Key result
Frequent transient blood pressure elevations occur in ~68% of adults with chronic spinal cord injury.
Why the study?
Clinically silent autonomic dysfunction and bowel and bladder care are postulated to contribute to cardiovascular disease after chronic spinal cord injury, but the frequency and severity of transient blood pressure elevations are not well described.
Observational (n=19)
No
BACKGROUND: Clinically silent autonomic dysfunction with bowel and bladder care, are postulated to contribute to cardiovascular disease after chronic spinal cord injury (SCI). OBJECTIVE: We describe the frequency and severity of dysreflexic episodes, termed transient blood pressure elevations (T-BPE) over 48 hours in adults with cervical or high-thoracic motor-complete SCI. SETTING: Tertiary SCI Rehabilitation Centre in Toronto, Canada. PARTICIPANTS: Individuals with chronic SCI, C1-T3 AIS A or B, >1 year post-injury, living in the community (n=19). OUTCOME MEASURES: Data were obtained via 48-hour ambulatory blood pressure (BP) and heart rate (HR) monitoring, with data captured at 10-minute intervals and a concurrent diary describing activities of daily living, and bladder/bowel routines. T-BPE were defined as a ≥ 40 mmHg elevation in systolic blood pressure (SBP) above the participant's supine baseline. Severe (≥ 60-79 mmHg) and Extreme ≥80 mmHg elevations in SBP were described. RESULTS: Thirteen participants experienced T-BPE within the assessment period, with 7/13 experiencing "severe", and 3/13 experiencing "extreme" SBP elevations. The median number of T-BPE was 8 (IQR = 3), and the mean ± SD SBP during T-BPE was 150 ± 16 mmHg, These T-BPE were verified as dysreflexic events using a conservative definition of a >40 mmHg increase in SBP, with a concurrent 10 bpm decrease in HR, above the 48-hour average SBP, yielding 12/19 participants with T-BPE. CONCLUSIONS: T-BPE were frequent, often with severe or extreme elevations in SBP, despite few reported symptoms. Recognition and management of these dysreflexic events associated with T-BPE are needed, which may ameliorate cardiovascular disease risk.
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Dance et al. (2016) conducted an observational in chronic spinal cord injury (n=19). Transient blood pressure elevations (T-BPE) was evaluated on Frequency and severity of transient blood pressure elevations (T-BPE) defined as ≥ 40 mmHg elevation in systolic blood pressure above baseline. During 48-hour monitoring, 13 of 19 adults (68.4%) with chronic spinal cord injury experienced frequent transient blood pressure elevations, often with severe or extreme increases in systolic blood pressure.
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