Symptoms of low blood pressure: a population study.

Wessely, Simon; Nickson, Judith; Cox, Brian D.

doi:10.1136/bmj.301.6748.362

Cited by 148 publications

(98 citation statements)

References 13 publications

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“…Is it a forgotten illness? 9 A number of symptoms have been attributed to hypotension, from somatic symptoms of depression, 10 fatigue, anergia, 11 to an inability to perform prolonged physical work. 12 Some authors have speculated that symptoms of the chronic fatigue syndrome may be referable to low systemic arterial pressure.…”

Section: Discussionmentioning

confidence: 99%

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Arterial hypotension: prevalence of low blood pressure in the general population using ambulatory blood pressure monitoring

2000

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Background: Chronic constitutional hypotension has been described in a proportion of the population, and has a symptom complex ascribed to it. The true prevalence of low blood pressure in the normal population has not been defined. Aim of study: This study was undertaken to determine the prevalence of low blood pressure states, as measured using ambulatory blood pressure monitoring, in a general population cohort, and to determine the association between low blood pressure and clinical and demographic variables. Patient population: The population enrolled were a cohort of mainly urban dwelling Irish subjects, either employees or spouses of employees of a major national bank. Methods: Subjects had an ambulatory blood pressure monitor fitted between 09.00 and 12.00 and wore the monitor for 24 hours. The subjects also filled out a detailed lifestyle questionnaire, and kept an activity

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Section: Discussionmentioning

confidence: 99%

“…Other work however has shown a linear association between symptoms and blood pressure falling from the middle of the blood pressure distribution. 11,16 The above values are based on clinic blood pressure estimation, so correlation with ambulatory blood pressure measurement is not straightforward.…”

Section: Discussionmentioning

confidence: 99%

Arterial hypotension: prevalence of low blood pressure in the general population using ambulatory blood pressure monitoring

2000

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“…Indeed, it is known that even moderate resting hypotension (systolic pressure below 110 mmHg) is associated with deficits in cognitive performance. 85 Furthermore, orthostatic hypotension is commonly associated with fatigue, 86,87 which is an other factor that adversely impacts upon quality of life and participation in rehabilitation. In addition, it is possible that those individuals with more severe orthostatic hypotension, and thus presumably the greatest impairment of cardiovascular control, may also be more prone to other cardiovascular abnormalities such as episodes of autonomic dysreflexia.…”

Section: Implications Of Impaired Blood Pressure Control In Scimentioning

confidence: 99%

Orthostatic hypotension following spinal cord injury: understanding clinical pathophysiology

2005

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Motor and sensory deficits are well-known consequences of spinal cord injury (SCI). During the last decade, a significant number of experimental and clinical studies have focused on the investigation of autonomic dysfunction and cardiovascular control following SCI. Numerous clinical reports have suggested that unstable blood pressure control in individuals with SCI could be responsible for their increased cardiovascular mortality. The aim of this review is to outline the incidence and pathophysiological mechanisms underlying the orthostatic hypotension that commonly occurs following SCI. We describe the clinical abnormalities of blood pressure control following SCI, with particular emphasis upon orthostatic hypotension. Possible mechanisms underlying orthostatic hypotension in SCI, such as changes in sympathetic activity, altered baroreflex function, the lack of skeletal muscle pumping activity, cardiovascular deconditioning and altered salt and water balance will be discussed. Possible alterations in cerebral autoregulation following SCI, and the impact of these changes upon cerebral perfusion are also examined. Finally, the management of orthostatic hypotension will be considered.

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“…24 In the 1990s the British Medical Journal published a series of articles describing the association between low BP and mood disorders in the general population. 8,9,25,26 The findings indicate that individuals with chronic hypotension have significantly increased incidence of depression, 8,[27][28][29][30][31][32][33] anxiety, 28, 29 unexplained tiredness, 8,9 and poor perception of well-being compared to matched-normotensive controls. 25 More recently we conducted focus group sessions in individuals with SCI and clinical care providers and found that both patients and clinicians were able to ascribe adverse effects of persistent asymptomatic hypotension on health related quality of life in those with SCI.…”

Section: Discussionmentioning

confidence: 86%

Orthostatic responses to anticholinesterase inhibition in spinal cord injury

et al. 2015

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Acetylcholine (Ach) is the pre-synaptic neurotransmitter of the sympathetic nervous system. Increased pre-synaptic Ach may augment post-synaptic release of norepinephrine thereby increasing systemic blood pressure (BP). The primary objective of this investigation was to determine the hemodynamic effect of pyridostigmine bromide (PYRIDO: 60 mg), an Ach inhibitor (AchI), compared to no-drug (NO-D) during head-up tilt (HUT) in individuals with spinal cord injury (SCI). Secondarily we aimed to determine the effects of PYRIDO compared to NO-D on symptoms of orthostatic intolerance (OI) and adverse event reporting (AE). Ten individuals with SCI (C4-C7) were studied on 2 occasions: visit 1) NO-D and visit 2) PYRIDO. On each visit subjects underwent a progressive HUT maneuver to 15°, 25°, 35° for 5 minutes at each angle and 45 minutes at 45°. Supine and orthostatic heart rate (HR), systolic and diastolic BP (SBP & DBP) were monitored and symptoms of OI and AE recorded. Supine hemodynamics did not differ between the trials. The significant fall in SBP during the NO-D trial was diminished with PYRIDO and five subjects had an increased DBP during HUT with PYRIDO compared to the NO-D trial. Individuals that responded to PYRIDO with an increase in orthostatic BP had significantly lower resting HR than non-responders (p<0.01), which suggests increased levels of pre-synaptic Ach. Subjective symptoms of OI and AE reporting did not differ between the two trials. These preliminary data suggest that PYRIDO is safe and may be effective at ameliorating the orthostatic fall in BP in select individuals with SCI.

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Symptoms of low blood pressure: a population study.

Cited by 148 publications

References 13 publications

Arterial hypotension: prevalence of low blood pressure in the general population using ambulatory blood pressure monitoring

Arterial hypotension: prevalence of low blood pressure in the general population using ambulatory blood pressure monitoring

Orthostatic hypotension following spinal cord injury: understanding clinical pathophysiology

Orthostatic responses to anticholinesterase inhibition in spinal cord injury

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