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Title: A retrospective review of the ambulatory blood pressure patterns and diurnal urine production in subgroups of spinal cord injured patients.
Austin Authors: Goh, MY;Wong, EC;Millard, MS;Brown, DJ;O'Callaghan, CJ
Affiliation: The Spinal Research Institute, Heidelberg, Victoria, Australia
Austin Health, Heidelberg, Victoria, Australia
Victorian Spinal Cord Service, Heidelberg, Victoria, Australia
University of Melbourne, Parkville, Victoria, Australia
Issue Date: Jan-2015
Publication information: Spinal Cord, vol. 53(1) p. 49-53.
Abstract: OBJECTIVES: To quantify diurnal blood pressure (BP) patterns and nocturnal hypertension and to measure diurnal urine production in spinal cord injury (SCI) patients with clinically significant disorders of BP control. SETTING: A specialist state-based spinal cord service in Victoria, Australia. METHODS: Medical records of patients with traumatic SCI who were referred to a specialist service for management of a BP disorder were examined. Ambulatory BP and nocturnal urine production were compared between groups of patients classified according to level, completeness and chronicity of SCI. Patients with night:day systolic BP <90% were classified as dippers, 90-100% as non-dippers and >100% as reversed dippers. RESULTS: Patients (44 tetraplegic, 10 paraplegic) were predominantly males (92.6%) aged 41±2.5 years (mean±s.e.m.). Referral was for orthostatic intolerance (n=37), autonomic dysreflexia (n=6), nocturnal polyuria (n=4), elevated BP (n=1) and peripheral oedema (n=1). The average BP was 111.1±1.4/65.0±1.2 mm Hg. In 56% of patients (n=30), BP at night was higher than during the day and another 37% (n=20) were non-dippers. Nocturnal hypertension was present in 31% (n=17) of the patients. In the tetraplegic patients, urine flow rate was greater during the night than day (121±9.5 ml h(-1) vs 89±8.2 ml h(-1), P=0.025). CONCLUSION: Ambulatory BP monitoring in patients with SCI and clinically significant BP disorders detected a high incidence of reversed dipping and nocturnal hypertension. We postulate elevated nocturnal BP may contribute to nocturnal diuresis that might cause relative volume depletion and thereby contribute to daytime orthostatic hypotension.
DOI:  10.1038/sc.2014.192.
PubMed URL:
Type: Journal Article
Subjects: Blood Pressure/physiology
Blood Pressure Monitoring, Ambulatory
Circadian Rhythm/physiology
Retrospective Studies
Spinal Cord Injuries/classification
Spinal Cord Injuries/complications
Spinal Cord Injuries/therapy
Time Factors
Urination Disorders/etiology
Appears in Collections:Journal articles

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