Homocysteine and hypertension in persons with spinal cord injury

Lee, M Y; Myers, Jonathan; Abella, Joshua; Froelicher, Victor; Perkash, Inder; Kiratli, B. Jenny

doi:10.1038/sj.sc.3101873

Cited by 10 publications

(10 citation statements)

References 31 publications

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“…A study of 168 Veterans in California revealed 45% prevalence of HTN, of which 67% had paraplegia. 17 Prevalence was also higher than reported in the recent Stockholm SCI study, which found 40% of their SCI/D cohort with post-traumatic paraplegia to have HTN. 7 The higher prevalence may be partially attributed to the age of the cohorts, an increased duration of our retrospective review and the lack of NTSCI/D patients in the Stockholm study.…”

Section: Prevalence Of Htn and Associated Factorscontrasting

confidence: 44%

Hypertension and antihypertensive treatment in veterans with spinal cord injury and disorders

et al. 2012

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Objectives: Hypertension (HTN) is an important risk factor for cardiovascular disease, a major cause of morbidity and mortality among people with spinal cord injury and disorders (SCI/D). Our study examined prevalence, associated factors, and pharmacological treatment of HTN in Veterans with SCI/D compared with a matched control group. CVD is a major cause of morbidity and mortality in patients with spinal cord injury and disorders (SCI/D). 4-6 Septicemia, respiratory disorders and renal failure were once the primary cause of death in SCI/D patients. 7 Treatments for these complications have continued to improve and SCI/D patients are now living an average of 20-40 years post-injury. 8 As the life expectancy of individuals with SCI/D increases, the risk of developing CVD is a more significant concern. A recent study revealed that CVD was the cause of death for 40% of SCI/D Veterans. 4 It is also suggested that patients with SCI/D

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Section: Prevalence Of Htn and Associated Factorscontrasting

confidence: 44%

Hypertension and antihypertensive treatment in veterans with spinal cord injury and disorders

et al. 2012

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“…43,44 The prevalence of hypertension in veterans with SCI has been reported to be 22% based on a retrospective review in 7959 patients with paraplegia and tetraplegia. 45 In a prospective examination of BP in persons with SCI, Lee et al 46 reported hypertension in 45% of the study population. Although the proportion of hypertensive individuals with paraplegia was increased compared to those with tetraplegia, 45,46 these authors did not distinguish between HP and LP.…”

Section: Discussionmentioning

confidence: 99%

“…45 In a prospective examination of BP in persons with SCI, Lee et al 46 reported hypertension in 45% of the study population. Although the proportion of hypertensive individuals with paraplegia was increased compared to those with tetraplegia, 45,46 these authors did not distinguish between HP and LP. However, our data suggest that the prevalence of hypertension is increased in persons with lesions ≤T7 compared to those with injuries above this level.…”

Section: Discussionmentioning

confidence: 99%

A prospective report on the prevalence of heart rate and blood pressure abnormalities in veterans with spinal cord injuries

Wecht

Zhu

Weir

et al. 2013

The Journal of Spinal Cord Medicine

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Objective: Decentralized autonomic cardiovascular regulation may lead to increased prevalence of heart rate (HR) and blood pressure (BP) abnormalities in veterans with SCI. In addition, comorbid medical conditions and prescription medication use may increase HR and BP abnormalities. These abnormalities include bradycardia, and tachycardia, hypotension, hypertension as well as autonomic dysreflexia and orthostatic hypotension; the prevalence of which is unknown. Design: HR and BP data were measured during a routine annual physical examination in 64 veterans with SCI. Measurements of HR and BP were recorded in the seated and supine positions to document the influence of body position and to document intra-subject variability in these assessments. Results: All subjects were chronically injured (20 ± 14 years), 33 subjects were tetraplegic (T: C3-C8), nine had high paraplegia (HP: T1-T6), and 22 had low paraplegia (LP: T7-L2). Regardless of position, the prevalence of bradycardia was increased in the T group, whereas prevalence of tachycardia was increased in the HP and LP groups. Systolic hypotension was more common in the T and HP groups than the LP group and positional effects were most evident in the T group. Systolic hypertension was comparable in the T and HP groups but was twice as prevalent in the LP group. Increased prevalence of individuals with three or more medical conditions and prescribed three or more medications which might influence HR and BP was observed. Conclusion: Decentralized autonomic regulation, comorbid medical conditions, and prescription medication use in veterans with SCI result in HR and BP abnormalities; our data suggest that these abnormalities vary depending on the level of injury and orthostatic positioning.

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“…These same CAD risk factors are common among people with SCI (28)(29)(30)(31)(32). In addition, people with SCI above the splanchnic outflow (T6) have autonomic dysfunction, which may contribute to disordered cardiac regulation and abnormalities of the vascular system.…”

Section: Introductionmentioning

confidence: 99%

Pulse Wave Velocity for Assessment of Arterial Stiffness Among People With Spinal Cord Injury: A Pilot Study

Miyatani

Masani

et al. 2009

The Journal of Spinal Cord Medicine

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Background/Objective: The most significant complication and leading cause of death for people with spinal cord injury (SCI) is coronary artery disease (CAD). It has been confirmed that aortic pulse wave velocity (PWV) is an emerging CAD predictor among able-bodied individuals. No prior study has described PWV values among people with SCI. The objective of this study was to compare aortic (the common carotid to femoral artery) PWV, arm (the brachial to radial artery) PWV, and leg (the femoral to posterior tibial artery) PWV in people with SCI (SCI group) to able-bodied controls (non-SCI group). Methods: Participants included 12 men with SCI and 9 non-SCI controls matched for age, sex, height, and weight. Participants with a history of CAD or current metabolic syndrome were excluded. Aortic, arm, and leg PWV was measured using the echo Doppler method. Results: Aortic PWV (mean 6 SD) in the SCI group (1,274 6 369 cm/s) was significantly higher (P , 0.05) than in the non-SCI group (948 6 110 cm/s). There were no significant between-group differences in mean arm PWV (SCI: 1,152 6 193 cm/s, non-SCI: 1,237 6 193 cm/s) or mean leg PWV (SCI: 1,096 6 173 cm/s, non-SCI: 994 6 178 cm/s) values. Conclusions: Aortic PWV was higher among the SCI group compared with the non-SCI group. The higher mean aortic PWV values among the SCI group compared with the non-SCI group indicated a higher risk of CAD among people with SCI in the absence of metabolic syndrome.

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Homocysteine and hypertension in persons with spinal cord injury

Cited by 10 publications

References 31 publications

Hypertension and antihypertensive treatment in veterans with spinal cord injury and disorders

Hypertension and antihypertensive treatment in veterans with spinal cord injury and disorders

A prospective report on the prevalence of heart rate and blood pressure abnormalities in veterans with spinal cord injuries

Pulse Wave Velocity for Assessment of Arterial Stiffness Among People With Spinal Cord Injury: A Pilot Study

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