Pressure Profile In Patients Research Articles

Blood pressure profile in patients with microvascular angina

Normotensive patients with microvascular angina exhibit increased diastolic blood pressure and blood pressure loads during daily activities and decreased diurnal variation of systolic blood pressure, compared with age- and sex-matched normotensive controls. The abnormal blood pressure profile could play a role in the pathogenesis of microvascular angina.

Nocturnal hypoxemia, night-day arterial pressure changes and left ventricular geometry in dialysis patients

Nocturnal hypoxemia, night-day arterial pressure changes and left ventricular geometry in dialysis patients

Nocturnal hypoxemia, night-day arterial pressure changes and left ventricular geometry in dialysis patients

It is well established that nocturnal hypoxemia in sleep apnea causes an inversion of the circadian arterial pressure rhythm and triggers nocturnal hypertension. Since sleep apnea is very frequent in dialysis patients, we hypothesized that nocturnal hypoxemia may be a factor that contributes to alter the 24-hour arterial pressure profile in these patients. To test the hypothesis 32 dialysis patients underwent 24-hour blood pressure (BP) monitoring and continuous monitoring of arterial O2 saturation during the night-time. Hemodialysis patients were studied during the non-dialysis day. All patients underwent an echocardiographic study. Thirteen patients had no episode of nocturnal hypoxemia (group I), 7 had at least one episode overnight but less than 2 episodes/hr (group II) and 12 had > or = 2 episodes/hr (group III). The average daytime systolic pressure was similar in the three groups. However, the average nocturnal systolic pressure fell in the first group (-2.5 +/- 4.2%) and rose in the second (+2.0 +/- 3.6%) and in the third (+3.9 +/- 2.2%) group (one way ANOVA, P < 0.005). The relative wall thickness of the left ventricle (RWT) was significantly (P < 0.05) higher in group III than in group I, and in the aggregate (N = 32) there was an inverse relationship between average nocturnal SaO2 and RWT (r = -0.43, P = 0.015). The proportion of patients with concentric remodeling or concentric hypertrophy was higher (P = 0.05) in the group with a more severe degree of nocturnal hypoxemia (group III, 8 of 12) than in the other two groups (group I, 3 of 13; group II, 2 of 7). Nocturnal hypoxemia is associated with the "non-dipping" arterial pressure profile in dialysis patients. Disturbed respiratory control during the night may represent an important cardiovascular risk factor in dialysis patients.

Comparison of the Effect of Carvedilol and Atenolol on Circadian Blood Pressure Profile in Patients with Essential Hypertension

We conducted a single-blind, randomised block trial to assess the diurnal blood pressure (BP) profile after therapy with carvedilol, a nonselective β-blocker with additional α-blockade activity, and atenolol, a cardioselective β-blocker. 30 patients with mild to moderate essential hypertension were studied. After a 2-week placebo run-in period, they were randomly assigned to receive either atenolol 50 to 100mg once daily (15 patients) or carvedilol 25 to 50mg once daily (15 patients). 24-hour ambulatory blood pressure (ABP) monitoring was performed before and after 12 weeks of therapy, using a Kontron Micro AM 5600 device. The ABP readings were analysed with Fourier series with 4 harmonics. Atenolol and carvedilol significantly decreased office and ABP values versus placebo. Carvedilol: office systolic (SBP)/diastolic blood pressure (DBP) 131 ± 4/84 ± 7 vs 160 ± 6/101 ± 5; daytime SBP/DBP 125 ± 4/79 ± 6 vs 138 ±5/91 ±4; night-time SBP/DBP 115 ± 5/72 ± 5 vs 127 ± 3/80 ± 4. Atenolol: office SBP/DBP 133 ± 4/88 ± 3 vs 158 ± 5/102 ± 6; daytime SBP/DBP 124 ± 4/84 ± 3 vs 143 ± 3/97 ± 5; night-time SBP/DBP 117 ± 3/80 ± 6 vs 124 ± 5/88 ± 4. Heart rate was not significantly reduced by carvedilol. Carvedilol and atenolol showed a similar effect on BP profile; they did not modify the BP circadian rhythm. By contrast, both agents induced a significant decrease in the percentage of dippers (carvedilol from 73 to 33%, and atenolol from 60 to 40%), thus reducing the nocturnal BP dip.

Ambulatory blood pressure in hypertensive patients with autosomal dominant polycystic kidney disease.

Ambulatory blood pressure is more closely correlated with various indices of hypertensive target-organ damage, and is a better prognostic predictor of cardiovascular morbidity and mortality than conventional methods of blood pressure measurement. Autosomal dominant polycystic kidney disease (ADPKD) is complicated by hypertension, progressive renal failure, and an increased risk of cardiovascular mortality. This study investigated the 24-h ambulatory blood pressure profile in patients with ADPKD in view of the sparsity of such data in these patients and the possibility that abnormal diurnal blood pressure variations may have prognostic consequences. Ambulatory blood pressure was measured over a 24-h period by the oscillometric method with an automatic non-invasive recorder (SpaceLabs 90207 system) in matched groups of 25 hypertensive patients with ADPKD and 25 patients with essential hypertension. Both groups showed a nocturnal decrease in blood pressure, but this was significantly smaller in patients with ADPKD. There was no evidence of enhanced lability of blood pressure in ADPKD. The nocturnal fall in blood pressure was attenuated in patients with ADPKD. Further studies are required to assess the importance of this finding and its possible contribution to the progression of renal failure or increased cardiovascular mortality in these patients.

Effect of propofol on human sphincter of Oddi.

The effect of propofol was studied in 11 patients who had common bile duct sphincter of Oddi manometry for suspected dysfunction. Patients were initially sedated with midazolam and then further or resedated with propofol for the second set of pressure measurements. Recordings were made about 10 min after giving each drug. No patient had elevated basal pressure initially. Average basal pressure was unchanged (16.7 +/- 16.4 mm Hg), phasic contraction frequency was unchanged (3.4 +/- 3.8/min), and phasic contraction amplitude fell but did not achieve statistical significance (91.8 +/- 77.3 mm Hg, P = 0.1). There was no difference in lowest blood pressure, pulse, or oxygen saturation recorded during midazolam or propofol sedation. Subjectively, the patients were more sedated during propofol administration. It is concluded that propofol is a safe and effective agent for conscious sedation. It does not alter the sphincter of Oddi pressure profile in patients with normal basal sphincter pressures and thus could be used as an alternative and perhaps better form of sedation for ERCP with sphincter of Oddi manometry.

Diurnal blood pressure profile in patients with severe congestive heart failure: Dippers and non-dippers

Diurnal blood pressure profile in patients with severe congestive heart failure: Dippers and non-dippers

Effects of Prazosin HCl on the Urethral Pressure Profile in Patients with Benign Prostatic Hyperplasia

The effects of prazosin HCl on the urethral pressure profile (UPP) were studied in 14 patients with benign prostatic hyperplasia. Urethral pressure profilometry was performed 1 h after oral administration of 1 or 2 mg prazosin HCl. Functional profile and continence zone lengths were significantly reduced following administration of 1 or 2 mg prazosin HCl, as compared with the pretreatment lengths. The administration of 2 mg prazosin HCl resulted in a significant decrease in prostatic peak pressure, whereas the maximum urethral closure pressure exhibited an insignificant decrease. The results suggest that the effects of prazosin HCl on UPP were dose dependent within the range from 1 to 2 mg.

The Effects of Epidural Anesthesia on the Urethral Closure Pressure Profile in Patients with Prostatic Enlargement

APPELL, R. A.; ENGLAND, H. R.; RUSSELL, A. R.; MCGUIRE, E. J.; Larcom, Gordon D. Jr. M.D. Author Information

The Effects of Epidural Anesthesia on the Urethral Closure Pressure Profile in Patients with Prostatic Enlargement

In 10 patients with obstructive manifestations of prostatic enlargement the urethral closure pressure profile was observed before and after the effective blockade of thoracolumbar sympathetic outflow by epidural anesthesia. While epidural anesthesia significantly decreased urethral closure pressure considerable profile responses still remained in these patients. This fact suggests that the bulk of the prostatic tissue is responsible for the bladder outlet obstruction, since urethral closure pressure persists despite urethral smooth and skeletal muscular relaxation as a result of epidural anesthesia. After transurethral resection of the prostatic tissue in these patients the urethral closure pressure did decrease to zero. The result of the prostatic resection is to decrease the urethral closure pressure and, thereby, increase the efficiency of voiding.

Urodynamic Observations Following Spinal Trauma

A method of the urodynamic investigation of paraplegic and quadriplegie patients is described. Serial measurements of the urethral pressure profile in patients with developing reflex micturition demonstrate a rising pressure at the external urethral sphincter with time following spinal trauma. Patterns of micturition with detrusor-sphincteric imbalance are described in patients with both early and well-established reflex micturition.