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Blood Pressure Instability in Persons With SCI: Evidence From a 30-Day Home Monitoring Observation
Caitlyn G Katzelnick1,2, Joseph P Weir3, April Jones1
1Spinal Cord Injury Research, James J Peters VA Medical Center, Bronx, New York, USA.
American Journal of Hypertension
|May 25, 2019
Summary
Blood pressure instability is common in spinal cord injury (SCI) patients, particularly those with tetraplegia. Home monitoring over 30 days revealed significant fluctuations, highlighting the need for clinical tracking of secondary SCI complications.
Area of Science:
- Neurology
- Cardiovascular Science
- Rehabilitation Medicine
Background:
- Cardiovascular autonomic regulation is often impaired in individuals with spinal cord injury (SCI).
- Blood pressure instability is a recognized secondary complication in the SCI population.
- The level of SCI may influence the degree of autonomic dysregulation and blood pressure variability.
Purpose of the Study:
- To assess blood pressure instability over a 30-day period in individuals with SCI.
- To compare blood pressure fluctuations based on the level of spinal cord injury.
- To identify factors contributing to blood pressure instability in SCI.
Main Methods:
- An observational study was conducted with 113 participants with SCI (tetraplegia, high thoracic, and low thoracic injuries).
- Participants used ambulatory blood pressure monitors to record readings three times daily for 30 days.
- Data were analyzed to determine the frequency and severity of blood pressure fluctuations.
Main Results:
- Participants with tetraplegia exhibited significantly more blood pressure fluctuations than those with paraplegia.
- Older age and longer duration of SCI were associated with increased blood pressure instability.
- Completeness of the spinal cord injury did not significantly impact blood pressure instability.
Conclusions:
- Significant blood pressure instability is present in individuals with SCI, extending beyond tetraplegia to include those with low thoracic injuries.
- Extended home blood pressure monitoring can effectively document extreme fluctuations.
- This monitoring approach is a valuable clinical tool for managing secondary complications in the SCI population.
Keywords:
autonomic dysreflexiablood pressurehypertensionhypotensionorthostatic hypotensionspinal cord injuryMore Related Videos
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