Blood pressure variability at rest and during pressor challenges in patients with acute ischemic stroke.

IF 1.2 4区 医学 Q4 PERIPHERAL VASCULAR DISEASE Blood Pressure Monitoring Pub Date : 2024-10-01 Epub Date: 2024-06-04 DOI:10.1097/MBP.0000000000000710
Sankanika Roy, Man Y Lam, Ronney B Panerai, Thompson G Robinson, Jatinder S Minhas
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Abstract

Introduction: Patients with acute ischemic stroke (AIS) have elevated blood pressure (BP) variability (BPV) and reduced baroreflex sensitivity (BRS) at rest for several days after initial stroke symptoms. We aimed to assess BPV and BRS in AIS patients during pressor challenge maneuvers in the acute and subacute phases of stroke. Pressor challenge maneuvers simulate day-to-day activities and can predict the quality of life.

Methods: Continuous beat-to-beat BP and ECG in 15 AIS patients (mean age 69 ± 7.5 years) and 15 healthy controls (57 ± 16 years) were recorded at rest and during a 5-min rapid head positioning (RHP) paradigm. Patients were assessed within 24 h (acute phase) and 7 days (subacute phase) of stroke onset. Low frequency (LF) SBP power (measure of BPV), LF-α, and combined α-index (measure of BRS) were calculated from the recordings.

Results: In the acute phase, at rest, LF-SBP power was higher ( P  = 0.024) and α-index was lower ( P  = 0.006) in AIS patients than in healthy controls. There was no change in LF-SBP during RHP in the patients but in healthy controls, it increased significantly ( P  = 0.018). In the subacute phase, at rest, the alpha-index increased ( P  = 0.037) and LF-SBP decreased ( P  = 0.029) significantly in the AIS patients, however, there was still no rise in the LF-SBP power during RHP ( P  = 0.240).

Conclusion: AIS patients have a high resting BPV. High resting BPV may be responsible for blunted BPV responses during pressor challenge maneuvers such as RHP, suggesting ongoing autonomic dysfunction and compromised quality of life.

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急性缺血性脑卒中患者静息时和加压挑战时的血压变异性。
导言:急性缺血性脑卒中(AIS)患者在最初出现脑卒中症状后的数天内,静息状态下的血压(BPV)变异性(BPV)升高,气压反射敏感性(BRS)降低。我们的目的是评估 AIS 患者在中风急性期和亚急性期进行加压挑战操作时的血压变异性和血压反射敏感性。加压挑战操作模拟日常活动,可预测生活质量:方法:记录 15 名 AIS 患者(平均年龄 69 ± 7.5 岁)和 15 名健康对照者(57 ± 16 岁)在静息状态和 5 分钟快速头部定位(RHP)模式下的连续逐次血压和心电图。患者在中风发生后 24 小时内(急性期)和 7 天内(亚急性期)接受评估。根据记录计算低频(LF)SBP 功率(衡量 BPV 的指标)、LF-α 和综合 α 指数(衡量 BRS 的指标):结果:与健康对照组相比,急性期静息时,AIS 患者的 LF-SBP 功率更高(P = 0.024),α 指数更低(P = 0.006)。在 RHP 期间,患者的 LF-SBP 没有变化,但在健康对照组中,LF-SBP 显著增加(P = 0.018)。在亚急性阶段,AIS 患者静息时的α-指数明显增加(P = 0.037),低频-SBP 明显下降(P = 0.029),但在 RHP 时低频-SBP 功率仍无上升(P = 0.240):结论:AIS 患者的静息血压变压值很高。结论:AIS 患者的静息血压偏高,这可能是 RHP 等加压挑战操作时血压反应迟钝的原因,表明患者的自主神经功能持续失调,生活质量受到影响。
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来源期刊
Blood Pressure Monitoring
Blood Pressure Monitoring 医学-外周血管病
CiteScore
2.00
自引率
7.70%
发文量
110
审稿时长
>12 weeks
期刊介绍: Blood Pressure Monitoring is devoted to original research in blood pressure measurement and blood pressure variability. It includes device technology, analytical methodology of blood pressure over time and its variability, clinical trials - including, but not limited to, pharmacology - involving blood pressure monitoring, blood pressure reactivity, patient evaluation, and outcomes and effectiveness research. This innovative journal contains papers dealing with all aspects of manual, automated, and ambulatory monitoring. Basic and clinical science papers are considered although the emphasis is on clinical medicine. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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