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A retrospective review of the ambulatory blood pressure patterns and diurnal urine production in subgroups of spinal cord injured patients.
Goh, M Y; Wong, E C K; Millard, M S; Brown, D J; O'Callaghan, C J.
Afiliación
  • Goh MY; 1] Department of Clinical Pharmacology, Austin Hospital, Heidelberg, Victoria, Australia [2] University of Melbourne, Parkville, Victoria, Australia [3] The Spinal Research Institute, Heidelberg, Victoria, Australia.
  • Wong EC; Department of Clinical Pharmacology, Austin Hospital, Heidelberg, Victoria, Australia.
  • Millard MS; 1] Department of Clinical Pharmacology, Austin Hospital, Heidelberg, Victoria, Australia [2] The Spinal Research Institute, Heidelberg, Victoria, Australia [3] Victorian Spinal Cord Service, Heidelberg, Victoria, Australia.
  • Brown DJ; The Spinal Research Institute, Heidelberg, Victoria, Australia.
  • O'Callaghan CJ; Department of Clinical Pharmacology, Austin Hospital, Heidelberg, Victoria, Australia.
Spinal Cord ; 53(1): 49-53, 2015 Jan.
Article en En | MEDLINE | ID: mdl-25384400
STUDY DESIGN: Retrospective study. OBJECTIVES: To quantify diurnal blood pressure (BP) patterns and nocturnal hypertension and to measure diurnal urine production in spinal cord injury (SCI) patients with clinically significant disorders of BP control. SETTING: A specialist state-based spinal cord service in Victoria, Australia. METHODS: Medical records of patients with traumatic SCI who were referred to a specialist service for management of a BP disorder were examined. Ambulatory BP and nocturnal urine production were compared between groups of patients classified according to level, completeness and chronicity of SCI. Patients with night:day systolic BP <90% were classified as dippers, 90-100% as non-dippers and >100% as reversed dippers. RESULTS: Patients (44 tetraplegic, 10 paraplegic) were predominantly males (92.6%) aged 41±2.5 years (mean±s.e.m.). Referral was for orthostatic intolerance (n=37), autonomic dysreflexia (n=6), nocturnal polyuria (n=4), elevated BP (n=1) and peripheral oedema (n=1). The average BP was 111.1±1.4/65.0±1.2 mm Hg. In 56% of patients (n=30), BP at night was higher than during the day and another 37% (n=20) were non-dippers. Nocturnal hypertension was present in 31% (n=17) of the patients. In the tetraplegic patients, urine flow rate was greater during the night than day (121±9.5 ml h(-1) vs 89±8.2 ml h(-1), P=0.025). CONCLUSION: Ambulatory BP monitoring in patients with SCI and clinically significant BP disorders detected a high incidence of reversed dipping and nocturnal hypertension. We postulate elevated nocturnal BP may contribute to nocturnal diuresis that might cause relative volume depletion and thereby contribute to daytime orthostatic hypotension.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Traumatismos de la Médula Espinal / Trastornos Urinarios / Presión Sanguínea / Ritmo Circadiano Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Revista: Spinal Cord Asunto de la revista: NEUROLOGIA Año: 2015 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Traumatismos de la Médula Espinal / Trastornos Urinarios / Presión Sanguínea / Ritmo Circadiano Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Revista: Spinal Cord Asunto de la revista: NEUROLOGIA Año: 2015 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido