Variable Blood Pressure Risks

[Noreen]

An article in Lancet on hypertension research said that those with the most variable blood pressure readings were most at risk of stroke.

http://www.nlm.nih.gov/medlineplus/news/fullstory_96301.html

None of my doctors ever take my blood pressure standing. I am seeing the neurologist and my primary MD on Tuesday. I went to a large university hospital neurology dept this week and was told fortunately that it doesn't look like I have Parkinson's and that my cervical torticullis should respond to botulism. However, she referred me to NYC or Rochester for the dysautonomia as they don't have a specialist. It took since Sept to get into this Neuroscience Dept. Beyond frustrating!

I have not been happy with the info or lack thereof I've received from my cardiologist. I had no idea the symptoms that could go along with this. This website has been an absolute godsend in that regard.

However, since it looks like I will have to educate the docs at least to a degree, do I start by insisting that the nurse give me both standing and sitting BP/pulse prior to seeing the doc?

Anybody have a quick reference sheet for docs that I could use to orientate them?

Thanks,

Noreen

[firewatcher]

Intermittent versus constant aerobic exercise: effects on arterial stiffness.

Tordi N, Mourot L, Colin E, Regnard J.

Eur J Appl Physiol. 2010 Mar;108(4):801-9.

EA 3920 Physiopathologie cardiovasculaire et pr?vention IFR 133, Universit? de Franche-Comt?, Besan?on Cedex, France.

Aerobic exercises (of sufficient duration and intensity) decreases arterial stiffness. However, the direct relationship between the type of aerobic exercise (i.e. constant versus interval) and the alteration in arterial stiffness has been poorly explored. We evaluated the hemodynamic responses of 11 healthy males (22.5 +/- 0.7 years, height 177.7 +/- 1.1 cm, body mass 70.5 +/- 2.4 kg) following acute constant (CE) and intermittent cycling exercise (IE). Exercise duration and intensity (mean heart rate) were matched during both exercises (142.9 +/- 2.4 bpm for CE and 144.2 +/- 2.4 bpm for IE). Heart rate (HR) and cardiac output (CO) were measured throughout the whole session, while blood pressure and pulse wave velocity (PWV) were measured during pre exercise and 30 min recovery. Arterial stiffness and cardiac autonomic control were assessed through PWV and heart rate variability, respectively. After IE, lower limb arterial stiffness was significantly and steadily decreased compared to pre exercise value (from 8.6 +/- 0.1 to m s(-1) to 7.6 +/- 0.3 to m s(-1) at 30 min) and was lower than after CE (8.2 +/- 0.3 m s(-1) at 30 min, which did not significantly change compared to pre exercise: 8.7 +/- 0.2 m s(-1)). We hypothesized that the higher HR and lower arterial stiffness after IE were likely due to variations in peripheral vascular changes during the exercise which may trigger the release of endothelial or metabolic vasoactive factors. These data appear to show that IE may result in a greater stimulus for vascular adaptations when compared to CE.

PMID: 20187285 [PubMed - in process]

If this is true, then just by having POTS, our arteries are more flexible due to our constant HR fluctuations. Many factors contribute to stroke and increased risk, migraine, diabetes, hypertension (not the postural kind, but the constant kind.) Usually hypertension is due to arterial stiffness due to plaque build-up or another condition/risk factor. If your BP drops when you sit down and lie down, then I would think that you are at no greater risk than everyone else, unless you also have a condition that would predispose you to a stroke.

I also think that "we" are the exception and not the norm when it comes to these studies. If you were to give me a diuretic it would definitely lower my BP and it would be really ugly!

Edited March 13, 2010 by firewatcher