese subjects.

Study of Autonomic Activities in Primary Open Angle Glaucoma

Effect of Haemodialysis on the Control of the Circulation in Patients with Chronic Renal Failure

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