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Heart rate and blood pressure response improve the prediction of orthostatic cardiovascular dysregulation in persons with chronic spinal cord injury


As published in Physiological Reports

by co-lead authors: Siqi Wang, PhD and Jill M. Wecht, EdD

Unstable blood pressure after spinal cord injury (SCI) is not routinely examined but rather predicted by the neurological classification of SCI: individuals with high level and complete injury are anticipated to experience more frequent and severe blood pressure instability compared with lower level and incomplete SCI. Orthostatic hypotension, that is, a drop of at least 20 mmHg systolic blood pressure or 10 mmHg diastolic blood pressure when assuming an upright position, is a manifestation of this impairment.

An unexpected finding was that completeness of injury did not predict the incidence of orthostatic hypotension. Additionally, the definition of orthostatic hypotension based solely on an absolute decrease in blood pressure is insufficient to characterize the adverse blood pressure and heart rate responses during orthostatic stress.

Algorithmic cluster analysis of heart rate and blood pressure is more sensitive to diagnosing orthostatic cardiovascular dysregulation. These results demonstrate that cardiovascular instability cannot be predicted by level and completeness of SCI, and both blood pressure and heart rate responses are needed to characterize autonomic dysfunction after SCI.

This journal was authored by:

  • Siqi Wang, PhD
  • Jill M. Wecht, EdD
  • Bonnie Legg Ditterline, PhD
  • Beatrice Ugiliweneza, PhD, MSPH
  • Matthew T. Maher, MS, CEP
  • Alexander T. Lombard, MS, CEP
  • Sevda C. Aslan, PhD
  • Alexander V. Ovechkin, MD, PhD
  • Brielle Bethke
  • Jordan T. H. Gunter
  • Susan J. Harkema, PhD

Read the Complete Journal in Physiological Reports.

Posted in Publications