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Continuous Blood Pressure Monitoring in the Clinical Evaluation of Hypertensive Patients and in the Study of Neural Cardiovascula Control

  • G. Mancia
  • A. Ferrari
  • G. Bertinieri
  • M. Di Rienzo
  • G. Grassi
  • G. Parati
  • G. Pomidossi
Chapter
  • 29 Downloads
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 37)

Abstract

Towards the end of the sixties Pickering and his Oxford group (1,2) deviced a method that allowed blood pressure to be measured intra-arterially in ambulant subjects with limited interference with their ambulation and to some extent with their life-patter. Beside being repeatedly referred to in this workshop, the Oxford method is too well known to necessitate a detailed description. Suffice it to say that its design effectively minimizes the incovenience and risk inherent to the invasiveness of the procedure, and that its technical features usually allow a blood pressure signal of adequate quality to be recorded (3). By means of some precautions the recording can be carried out under condition of stable 0 signal and equal sensitivity throughout the range of existing blood pressures.

We have adopted the Oxford method since 1977 and have so far completed few hundred 24 hour blood pressure recordings in normotensive subjects and in subjects with untreated or treated hypertension of essential or secondary nature. Although this large experience has allowed us to gather information on several pathophysiological and clinical aspects of conditions of deranges blood pressure, we will limit ourselves to three topics only: 1) effects of bahaviours on blood pressure, 2) blood pressure variability and 3) clinical applications of continuous blood pressure recording.

Keywords

Heart Rate Variability Mean Arterial Pressure Blood Pressure Variability Blood Pressure Recording Blood Pressure Signal 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Pickering GW. High Blood Pressure. JA Churchill, Ltd, London, 1968.Google Scholar
  2. 2.
    Bevan AT, Honour AJ, Stott FM. Direct arterial blood pressure recording in unrestricted man. Clin Sci 36, 329–344, 1969.PubMedGoogle Scholar
  3. 3.
    Stott FD, Teny VG, Honour AJ. Factors determining the design and construction of a portable pressure transducer system. Postgrad Med J 52 (suppl 7) 97–99, 1976.PubMedGoogle Scholar
  4. 4.
    Littler WA, Honour AJ, Carter RD, Sleight P. Sleep and blood pressure. Br Med J 3, 346–348, 1975.PubMedCrossRefGoogle Scholar
  5. 5.
    Littler WA, Honour AJ, Sleight P, Stott FD. Continuous recording of direct arterial pressure and electrocardiogram in unrestricted man. Br Med J 3, 76–78, 1977.CrossRefGoogle Scholar
  6. 6.
    Raftery EB. Hypertension day by day. The Practitioner 223, 166–175, 1979.PubMedGoogle Scholar
  7. 7.
    Littler WA, Honour AJ, Sleight P. Direct arterial pressure, pulse rate and electrocardiogram during micturition and defecation in unrestricted man. Am Heart J 88, 205–210, 1974.PubMedCrossRefGoogle Scholar
  8. 8.
    Mancia G, Zanchetti A. Cardiovascular regulation during sleep. In Physiology of Sleep, edited by J Orem, New York, Academic Press, pp 1–55, 1981.Google Scholar
  9. 9.
    Mancia G, Ferrari A, Gregorini L, Parati G, Pomidossi G, Bertinieri G, Grassi G, Di Rienzo M, Pedotti A, Zanchetti A. Blood pressure and heart rate variabilities in normotensive and hypertensive human beings. Circ Res, in press.Google Scholar
  10. 10.
    Mancia G, Bertinieri G, Grassi G, Parati G, Pomidossi G, Ferrari A, Gregorini L, Zanchetti A. Measurement of blood pressure by the doctor: effects on the blood pressure and heart rate of the patient. Lancet,.in press.Google Scholar
  11. 11.
    Mancia G. Methods for assessing blood pressure values in humans. Hypertension, in press.Google Scholar
  12. 12.
    Floras JS, Assan MD, Sever PS, Jones JV, Osikowska B, Sleight P. Cuff and ambulatory blood pressure in subjects with essential hypertension. Lancet 2, 107–109, 1981.PubMedCrossRefGoogle Scholar
  13. 13.
    Sokolow M, Wertegard D, Kain HK, Hinman AT. Relationship between level of blood pressure measured casually and by portable recorders and severity of complications in essential hypertension. Circulation 34, 279–298, 1966.PubMedGoogle Scholar
  14. 14.
    Loriman AR, MacFarlane PW, Provan G, Duffy T, Lawrie TDV. Blood pressure and catecholamine responses to “stress” in normotensive and hypertensive subjects. Cardiovasc Res 5, 169-, 1971.CrossRefGoogle Scholar
  15. 15.
    Falkner B, Onesti G, Angelakos ET, Fernandes M, Langman C. Cardiovascular response to mental stress in normal adolescents with hypertensive parents. Hypertension 1, 23–30, 1979.PubMedGoogle Scholar
  16. 16.
    Mancia G, Ferrari A, Gregorini L, Parati G, Pomidossi G, Bertinieri G, Grassi G, Zanchetti A. Blood pressure variability in man: its relation to high blood pressure, age and baroreflex sensitivity. Clin Sci 50, 401s–404s, 1980.Google Scholar
  17. 17.
    Watson RDS, Stallard TJ, Littler WA. Factors determining the variability of arterial pressure in hypertension. Clin Sci 57 (suppl 5), 283s–295s, 1979.PubMedGoogle Scholar
  18. 18.
    Smirnov NV. Table for estimating the goodness of fit of empirical distributions. Ann Math Statistics 19, 279–281, 1948.CrossRefGoogle Scholar
  19. 19.
    Anderson DE, Yingling JE, Sagawa K. Minute-to-minute covariations in cardiovascular activity of conscious dogs. Am J Physiol 236, H434–H439, 1979.PubMedGoogle Scholar
  20. 20.
    Ramirez AJ, Bertinieri G, Belli L, Cavallazzi A, Di Rienzo M, Pedotti A, Mancia G. Reflex control of blood pressure and heart rate by arterial baroreceptors and cardiopulmonary receptors in the unanesthetized cat. Submitted for publication.Google Scholar
  21. 21.
    Cowley AW, Liard JF, Guyton AC. Role of the baroreceptor reflex in daily control of arterial blood pressure and other variables in dogs. Circ Res 32, 564–576, 1973.PubMedGoogle Scholar
  22. 22.
    Mancia G. Blood pressure variability at normal and high blood pressure. Chest 83, 317S–320S, 1983.Google Scholar
  23. 23.
    Mancia G, Zanchetti A. Continuous arterial blood pressure recording in human hypertension: A methodological approach. Atherosclerosis Reviews, vol 7: Measurement and control of cardiovascular risk factors, edited by R Hegyeli, Raven Press, New York, pp 247–254, 1980.Google Scholar
  24. 24.
    Mancia G, Ferrari A, Gregorini L, Parati G, Pomidossi G, Zanchetti A. Prolonged intra-arterial blood pressure recording in the diagnosis of pheochromocytoma. Lancet 2, 1193–1194, 1979.PubMedCrossRefGoogle Scholar
  25. 25.
    Di Rienzo M, Grassi G, Pedotti A, Mancia G. Continuous vs intermittent blood pressure measurement in estimating 24 hour average blood pressure. Hypertension 5, 264–269, 1983.PubMedGoogle Scholar

Copyright information

© ECSC, EEC, EAEC, Brussels-Luxembourg 1984

Authors and Affiliations

  • G. Mancia
    • 1
    • 2
  • A. Ferrari
    • 1
    • 2
  • G. Bertinieri
    • 1
    • 2
  • M. Di Rienzo
    • 3
  • G. Grassi
    • 1
    • 2
  • G. Parati
    • 1
    • 2
  • G. Pomidossi
    • 1
    • 2
  1. 1.Istituto di Clinica Medica IVUniversità di MilanoMilanoItaly
  2. 2.Centro di Fisiologia Clinica e IpertensioneOspedale MaggioreMilanoItaly
  3. 3.Centro di Bioingegneria, Politecnico e Fondazione Don GnocchiMilanoItaly

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