Using an in-office passive leg raise to identify older adults with suboptimal blood pressure control.

IF 3.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE
Journal of Hypertension Pub Date : 2024-12-01 Epub Date: 2024-09-02 DOI:10.1097/HJH.0000000000003858
Jeremy R Williams, Molly A Cole, Ryan J Pewowaruk, Amy J Hein, Claudia E Korcarz, Farhan Raza, Naomi C Chesler, Jens C Eickhoff, Adam D Gepner
{"title":"Using an in-office passive leg raise to identify older adults with suboptimal blood pressure control.","authors":"Jeremy R Williams, Molly A Cole, Ryan J Pewowaruk, Amy J Hein, Claudia E Korcarz, Farhan Raza, Naomi C Chesler, Jens C Eickhoff, Adam D Gepner","doi":"10.1097/HJH.0000000000003858","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Passive leg raise (PLR) is a simple, dynamic maneuver that has been used to increase preload to the heart. We hypothesize that PLR may offer a new and efficient office-based tool for assessing blood pressure (BP) control in older adults.</p><p><strong>Methods: </strong>One hundred and three veterans (≥60 years old) without known cardiovascular disease and varying degrees of blood pressure control were included in this cross-sectional cohort study. Twenty-four hour ambulatory BP monitoring identified Veterans with optimal and suboptimal BP control (≥125/75 mmHg). Bioimpedance electrodes (Baxter Medical, Deerfield, Illinois, USA) and brachial BP were used to calculate hemodynamic parameter changes across PLR states [pre-PLR, active PLR (3 min), and post-PLR]. Multiple linear regression was used to assess associations between BP control status with changes in hemodynamic parameters between PLR states.</p><p><strong>Results: </strong>The 24-h ambulatory BP monitoring identified 43 (42%) older Veterans with optimal BP control (mean age of 70.5 ± 7.0 years) and 55 (54%) with suboptimal BP (mean age of 71.3 ± 8.7 years). Veterans with suboptimal BP control had significantly reduced change in total peripheral resistance (ΔTPR) (7.0 ± 156.0 vs. 127.3 ± 145.6 dynes s/cm 5 ; P  = 0.002) following PLR compared with Veterans with optimal BP control. Suboptimal BP control ( β  = -0.35, P  = 0.004) had a significant association with reduced ΔTPR, even after adjusting for demographic variables.</p><p><strong>Conclusion: </strong>Measuring PLR-induced hemodynamic changes in the office setting may represent an alternative way to identify older adults with suboptimal BP control when 24-h ambulatory BP monitoring is not available.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.3000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hypertension","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/HJH.0000000000003858","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/2 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: Passive leg raise (PLR) is a simple, dynamic maneuver that has been used to increase preload to the heart. We hypothesize that PLR may offer a new and efficient office-based tool for assessing blood pressure (BP) control in older adults.

Methods: One hundred and three veterans (≥60 years old) without known cardiovascular disease and varying degrees of blood pressure control were included in this cross-sectional cohort study. Twenty-four hour ambulatory BP monitoring identified Veterans with optimal and suboptimal BP control (≥125/75 mmHg). Bioimpedance electrodes (Baxter Medical, Deerfield, Illinois, USA) and brachial BP were used to calculate hemodynamic parameter changes across PLR states [pre-PLR, active PLR (3 min), and post-PLR]. Multiple linear regression was used to assess associations between BP control status with changes in hemodynamic parameters between PLR states.

Results: The 24-h ambulatory BP monitoring identified 43 (42%) older Veterans with optimal BP control (mean age of 70.5 ± 7.0 years) and 55 (54%) with suboptimal BP (mean age of 71.3 ± 8.7 years). Veterans with suboptimal BP control had significantly reduced change in total peripheral resistance (ΔTPR) (7.0 ± 156.0 vs. 127.3 ± 145.6 dynes s/cm 5 ; P  = 0.002) following PLR compared with Veterans with optimal BP control. Suboptimal BP control ( β  = -0.35, P  = 0.004) had a significant association with reduced ΔTPR, even after adjusting for demographic variables.

Conclusion: Measuring PLR-induced hemodynamic changes in the office setting may represent an alternative way to identify older adults with suboptimal BP control when 24-h ambulatory BP monitoring is not available.

利用诊室内被动抬腿来识别血压控制不理想的老年人。
介绍:被动抬腿(PLR)是一种简单的动态动作,用于增加心脏的前负荷。我们假设被动抬腿运动可以为评估老年人血压控制情况提供一种新的、有效的诊室工具:这项横断面队列研究纳入了 103 名退伍军人(≥ 60 岁),他们没有已知的心血管疾病,血压控制程度各不相同。24 小时动态血压监测确定了血压控制最佳和次佳(≥125/75 mmHg)的退伍军人。生物阻抗电极(Baxter Medical,Deerfield,Illinois,USA)和肱动脉血压用于计算不同 PLR 状态下[PLR 前、主动 PLR(3 分钟)和 PLR 后]的血液动力学参数变化。采用多元线性回归评估血压控制状态与 PLR 状态之间血液动力学参数变化之间的关联:通过 24 小时动态血压监测发现,43 名老年退伍军人(42%)血压控制最佳(平均年龄为 70.5 ± 7.0 岁),55 名老年退伍军人(54%)血压控制欠佳(平均年龄为 71.3 ± 8.7 岁)。与血压控制达标的退伍军人相比,血压控制不达标的退伍军人在 PLR 后总外周阻力(ΔTPR)的变化明显降低(7.0 ± 156.0 vs. 127.3 ± 145.6 达因 s/cm5;P = 0.002)。即使在调整了人口统计学变量后,血压控制不达标(β = -0.35,P = 0.004)也与ΔTPR 降低有显著关系:结论:在无法进行 24 小时动态血压监测的情况下,在办公室环境中测量 PLR 引起的血流动力学变化可能是识别血压控制不佳的老年人的另一种方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Hypertension
Journal of Hypertension 医学-外周血管病
CiteScore
7.90
自引率
6.10%
发文量
1389
审稿时长
3 months
期刊介绍: The Journal of Hypertension publishes papers reporting original clinical and experimental research which are of a high standard and which contribute to the advancement of knowledge in the field of hypertension. The Journal publishes full papers, reviews or editorials (normally by invitation), and correspondence.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信