Diastolic blood pressure changes during episodes of autonomic dysreflexia

Model System:

SCI

Reference Type:

Journal article

Accession No.:

J87986

Journal:

Journal of Spinal Cord Medicine - JSCM (formerly Journal of the American Paraplegia Society)

Year, Volume, Issue, Page(s):

2021 , 44, 5, 720-724

Publication Website:

Abstract:

Study evaluated diastolic blood pressure (DBP) changes associated with autonomic dysreflexia (AD) episodes during urodynamics in individuals with spinal cord injury (SCI) at or above the sixth thoracic level (T6). The current diagnostic criteria of AD is based solely on systolic blood pressure (SBP) increases from baseline without regard to changes in DBP. Data were collected from subjects who had urodynamic procedures performed between August 2018 to January 2019, as well as their prior testing for up to 10 years. Systolic and diastolic blood pressures were recorded during the procedure and episodes of AD defined as SBP >20 mmHg above baseline. Seventy people met the inclusion criteria during the study period and had 282 urodynamic tests were reviewed. AD occurred in 43.3 percent (122/282) of all urodynamics tests. The mean maximum SBP and DBP increase from baseline for those with AD were 35.5 mmHg and 19.0 mmHg, respectively. There was a concomitant rise of DBP >10 mmHg with a SBP rise of >20 mmHg in 76.2 percent (93/122) of urodynamic tests. An elevation of DBP >10 mmHg was recorded in 23.8 percent (38/160) of urodynamics that did not have AD by the SBP definition. The findings suggest that DBP increments of >10 mmHg with concurrent SBP increases of >20 mmHg occurs in the majority of AD episodes. Given the significance of cardiovascular complications in chronic SCI, further work is warranted to determine the significance of DBP elevations for defining AD.

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