Risk from low blood pressure in frail older adults: diastolic pressure and pulse pressure are important

2020 ◽  
Author(s):  
J David Spence
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Blood Flow ◽  
Pulse Pressure ◽  
Coronary Flow ◽  
Older Patients ◽  
Diastolic Pressure ◽  
Blood Pressure Measurement ◽  
J Curve ◽  
Low Blood Pressure

Abstract Blood pressure measurement with a cuff in patients with stiff arteries can be misleading, with false elevation of the diastolic pressure. Coronary flow, and most of the cerebral blood flow occur during diastole. There is a marked diastolic J curve in patients with diastolic pressure <60 mmHg and pulse pressure >60 mmHg. Aiming for a systolic target of 120 mmHg is not safe in some frail older patients.

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.

scholarly journals Calibration methods of new device for human blood pressure measurement

2019 ◽  
Vol 201 ◽  
pp. 06003
Author(s):  
Łukasz Stala ◽  
Krzysztof Tomczuk
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Diastolic Pressure ◽  
Blood Pressure Measurement ◽  
New Device ◽  
Reference Device ◽  
Calibration Methods ◽  
Pressure Maximum ◽  
Parallel Measurement ◽  
Pneumatic Sensor

The paper presents two methods of determining calibration curve of a new device for blood pressure measurement. The device was developed at Wrocław University of Science and Technology. First method is based on parallel measurement of systolic and diastolic pressure measurement with use of reference device such as sphygmomanometer and researched new device with pneumatic sensor equipped with voltage type output. Obtained data (systolic ps and diastolic pd pressure, maximum us and minimum ud voltage) was then used to determine individual pressure-voltage characteristic of the device, which can be represented as a linear equation. Second method is based on substitution of experimentally proved coefficient b with its analytical equivalent extracted from mathematical model of described pneumatic sensor. Described methods were verified experimentally and compared. Metrological parameters of the device were designated.

Effects of Crossing Legs on Blood Pressure Measurement

2001 ◽  
Vol 10 (2) ◽  
pp. 202-213 ◽  
Author(s):  
Rebecca Keele-Smith ◽  
CeCilia Price-Daniel
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Diastolic Pressure ◽  
Blood Pressure Measurement ◽  
Systolic Pressure ◽  
Nursing Intervention ◽  
Health Condition ◽  
Senior Population

The purpose of this study was to determine if blood pressure measurement is affected by the leg crossed at the knee as compared with feet flat on the floor in a well-senior population. Participants (N = 110) either had their blood pressure measured with feet flat first and then crossed or the reverse of this. Results indicate that blood pressure was significantly higher when legs were crossed versus uncrossed. Systolic pressure changed by 5.9 mmHg, from 127.32 to 133.24, whereas diastolic pressure changed by 2.97, from 72.54 to 75.52. There were no significant differences between those who had their blood pressure measured first with their legs crossed versus uncrossed or between those with and without hypertension. Instructing patients to keep feet flat on the floor during blood pressure measurement is an important nursing intervention that can contribute to the accurate measurement, interpretation, and treatment of a patient's health condition.

Blood pressure measurement assistance and antihypertensive drug compliance in older patients

2016 ◽  
Vol 3 ◽  
pp. 199-209
Author(s):  
Elena N. Nalotova ◽  
Michail M. Alesinskiy ◽  
Alexander E. Berezin ◽  
Sergey V. Nalotov
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Drug ◽  
Pressure Measurement ◽  
Older Patients ◽  
Blood Pressure Measurement ◽  
Drug Compliance

scholarly journals Regional Neurovascular Coupling and Cognitive Performance in Those with Low Blood Pressure Secondary to High-Level Spinal Cord Injury: Improved by Alpha-1 Agonist Midodrine Hydrochloride

2014 ◽  
Vol 34 (5) ◽  
pp. 794-801 ◽  
Author(s):  
Aaron A Phillips ◽  
Darren ER Warburton ◽  
Philip N Ainslie ◽  
Andrei V Krassioukov
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Blood Flow ◽  
Cognitive Function ◽  
Neurovascular Coupling ◽  
Control Group ◽  
Cord Injury ◽  
Low Blood Pressure ◽  
High Level

Individuals with high-level spinal cord injury (SCI) experience low blood pressure (BP) and cognitive impairments. Such dysfunction may be mediated in part by impaired neurovascular coupling (NVC) (i.e., cerebral blood flow responses to neurologic demand). Ten individuals with SCI > T6 spinal segment, and 10 age- and sex-matched controls were assessed for beat-by-beat BP, as well as middle and posterior cerebral artery blood flow velocity (MCAv, PCAv) in response to a NVC test. Tests were repeated in SCI after 10 mg midodrine (alpha1-agonist). Verbal fluency was measured before and after midodrine in SCI, and in the control group as an index of cognitive function. At rest, mean BP was lower in SCI (70 ± 10 versus 92 ± 14 mm Hg; P<0.05); however, PCAv conductance was higher (0.56 ± 0.13 versus 0.39 ± 0.15 cm/second/mm Hg; P<0.05). Controls exhibited a 20% increase in PCAv during cognition; however, the response in SCI was completely absent ( P<0.01). When BP was increased with midodrine, NVC was improved 70% in SCI, which was reflected by a 13% improved cognitive function ( P<0.05). Improvements in BP were related to improved cognitive function in those with SCI ( r2 = 0.52; P<0.05). Impaired NVC, secondary to low BP, may partially mediate reduced cognitive function in individuals with high-level SCI.

Indirect Arterial Blood Pressure Measurement in Nonsedated Irish Wolfhounds: Reference Values for the Breed

2002 ◽  
Vol 38 (6) ◽  
pp. 521-526 ◽  
Author(s):  
Janice M. Bright ◽  
Mariellen Dentino
Keyword(s):  
Blood Pressure ◽  
Arterial Blood Pressure ◽  
Reference Values ◽  
Diastolic Pressure ◽  
Blood Pressure Measurement ◽  
Systolic Pressure ◽  
Standing Position ◽  
Mean Value ◽  
Pressure Measurements ◽  
Arterial Blood

Arterial blood pressure measurements were obtained from 158 healthy Irish wolfhounds using the oscillometric technique to establish reference values for the breed. In contrast to other sight hounds, Irish wolfhounds have low arterial blood pressure. Mean systolic pressure for the group was 116.0 mm Hg. Mean diastolic pressure was 69.2 mm Hg, and the mean value for mean arterial pressure was 87.8 mm Hg. Blood pressure measurements were higher in older wolfhounds than in young dogs. There was no difference between systolic and mean arterial blood pressures in lateral recumbency compared to standing position. However, diastolic pressure was slightly lower when standing. Calm dogs had lower pressure than anxious wolfhounds. There was a significant interaction between the effects of age, gender, and mood on systolic, diastolic, and mean arterial blood pressure values.

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