Pseudohypertension in the Elderly

1978 ◽  
Vol 55 (s4) ◽  
pp. 399s-402s ◽  
Author(s):  
J. D. Spence ◽  
W. J. Sibbald ◽  
R. D. Cape
Keyword(s):  
Blood Pressure ◽  
Diastolic Pressure ◽  
The Elderly ◽  
Indirect Measurement ◽  
Hypertensive Retinopathy ◽  
Hypertensive Patients ◽  
Arterial Blood ◽  
Blood Pressures ◽  
Indirect Blood Pressure ◽  
Mercury Sphygmomanometer

1. Direct intra-arterial blood pressure (radial artery) has been compared with indirect blood pressures using a regular sized adult cuff and a thigh cuff, with a mercury sphygmomanometer, in 24 hypertensive patients aged 62–84 years, and in 16 hypertensive patients aged 29–59 years. 2. The patients were studied because they were suspected of having a false elevation of their indirect blood pressure, since they had diastolic pressures over 100 mmHg, without hypertensive retinopathy, cardiac hypertrophy, or nephropathy. 3. Indirect diastolic pressure was falsely elevated by 30 mmHg or more in 12 out of 24 of the subjects over age 60, and in four of the 16 of those under age 60. Pseudohypertension (indirect diastolic > 100 mmHg, direct diastolic < 90 mmHg) was present in 12 subjects over age 60 and 5 under age 60. 4. Errors in indirect measurement of blood pressure are a serious problem, particularly in the elderly. Direct intra-arterial measurement may be useful in the management of hypertension.

Indirect blood pressure determination by Doppler technique in renal hypertensive cats

1979 ◽  
Vol 237 (6) ◽  
pp. H720-H723 ◽  
Author(s):  
L. R. Klevans ◽  
G. Hirkaler ◽  
J. L. Kovacs
Keyword(s):  
Blood Pressure ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Pressure Measurements ◽  
Blood Pressure Determination ◽  
Monitoring Period ◽  
Direct Pressure ◽  
Blood Pressures ◽  
Pressure Changes ◽  
Indirect Blood Pressure

The Doppler ultrasonic recording technique was used to measure systolic and diastolic blood pressures indirectly in renal hypertensive cats. The accuracy of the method was evaluated by comparing indirect blood pressures from one leg of a cat with direct pressure measurements from the other leg. A linear relationship existed between indirect and direct systolic and diastolic pressures. The consistency of the method was assessed by measuring blood pressure during a 5-h monitoring period in normotensive and renal hypertensive cats. No significant variation occurred over this period. The sensitivity of the method to blood pressure changes was determined also. A significant reduction in systolic and diastolic pressure induced by hydralazine, 10 mg/kg po, was recorded during a 5-h monitoring period. The development of renovascular hypertension was followed for approximately 70 days. Systolic pressure rose in a logarithmic fashion from 160 to a maximum of 240 mmHg. It was concluded that the Doppler ultrasonic technique is a simple and reliable method for recording indirect blood pressure acutely and chronically in conscious unrestrained cats.

Evaluating Indirect Blood Pressure Measurement Techniques: A Comparison of Three Systems in Infants and Children

PEDIATRICS ◽  
1978 ◽  
Vol 62 (3) ◽  
pp. 326-330
Author(s):  
Robert F. Reder ◽  
Ivan Dimich ◽  
Myron L. Cohen ◽  
Leonard Steinfeld
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Measurement ◽  
Measurement Techniques ◽  
Infants And Children ◽  
Arterial Blood ◽  
Measuring Devices ◽  
Blood Pressures ◽  
Indirect Blood Pressure ◽  
In Infants And Children ◽  
Better Than

The systemic arterial blood pressures obtained in infants and children utilizing three indirect measuring devices—Arteriosonde 1010, Infrasonde 3000, Pedisphyg system—were compared to each other and to intra-arterial pressure measured directly. The results indicate that Arteriosonde performs considerably better than Infrasonde; nevertheless, the Arteriosonde values are often only approximations of true systole and diastole. The Pedisphyg system yields accurate, reproducible values for systole; however, the system is not designed to determine diastolic blood pressure.

Relation between Prognosis and the Blood Pressure before and during Treatment of Hypertensive Patients

1978 ◽  
Vol 55 (s4) ◽  
pp. 333s-336s
Author(s):  
D. G. Beevers ◽  
J. Johnston ◽  
B. L. Devine ◽  
F. G. Dunn ◽  
H. Larkin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Predictive Power ◽  
Diastolic Pressure ◽  
Relative Importance ◽  
Men And Women ◽  
Hypertensive Patients ◽  
Blood Pressures ◽  
Better Than

1. A study was conducted amongst 1247 treated hypertensive patients to determine the predictive power of untreated baseline and achieved treated blood pressures in the development of the complications of hypertension. In addition the relative importance of systolic and diastolic pressures was calculated. 2. Statistical analysis was done by calculating univariate differences in blood pressure between cases with and without complications. The higher the univariate distance, the greater the predictive power. 3. Blood pressures achieved during treatment were more important than baseline pressures for predicting stroke in both men and women, confirming the benefits of antihypertensive therapy in preventing strokes. 4. There was some evidence of prevention of myocardial infarction in men and of angina in women as a result of therapy. 5. There was no evidence to suggest that any one group of drugs, including β-adrenoreceptor-blocking drugs and thiazides, conferred any extra benefit in preventing coronary heart disease. 6. The systolic blood pressures achieved during treatment predicted stroke better than diastolic pressure, but no consistent trends were found for coronary heart disease.

Antenatal corticosteroid therapy and blood pressure at 14 years of age in preterm children

2000 ◽  
Vol 98 (2) ◽  
pp. 137-142 ◽  
Author(s):  
L. W. DOYLE ◽  
G. W. FORD ◽  
N. M. DAVIS ◽  
C. CALLANAN
Keyword(s):  
Blood Pressure ◽  
Corticosteroid Therapy ◽  
Animal Species ◽  
Antenatal Corticosteroid ◽  
Antenatal Corticosteroids ◽  
Preterm Children ◽  
Clinical Hypertension ◽  
Blood Pressures ◽  
The Relationship ◽  
Mercury Sphygmomanometer

Antenatal corticosteroid therapy substantially improves the survival rate of preterm infants, with few side effects. Higher blood pressure in adulthood has been described in several animal species after exposure to antenatal corticosteroids, but there are no similar reports in humans. The objective of the present study was to determine the relationship between exposure to antenatal corticosteroid therapy and blood pressure at 14 years of age. This was a cohort study of 210 preterm survivors with birthweights of < 1501 g born in the Royal Women's Hospital, Melbourne, between 1 January 1977 and 31 March 1982. Blood pressure was measured in 177 subjects (84.3%) at 14 years of age with a standard mercury sphygmomanometer. Children exposed to antenatal corticosteroids (n = 89) had higher systolic and diastolic blood pressures than those not exposed to corticosteroids (n = 88) [mean difference (95% confidence interval) (mmHg): systolic, 4.1 (0.1–8.0); diastolic, 2.8 (0.05–5.6)]. However, few had blood pressure in the hypertensive range. It is concluded that antenatal corticosteroid therapy is associated with higher systolic and diastolic blood pressures in adolescence, and might lead to clinical hypertension in survivors well beyond birth.

Effect of alcohol withdrawal on blood pressure, plasma renin activity, aldosterone, cortisol and dopamine β-hydroxylase

1984 ◽  
Vol 66 (6) ◽  
pp. 659-663 ◽  
Author(s):  
L. T. Bannan ◽  
J. F. Potter ◽  
D. G. Beevers ◽  
J. B. Saunders ◽  
J. R. F. Walters ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Plasma Renin Activity ◽  
Alcohol Withdrawal ◽  
Diastolic Pressure ◽  
Urine Volume ◽  
Plasma Renin ◽  
Renin Activity ◽  
Withdrawal Symptoms ◽  
Urinary Volume ◽  
Blood Pressures

1. Sixty-five alcoholic patients admitted for detoxification had blood pressure, withdrawal symptoms, plasma cortisol (PC) and plasma aldosteron (PA) levels, plasma renin activity (PRA), and serum dopamin β-hydroxylase (DBH) levels measured on the first and fourth days after admission. 2. On the morning after admission blood pressure was elevated (>140/90) in 32 patients (49%) and was 160/95mmHg or more in 21 (32%). PRA was initially elevated in 41 patients, PA levels in 14, and 13 patients had raised PC levels. By the fourth day, blood pressure and bio-chemical measures had fallen significantly while urine volume and sodium output, low on admission, had increased significantly. On admission urinary metanephrine levels were raised in four out of the 31 patients who had them measured. 3. The height of both the systolic and diastolic blood pressures was significantly related to the severity of the alcohol. withdrawal symptoms. Of the biochemical parameters measured, PC level correlated with systolic but not diastolic pressure, and urinary volume was inversely correlated with the height of the diastolic pressure. No relationship was found between blood pressure and PRA or PA level. 4. The pressor effect of alcohol withdrawal could be due to sympathetic nervous system overactivity, or possibly to hypercortisolaemia. The first hypothesis seems more likely.

Abstract WMP57: Declining Blood Pressure is Associated with Subcortical Microinfarcts in Older Adults

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mekala R Raman ◽  
Jonathan Graff-Radford ◽  
Scott A Przybelski ◽  
Timothy G Lesnick ◽  
Michelle M Mielke ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Elderly Population ◽  
Adult Population ◽  
Blood Pressure Measurement ◽  
The Elderly ◽  
Pressure Measurements ◽  
Autopsy Study ◽  
Cross Sectional ◽  
Blood Pressures

Hypertension is highly prevalent in the elderly population and microinfarcts are the most common vascular brain pathology identified in older adults at autopsy. We investigated the associations between systolic and diastolic blood pressures measured antemortem and the presence of microinfarcts at autopsy. Study subjects (n=302; age range=71-95) were participants in the population-based Mayo Clinic Study of Aging autopsy study, who had blood pressure measurements recorded during life. We investigated both cross-sectional systolic and diastolic blood pressure measurements at the baseline visit and the change in blood pressure (slope). Presence and location (subcortical or cortical) of chronic microinfarcts was abstracted from the autopsy reports. Of the 302 study subjects, 47 (16%) had cerebral microinfarcts, and, of those, 18 (38%) had subcortical microinfarcts and 29 (62%) had only cortical microinfarcts. The baseline blood pressures were not different between subjects with no microinfarcts, subcortical microinfarcts, and only cortical microinfarcts. In a logistic regression model including time between last blood pressure measurement and death, a greater decline in systolic [OR= 1.06 (1.01, 1.11); p=0.02]) and greater decline in diastolic [OR= 1.11 (1.02, 1.20); p=0.01] blood pressures were predictors of the presence of subcortical microinfarcts at autopsy. However, these variables were not associated with the presence of cortical microinfarcts. In conclusion, microinfarcts are common in the older adult population, and most of them are located in the cortex. A greater decline in both systolic and diastolic blood pressures and their association with subcortical microinfarcts, but not with cortical microinfarcts, may have implications for aggressive lowering of blood pressure in the elderly population.

Validity of Neonatal Blood Pressure Obtained By The Manometric Method

PEDIATRICS ◽  
1973 ◽  
Vol 52 (2) ◽  
pp. 293-296
Author(s):  
Rosemary D. Leake ◽  
Paul R. Williams ◽  
William Oh
Keyword(s):  
Blood Pressure ◽  
Neonatal Intensive Care ◽  
Umbilical Artery ◽  
Neonatal Intensive Care Units ◽  
Arterial Blood ◽  
Direct Recording ◽  
Blood Pressures ◽  
Manometric Method ◽  
Neonatal Blood ◽  
Precise Relationship

In neonatal intensive care units where direct arterial blood pressures obtained via a transducer are unavailable, a fluid-filled spinal manometer has been used. The latter method is practical and convenient although its validity has not been confirmed. This study is designed to establish the precise relationship between the blood pressure obtained by the manometric method and by direct recording via the arterial transducer. Materials and Methods Eleven infants with umbilical artery catheters in place 1 to 2 cm above the diaphragm were selected for the study. In all instances, the arterial catheters were placed for clinical management of various illnesses.

scholarly journals Old hypertensive patient: a hard challenge

2013 ◽  
pp. 109-112
Author(s):  
Giuseppe Rossetti ◽  
Diana Solari ◽  
Maria Laura Rainoldi ◽  
Stefano Carugo
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Elderly People ◽  
Diastolic Pressure ◽  
Beta Blockers ◽  
The Elderly ◽  
Pressure Control ◽  
World Population ◽  
Continuous Increase ◽  
Hypertensive Therapy

BACKGROUND High blood pressure is one of the most important cardiovascular risk factor and its incidence is continuously increasing: on 2025 1/3 of adult world population will suffer of it. Moreover, the therapy of elderly hypertension sufferer patient is still growing up in importance for the continuous increase of world population average life. With ageing, the cardiovascular system suffers neurohormonal and haemodinamic modifications which determine the onset of isolate systolic hypertension, which is characteristic of the elderly. This pathology results linked to a higher cardiovascular risk. AIM OF THE STUDY This review aims to analyze and evaluate present and future therapeutic opportunities about anti-hypertensive therapy in elderly people. DISCUSSION AND CONCLUSIONS Also in elderly people systolic blood pressure values must be lower than 150 mmHg, but it’s also important to maintain diastolic pressure not under 70 mmHg, to avoid phenomenons of cerebral and coronary hypo-perfusion (J curve). The benefits of an effective anti-hypertensive therapy are achieved thanks to both blood pressure lowering “per se” and to the decrease of cardiovascular mortality and morbility. Blood pressure control in the elderly is a hard challenge for the low compliance to the therapy, for the importance of the comorbidity and for the supplementary risk factors. ESH-ESC 2007 guidelines recommend for elderly highblood pressure sufferer patient the use first of all of calcium-antagonists and thiazides diuretics, and for second line ACE-inhibitors, ARB and beta-blockers. In several patients combinations of two or more drugs are necessary to obtain pressure control.

Validity of phonoarteriographic blood pressures during rest and exercise

1964 ◽  
Vol 19 (6) ◽  
pp. 1219-1233 ◽  
Author(s):  
Joseph A. Mastropaolo ◽  
Jeremiah Stamler ◽  
David M. Berkson ◽  
Hans U. Wessel ◽  
Walter E. Jackson
Keyword(s):  
Blood Pressure ◽  
Fitness Testing ◽  
Physical Effort ◽  
Indirect Measurements ◽  
Arterial Blood ◽  
Hearing Acuity ◽  
Pulse Sound ◽  
Blood Pressures ◽  
Pressure Record ◽  
Rest And Exercise

A modification of the auscultatory blood pressure method, the phonoarteriogram, was developed. The innovated method essentially is a modified amplifying stethoscope. The pressure in the cuff is recorded from a pressure transducer, and the systolic and diastolic criteria are recorded from a microphone. The phonoarteriogram gives the advantages of a permanent record, includes pulse rate and pulse sound data, is not affected by hearing acuity, permits determinations often denied using auscultation in high ambient noise and exercise conditions, and eliminates observer bias. Three hundred and forty resting determinations and 218 exercise determinations on 60 subjects indicated good agreement between the phonoarteriogram and auscultation. In 50 systolic and diastolic intra-arterial determinations before compression of the cuff, during rest and exercise from one subject, the phonoarteriogram was as valid as auscultation. In 56 intra-arterial determinations during deflation of the cuff, i.e., simultaneous with the indirect measurements, during rest and exercise from a second subject, the phonoarteriogram was less fallible than auscultation, particularly during exercise. Phonoarteriograms are valid, reliable, and objective blood pressure record blood pressure determination; auscultatory blood pressure; intra-arterial blood pressure; physical fitness testing; ausculation; effort or physical effort; exercise; exertion; fatigue; methods, physiological; instrumentation; pulse; work Submitted on January 16, 1964

scholarly journals Possible mechanism of the cardio-renal protective effects of AVE-0991, a non-peptide Mas-receptor agonist, in diabetic rats

2012 ◽  
Vol 13 (3) ◽  
pp. 334-340 ◽  
Author(s):  
Kulwinder Singh ◽  
Kuldeepak Sharma ◽  
Manjeet Singh ◽  
PL Sharma
Keyword(s):  
Blood Pressure ◽  
Receptor Agonist ◽  
Diastolic Pressure ◽  
Left Ventricular Pressure ◽  
Diabetic Rats ◽  
Left Ventricular ◽  
Ventricular Pressure ◽  
Protective Effects ◽  
Mas Receptor ◽  
Arterial Blood

Hypothesis: This study was designed to investigate the cardio-renal protective effect of AVE-0991, a non-peptide Mas-receptor agonist, and A-779, a Mas-receptor antagonist, in diabetic rats. Materials and methods: Wistar rats treated with streptozotocin (50 mg/kg, i.p., once), developed diabetes mellitus after 1 week. After 8 weeks, myocardial functions were assessed by measuring left ventricular developed pressure (LVDP), rate of left ventricular pressure development (d p/d tmax), rate of left ventricular pressure decay (d p/d tmin) and left ventricular end diastolic pressure (LVEDP) on an isolated Langendorff’s heart preparation. Further, mean arterial blood pressure (MABP) was measured by using the tail-cuff method. Assessment of renal functions and lipid profile was carried out using a spectrophotometer. Results: The administration of streptozotocin to rats produced persistent hyperglycaemia, dyslipidaemia and hypertension which consequently produced cardiac and renal dysfunction in 8 weeks. AVE0991 treatment produced cardio-renal protective effects, as evidenced by a significant increase in LVDP, d p/d tmax, d p/d tmin and a significant decrease in LVEDP, BUN, and protein urea. Further, AVE-0991 treatment for the first time has been shown to reduce dyslipidaemia and produced antihyperglycaemic activity in streptozotocin-treated rats. However, MABP and creatinine clearance remained unaffected with AVE-0991 treatment. Conclusions: AVE-0991 produced cardio-renal protection possibly by improving glucose and lipid metabolism in diabetic rats, independent of its blood pressure lowering action.

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