Value Of Blood Pressure Response Research Articles

Variable prognostic value of blood pressure response to exercise

AimThe aim of this study was to evaluate the impact of patient background including exercise capacity on the relationship between the blood pressure (BP) response to exercise and prognosis in patients visiting a cardiovascular hospital. MethodsA total of 2134 patients who were referred to our hospital underwent symptom-limited maximal cardiopulmonary exercise testing, and were followed through medical records and mail. The BP response to exercise was defined as the difference between peak and rest systolic BP. The end point was set as cardiovascular events including cardiovascular death, acute coronary syndrome, hospitalization for heart failure, and cerebral infarction. ResultsDuring a median follow-up period of 3 years, 179 (8%) patients reached the end point (2.5%/year). Multivariate analysis showed that BP response was independently and negatively associated with the occurrence of the end point. This prognostic significance of BP response was consistent regardless of left ventricular ejection fraction, renal function, presence of heart failure symptoms, the presence of organic heart disease, and hypertension. However, peak VO2 showed a significant interaction with the effects of BP response on the end point, suggesting that the prognostic value of BP response was limited in patients with preserved exercise capacity. ConclusionsThe role of BP response to exercise as the predictor depends on exercise capacity of each patient.

P642Variable prognostic value of blood pressure response to exercise

P642Variable prognostic value of blood pressure response to exercise

Study of cardiovascular responses to sustained handgrip and change in posture in Type II diabetes mellitus patients

Background: In India, more than 50% of patients with Type II diabetes have poor glycemic control and these patients suffer from complications of diabetes. One of the major complications of diabetes is impaired cardiovascular autonomic reflexes. Postural tachycardia index, blood pressure (BP) response to sustained handgrip (SHG), and BP response to standing these tests are used to assess cardiovascular autonomic responses. Aims and Objectives: This study was done to assess cardiovascular responses to SHG and change in posture in Type II diabetes mellitus patients. Materials and Methods: A total of 90 participants were selected out, of which 30 participants had uncontrolled diabetes, 30 had controlled diabetes, and remaining were 30 age- and gender-matched healthy controls. Postural tachycardia index, BP response to SHG, and BP response to standing were measured using Physiopac-8: Computerized 8-channel biopotential acquisition system and Omron Intellisense M3 BP monitor. Data obtained were analyzed statistically. Results: Postural tachycardia index values were significantly lower in uncontrolled diabetes patient group as compared to controlled diabetes patient group and healthy control group. The value of BP response to sustained handgrip in uncontrolled diabetes patient group was significantly lower as compared to healthy controls (P < 0.01), whereas no statistically significant difference observed between uncontrolled and controlled diabetes patient groups (P = 0.35). The value of BP response to standing was significantly higher in uncontrolled diabetes patient group as compared healthy controls (P < 0.01), there is a progressive increase in value of fall of BP to standing from healthy control group to uncontrolled diabetes patient group. Value of fall in BP is more in both controlled and uncontrolled diabetes patient group compared to controls but value is greater in patients with uncontrolled diabetes. Conclusion: Poor glycemic control leads to impairment of cardiovascular response to change in posture and SHG in Type II diabetes mellitus patients.

Blood pressure response to stress tests does not reflect blood pressure variability and degree of cardiovascular involvement in young hypertensives

The aim of the study was to assess the clinical value of blood pressure response to stress tests and to study its relationship with ambulatory blood pressure monitoring, daily blood pressure variability and hypertensive complications. Cold pressor test for 2 min, hand grip test at 25% of maximal voluntary contraction for 5 min and orthostatism were performed in 223 young men found hypertensive (BP systolic > 140 mmHg and/or diastolic > 90 mmHg) at the military service recruitment check-up. On the basis of ECG and fundoscopic examination, each patient was attributed a score of target organ damage. All patients underwent non-invasive 24-h blood pressure monitoring and 169 patients underwent echocardiographic examination. Hypertension was confirmed in 54.2% of the subjects at ambulatory monitoring. No correlation was found between blood pressure response to stress tests and ambulatory blood pressure, daily blood pressure variability, target organ damage and left ventricular mass. Night-time ambulatory blood pressure were correlated with posterior wall thickness/ventricular diastolic internal diameter ratio ( r = 0.26, P < 0.001). A negative correlation was found between the office-daytime blood pressure difference and systolic and diastolic response to orthostatic test ( r = −0.309, P < 0.0001 for systolic blood pressure and r = −0.433, P < 0.0001 for diastolic blood pressure) and between supine office blood pressure and blood pressure response to orthostatism ( r = −0.186. P = 0.013 for systolic blood pressure and r = −0.442, P < 0.0001 for diastolic blood pressure). These results emphasize the limitation of stress tests in predicting the degree of cardiovascular involvement and daytime blood pressure variability in young subjects with mild hypertension. They also suggest that the blood pressure response to standing affects the levels of daytime blood pressure.

Value of blood pressure response to exercise in the recognition of latent or early borderline hypertension

Value of blood pressure response to exercise in the recognition of latent or early borderline hypertension