Jeremy R Williams, Molly A Cole, Ryan J Pewowaruk, Amy J Hein, Claudia E Korcarz, Farhan Raza, Naomi C Chesler, Jens C Eickhoff, Adam D Gepner
{"title":"Using an in-office passive leg raise to identify older adults with suboptimal blood pressure control.","authors":"Jeremy R Williams, Molly A Cole, Ryan J Pewowaruk, Amy J Hein, Claudia E Korcarz, Farhan Raza, Naomi C Chesler, Jens C Eickhoff, Adam D Gepner","doi":"10.1097/HJH.0000000000003858","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Passive leg raise (PLR) is a simple, dynamic maneuver that has been used to increase preload to the heart. We hypothesize that PLR may offer a new and efficient office-based tool for assessing blood pressure (BP) control in older adults.</p><p><strong>Methods: </strong>One hundred and three veterans (≥60 years old) without known cardiovascular disease and varying degrees of blood pressure control were included in this cross-sectional cohort study. Twenty-four hour ambulatory BP monitoring identified Veterans with optimal and suboptimal BP control (≥125/75 mmHg). Bioimpedance electrodes (Baxter Medical, Deerfield, Illinois, USA) and brachial BP were used to calculate hemodynamic parameter changes across PLR states [pre-PLR, active PLR (3 min), and post-PLR]. Multiple linear regression was used to assess associations between BP control status with changes in hemodynamic parameters between PLR states.</p><p><strong>Results: </strong>The 24-h ambulatory BP monitoring identified 43 (42%) older Veterans with optimal BP control (mean age of 70.5 ± 7.0 years) and 55 (54%) with suboptimal BP (mean age of 71.3 ± 8.7 years). Veterans with suboptimal BP control had significantly reduced change in total peripheral resistance (ΔTPR) (7.0 ± 156.0 vs. 127.3 ± 145.6 dynes s/cm 5 ; P = 0.002) following PLR compared with Veterans with optimal BP control. Suboptimal BP control ( β = -0.35, P = 0.004) had a significant association with reduced ΔTPR, even after adjusting for demographic variables.</p><p><strong>Conclusion: </strong>Measuring PLR-induced hemodynamic changes in the office setting may represent an alternative way to identify older adults with suboptimal BP control when 24-h ambulatory BP monitoring is not available.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.3000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hypertension","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/HJH.0000000000003858","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/2 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Passive leg raise (PLR) is a simple, dynamic maneuver that has been used to increase preload to the heart. We hypothesize that PLR may offer a new and efficient office-based tool for assessing blood pressure (BP) control in older adults.
Methods: One hundred and three veterans (≥60 years old) without known cardiovascular disease and varying degrees of blood pressure control were included in this cross-sectional cohort study. Twenty-four hour ambulatory BP monitoring identified Veterans with optimal and suboptimal BP control (≥125/75 mmHg). Bioimpedance electrodes (Baxter Medical, Deerfield, Illinois, USA) and brachial BP were used to calculate hemodynamic parameter changes across PLR states [pre-PLR, active PLR (3 min), and post-PLR]. Multiple linear regression was used to assess associations between BP control status with changes in hemodynamic parameters between PLR states.
Results: The 24-h ambulatory BP monitoring identified 43 (42%) older Veterans with optimal BP control (mean age of 70.5 ± 7.0 years) and 55 (54%) with suboptimal BP (mean age of 71.3 ± 8.7 years). Veterans with suboptimal BP control had significantly reduced change in total peripheral resistance (ΔTPR) (7.0 ± 156.0 vs. 127.3 ± 145.6 dynes s/cm 5 ; P = 0.002) following PLR compared with Veterans with optimal BP control. Suboptimal BP control ( β = -0.35, P = 0.004) had a significant association with reduced ΔTPR, even after adjusting for demographic variables.
Conclusion: Measuring PLR-induced hemodynamic changes in the office setting may represent an alternative way to identify older adults with suboptimal BP control when 24-h ambulatory BP monitoring is not available.
期刊介绍:
The Journal of Hypertension publishes papers reporting original clinical and experimental research which are of a high standard and which contribute to the advancement of knowledge in the field of hypertension. The Journal publishes full papers, reviews or editorials (normally by invitation), and correspondence.