Diurnal variations of blood pressure in dogs.
Using the telemetry system, we measured the blood pressure (BP) invasively in seven adult mongrels while unanesthetized and unbound. Post-operative BP after implanting the telemetry BP transmitter showed temporarily high values due to the invasive nature of the surgery. It was, however, observed that BP gradually decreased thereafter, and showed settled trends from the eighth day post-operatively. When we took the average of the systolic, mean and diastolic BP at hourly intervals for each of the dogs once their BP had settled, a twin peak diurnal variation (at 8:00 and 19:00) was observed. Moreover, significantly high values (p < 0.05) were identified in active state compared with when sleeping or at rest. The 24 hr BP measured by the telemetry system in seven normal dogs resulted in the following values: systolic 123.4 +/- 7.9 mmHg, mean 91.1 +/- 5.6 mmHg, and diastolic 74.5 +/- 4.9 mmHg. (+info)
Effects of potassium on blood pressure in salt-sensitive and salt-resistant black adolescents.
This study examined the effects of increasing dietary potassium on ambulatory blood pressure nondipping status (<10% decrease in blood pressure from awake to asleep) and cardiovascular reactivity in salt-sensitive and salt-resistant black adolescents. A sample of 58 normotensive (blood pressure, 101/57+/-9/4 mm Hg) black adolescents (aged 13 to 16 years) participated in a 5-day low sodium diet (50 mmol/24 h) followed by a 10-day high sodium diet (150 mmol/24 h NaCl supplement) to determine salt-sensitivity status. Participants showed a significant increase in urinary sodium excretion (24+/-19 to 224+/-65 mmol/24 h) and were identified as salt-sensitive if their mean blood pressure increase was >/=5 mm Hg from the low to high sodium diet. Sixteen salt-sensitive and 42 salt-resistant subjects were then randomly assigned to either a 3-week high potassium diet (80 mmol/24 h) or usual diet control group. Urinary potassium excretion significantly increased in the treatment group (35+/-7 to 57+/-21 mmol/24 h). At baseline, a significantly greater percentage of salt-sensitive (44%) compared with salt-resistant (7%) subjects were nondippers on the basis of diastolic blood pressure classifications (P<0.04). After the dietary intervention, all of the salt-sensitive subjects in the high potassium group achieved dipper status as a result of a drop in nocturnal diastolic blood pressure (daytime, 69 versus 67 mm Hg; nighttime, 69 versus 57 mm Hg). No significant group differences in cardiovascular reactivity were observed. These results suggest that a positive relationship between dietary potassium intake and blood pressure modulation can still exist even when daytime blood pressure is unchanged by a high potassium diet. (+info)
Detection and control of high blood pressure in the community : Do we need a wake-up call?
At the community level, the effect of national programs in increasing hypertension awareness, prevention, treatment, and control is unclear. This study evaluated the degree of detection and control of high blood pressure in a random population-based sample of Olmsted County, Minnesota, residents >/=45 years old, of whom 636 subjects among 1245 eligible residents agreed to participate. Home interview and home and office measurements of blood pressure were used to estimate awareness, treatment, and control rates for hypertension in the community. Mean blood pressures (+/-SD) were 138/80+/-20/12 mm Hg for men and 137/76+/-23/11 mm Hg for women. The overall prevalence of hypertension was 53%. The percentage of subjects with treated and controlled hypertension was 16.6%. Thirty-nine percent of subjects were unaware of their hypertension. Despite clinical trial evidence of reduced morbidity and mortality with antihypertensive therapy, recently reported national data suggest a leveling-off trend for treatment and control of hypertension. This population-based study supports these observations and suggests that at a community level, hypertension awareness and blood pressure control rates are suboptimal, presumably because of decreased attention to the detection and control of hypertension. (+info)
Similarities and differences between augmentation index and pulse wave velocity in the assessment of arterial stiffness.
We investigated whether there was a correlation between the simultaneous assessments of augmentation index (AI) and pulse wave velocity (PWV), undertaken by the SphygmoCor system, and what were the principal factors responsible for differences in these two putative assessments of arterial stiffness, in 105 offspring (41 men, 64 women) aged 19-71 years, of patients with familial hypertension. Arterial stiffness was measured using the SphygmoCor pulse wave analysis system. AI and PWV correlated significantly and positively (r = 0.29, p < 0.005) and the strength of the correlation was greater when each gender was examined separately. This led us to observe several-fold higher AI in women (22.04 +/- 12) than in men (8.59 +/- 13) (p < 0.001); the difference could be explained only in part by an inverse regression correlation between AI and height (r = -0.45; p < 0.001), but not PWV. AI was also more influenced than PWV by heart rate and blood pressure. AI is strongly correlated with a previously validated estimate of arterial stiffness, PWV. It is probable that separate normal ranges should be established for men and women, while further studies determine what parameters other than height are responsible for the gender difference. (+info)
Long-term telemetric recording of arterial pressure and heart rate in mice fed basal and high NaCl diets.
Research examining the control of arterial pressure in mice has primarily relied on tail-cuff plethysmography and, more recently, on tethered arterial catheters. In contrast, the radiotelemetry method has largely become the "gold standard" for long-term monitoring of arterial pressure and heart rate in rats. Whereas smaller telemetry probes have recently been developed, no published studies have used radiotelemetric monitoring of arterial pressure in mice, largely because of a relatively low success rate in small mice (ie, <30 g body weight). We report on the development of a protocol for the use of these probes to continuously monitor arterial pressure and heart rate in mice as small as 19 g body weight. To test the accuracy and reliability of this method, adult C57/BL6 mice were monitored for 3 weeks during exposure to a basal followed by a high NaCl diet. The results demonstrate that carotid and aortic placements of the telemetry probe provide equally accurate monitoring of arterial pressure and heart rate, but the carotid placement has a much greater rate of success. Exposure to a high NaCl diet increases both the amplitude of the arterial pressure rhythm (+ 6.0+/-0.6 mm Hg, approximately 32%) and the average mean arterial pressure (+ 8.6+/-1.1 mm Hg, approximately 8%), as would be predicted from previous studies in NaCl-resistant rats. Thus, the data demonstrate that telemetric recording of long-term arterial pressure and heart rate provides a powerful tool with which to define the mechanisms of cardiovascular control in mice. (+info)
Optimum intermittent pneumatic compression stimulus for lower-limb venous emptying.
OBJECTIVE: intermittent pneumatic compression (IPC) of the foot (IPC(foot)), calf (IPC(calf)) or both (IPC(foot+calf)) augments calf inflow, and improves the walking ability and peripheral haemodynamics of claudicants (IPC(foot), IPC(foot+calf)), largely due to venous outflow enhancement. This cohort study, using direct pressure measurements in healthy limbs, determines the optimal combination of frequency (2-4 impulses/minute), applied pressure (60-140 mmHg), mode (IPC(foot)-IPC(calf)-IPC(foot+calf)) and delay time of calf-to-foot impulse (0 s-0.5 s-1 s) that enables IPC to generate an almost complete and sustained decrease in venous pressure. RESULTS: (a) IPC(foot)at 120 and 80 mmHg generated lower venous pressure than that with 100 and 60 mmHg (p=0.036) respectively, for 2-4 impulses/minute; venous pressure differences between applied pressures of 140 and 120 mmHg or between 80 and 100 mmHg were insignificant. (b) Venous pressure with IPC(calf)at 80 mmHg was lower than that with 60 mmHg (p=0.036) (2-4 cycles/minute); differences in venous pressure between applied pressures of 140 and 100 mmHg or between 120 and 80 mmHg were insignificant. (c) At applied pressures 60-140 mmHg, IPC(foot+calf)with one-second delay generated lower venous pressure than that with half-second delay (p=0.036), the latter being more efficient than zero delay; increasing applied pressures produced lower venous pressure, but differences were small. Venous pressure decreased with increasing IPC frequency (from 2 to 3-4/minute), at applied pressures 60-140 mmHg. CONCLUSIONS: IPC(foot+calf)at applied 120-140 mmHg, a frequency of 3-4 impulses/minute and one-second delay, provided the optimum intermittent pneumatic stimulus. (+info)
Arterial stiffness as underlying mechanism of disagreement between an oscillometric blood pressure monitor and a sphygmomanometer.
Oscillometric blood pressure devices tend to overestimate systolic blood pressure and underestimate diastolic blood pressure compared with sphygmomanometers. Recent studies indicate that discrepancies in performance between these devices may differ between healthy and diabetic subjects. Arterial stiffness in diabetics could be the underlying factor explaining these differences. We studied differences between a Dinamap oscillometric blood pressure monitor and a random-zero sphygmomanometer in relation to arterial stiffness in 1808 healthy elderly subjects. The study was conducted within the Rotterdam Study, a population-based cohort study of subjects aged 55 years and older. Systolic and diastolic blood pressure differences between a Dinamap and a random-zero sphygmomanometer were related to arterial stiffness, as measured by carotid-femoral pulse wave velocity. Increased arterial stiffness was associated with higher systolic and diastolic blood pressure readings by the Dinamap compared with the random-zero sphygmomanometer, independent of age, gender, and average mean blood pressure level of both devices. The beta-coefficient (95% CI) was 0.25 (0.00 to 0.50) mm Hg/(m/s) for the systolic blood pressure difference and 0.35 (0.20 to 0.50) mm Hg/(m/s) for the diastolic blood pressure difference. The results indicate that a Dinamap oscillometric blood pressure device, in comparison to a random-zero sphygmomanometer, overestimates systolic and diastolic blood pressure readings in subjects with stiff arteries. (+info)
Validation of the Welch Allyn 'Vital Signs' oscillometric blood pressure monitor.
This study has determined the accuracy of the Welch Allyn 'Vital Signs' blood pressure (BP) monitoring device in an adult population, according to the criteria of the British Hypertension Society (British Hypertension Society, 1993). Validation was also classified by the American 'Association for the Advancement of Medical Instrumentation' (AAMI). The Welch Allyn 'Vital Signs' monitor achieved a BHS grade A for both systolic and diastolic BP. It also met the criteria for the AAMI protocol. The mean differences between trained observers using a mercury sphygmomanometer and the device were -1 +/- 5 mm Hg for systolic BP and -3 +/- 4 mm Hg for diastolic BP. The Welch Allyn 'Vital Signs' monitor can be recommended for clinical use in the adult population. This is one of the first oscillometric monitors designed for routine use in a hospital environment that has been found to provide an accurate assessment of BP by accepted validation procedures. (+info)