Heart Rate and Blood Pressure Changes during Gastroscopy in Healthy Older Subjects

Abstract

Background: Previous studies uncontrolled for co-morbidity have shown increased heart rate and decreased oxygenation during gastroscopy in older people. One previous study of selected younger patients suggested that changes in blood pressure were more pronounced in non-premedicated patients. Aims: To prospectively examine blood pressure and heart rate responses during gastroscopy in healthy older people uninfluenced by medication or co-morbidity. Methods: Blood pressure and heart rate were monitored continuously in consecutive unselected patients attending for gastroscopy carried out by one endoscopist. Results: Thirty-seven patients were included with a mean age of 51.5 years (95% CI: 17–89); 10 patients were over the age of 65. During gastroscopy there were large increases in blood pressure and heart rate, with maximum changes occurring predominantly at intubation in the younger age group. Typically, increases in blood pressure in the older group occurred later in the procedure and were more sustained. Mean (95%CI) maximum changes in systolic blood pressure were more profound in those sedated [73 (55–91) mm Hg] compared to those having throat spray [47 (34–60) mm Hg; p < 0.05]. Maximum changes in heart rate during gastroscopy became significantly smaller with advancing age in those having throat spray (p = 0.03) but not in those receiving sedation. Conclusions: Gastroscopy stimulates blood pressure and heart rate changes that are greatest in those sedated. Further studies of the effect of gastroscopy upon blood pressure are required, particularly in older patients, the group regarded as at increased risk from complications.