Min Yin Goh1,2,3, Melinda S Millard4,5, Edmund C K Wong4, David J Berlowitz6,7,8, Marnie Graco6,7, Rachel M Schembri7, Douglas J Brown9, Albert G Frauman4,6, Christopher J O'Callaghan4,6. 1. Department of Clinical Pharmacology, Austin Hospital, Heidelberg, VIC, Australia. Min.Goh@austin.org.au. 2. Department of Medicine, University of Melbourne, Parkville, VIC, Australia. Min.Goh@austin.org.au. 3. The Spinal Research Institute, Kew, VIC, Australia. Min.Goh@austin.org.au. 4. Department of Clinical Pharmacology, Austin Hospital, Heidelberg, VIC, Australia. 5. Victorian Spinal Cord Service, Heidelberg, VIC, Australia. 6. Department of Medicine, University of Melbourne, Parkville, VIC, Australia. 7. Institute for Breathing and Sleep, Austin Hospital, Heidelberg, VIC, Australia. 8. Department of Respiratory and Sleep Medicine, Austin Hospital, Heidelberg, VIC, Australia. 9. The Spinal Research Institute, Kew, VIC, Australia.
Abstract
STUDY DESIGN: Observational study. OBJECTIVES: To quantify diurnal blood pressure (BP) patterns and nocturnal hypertension and to measure diurnal urine production in people with chronic spinal cord injury (SCI), compared with controls without SCI. SETTING: Chronic SCI population in the community in Victoria, Australia. METHODS: Participants were recruited by advertisement, and sustained SCI at least a year prior or were healthy able-bodied volunteers. Participants underwent ambulatory BP monitoring (ABPM), measurement of urine production, and completed questionnaires regarding orthostatic symptoms. Comparisons were made between participants with tetraplegia or paraplegia and able-bodied controls. Participants with night:day systolic BP < 90% were classified as dippers, 90-100% as nondippers, and >100% as reverse dippers. RESULTS: Groups with tetraplegia (n = 51) and paraplegia (n = 33) were older (42.1 ± 15 and 41.1 ± 15 vs. 32.4 ± 13 years, mean ± s.d.) and had a higher prevalence of males (88 and 85% vs. 60%) than controls (n = 52). The average BP was 110.8 ± 1.5/64.4 ± 1.2 mmHg, 119.4 ± 2.1/69.8 ± 1.5 mmHg, and 118.1 ± 1.4/69.8 ± 1.0 mmHg in tetraplegia, paraplegia, and controls, respectively. Of participants with tetraplegia, paraplegia and controls, reverse dipping was observed in 45, 13, and 2% (p < 0.001), while nocturnal hypertension was observed in 13, 23, and 18%, respectively (p = 0.48). A reduction in nocturnal urine flow rate compared with the day was observed in paraplegia and controls, but not tetraplegia. CONCLUSIONS: Similar to the effects of acute SCI, chronic SCI, specifically tetraplegia, also causes isolated nocturnal hypertension, reverse dipping, orthostatic intolerance, and nocturnal polyuria. Cardiovascular risk management and assessment of orthostatic symptoms should include ABPM.
STUDY DESIGN: Observational study. OBJECTIVES: To quantify diurnal blood pressure (BP) patterns and nocturnal hypertension and to measure diurnal urine production in people with chronic spinal cord injury (SCI), compared with controls without SCI. SETTING: Chronic SCI population in the community in Victoria, Australia. METHODS:Participants were recruited by advertisement, and sustained SCI at least a year prior or were healthy able-bodied volunteers. Participants underwent ambulatory BP monitoring (ABPM), measurement of urine production, and completed questionnaires regarding orthostatic symptoms. Comparisons were made between participants with tetraplegia or paraplegia and able-bodied controls. Participants with night:day systolic BP < 90% were classified as dippers, 90-100% as nondippers, and >100% as reverse dippers. RESULTS: Groups with tetraplegia (n = 51) and paraplegia (n = 33) were older (42.1 ± 15 and 41.1 ± 15 vs. 32.4 ± 13 years, mean ± s.d.) and had a higher prevalence of males (88 and 85% vs. 60%) than controls (n = 52). The average BP was 110.8 ± 1.5/64.4 ± 1.2 mmHg, 119.4 ± 2.1/69.8 ± 1.5 mmHg, and 118.1 ± 1.4/69.8 ± 1.0 mmHg in tetraplegia, paraplegia, and controls, respectively. Of participants with tetraplegia, paraplegia and controls, reverse dipping was observed in 45, 13, and 2% (p < 0.001), while nocturnal hypertension was observed in 13, 23, and 18%, respectively (p = 0.48). A reduction in nocturnal urine flow rate compared with the day was observed in paraplegia and controls, but not tetraplegia. CONCLUSIONS: Similar to the effects of acute SCI, chronic SCI, specifically tetraplegia, also causes isolated nocturnal hypertension, reverse dipping, orthostatic intolerance, and nocturnal polyuria. Cardiovascular risk management and assessment of orthostatic symptoms should include ABPM.
Authors: Roy Freeman; Wouter Wieling; Felicia B Axelrod; David G Benditt; Eduardo Benarroch; Italo Biaggioni; William P Cheshire; Thomas Chelimsky; Pietro Cortelli; Christopher H Gibbons; David S Goldstein; Roger Hainsworth; Max J Hilz; Giris Jacob; Horacio Kaufmann; Jens Jordan; Lewis A Lipsitz; Benjamin D Levine; Phillip A Low; Christopher Mathias; Satish R Raj; David Robertson; Paola Sandroni; Irwin Schatz; Ron Schondorff; Julian M Stewart; J Gert van Dijk Journal: Clin Auton Res Date: 2011-04 Impact factor: 4.435
Authors: Dwindally Rosado-Rivera; M Radulovic; John P Handrakis; Christopher M Cirnigliaro; A Marley Jensen; Steve Kirshblum; William A Bauman; Jill Maria Wecht Journal: J Spinal Cord Med Date: 2011 Impact factor: 1.985
Authors: Benoit Peyronnet; Lauren B Krupp; W Stuart Reynolds; Xavier Gamé; Gérard Amarenco; Jean-Nicolas Cornu; Lana Zhovtis Ryerson; Carrie Lyn Sammarco; Jonathan E Howard; Robert W Charlson; Roger R Dmochowski; Benjamin M Brucker Journal: Rev Urol Date: 2019