| Is blood pressure really a trigger for the circadian rhythm of subarachnoid hemorrhage? | |
| | |
MedLine Citation:
|
PMID: 7570729 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND AND PURPOSE: Circadian blood pressure changes are not infrequently cited as a trigger for the onset of subarachnoid hemorrhage (SAH). Our purpose was to determine the reliability of this chronorisk and study the variability and consequences of it as it occurs in hypertensive and normotensive individuals. METHODS: Of 273 consecutive patients with proven SAH of aneurysmal origin seen between January 1990 and December 1993, we studied 120 (44%) for whom the exact time of hemorrhage could be reliably determined. Beyond the recognition of a circadian rhythm for this collective, the patients were then sorted by blood pressure, yielding one group each of 80 normotensive (group N, 66.7%) and hypertensive (group H, 33.3%) individuals. The differential chronorisk of these two groups was studied. RESULTS: A circadian rhythm with a definitive characteristic acrophase was observed for the entire group, occurring between 9 AM and 10 AM (chi 2 test, P < .0005) with a possible secondary peak in the afternoon hours. The separation into two blood pressure groups somewhat surprisingly revealed a different curve for each group (chi 2 test, P = .01). Statistical analysis of each group's separate chronorisk revealed that this acrophase only holds true for hypertensive individuals, whereas normotensive patients not only lack a morning peak, but an apparent elevation in the afternoon is statistically irrelevant, leading to the impression that SAH in normotensive persons seems to be subject to no circadian rhythm at all. CONCLUSIONS: The incidence of SAH conforms to circadian blood pressure variation in hypertensive patients, similar to the diurnal rhythms observed with strokes and myocardial infarctions. This leads to the hypothesis that blood pressure elevation is a trigger for the onset of bleeding in this group. In clear contrast, normotensive individuals with cerebrovascular aneurysms seem to have a random 24-hour distribution of SAH onset times, thus leaving the nature of a possible trigger mechanism unresolved. |
| | |
Authors:
|
G Kleinpeter; R Schatzer; F Böck |
Related Documents
:
|
21717499 - Exogenously administered bombesin and gastrin releasing peptide contract the female rat... 2856789 - Adrenaline and noradrenaline excretion in placebo treated patients in the medical resea... 10915229 - Arterial hypertension in children and adolescents after surgical repair of aortic coarc... 2127829 - Changes of arterial prostaglandin e2 during haemodialysis. 9935049 - Cardiac sympathetic nervous system in early essential hypertension assessed by 123i-mibg. 22087429 - Erratum: urodynamic findings in an awake chemical cystitis rat model observed by simult... 21068739 - The role of blood pressure variability in misdiagnosed clinic hypertension. 22865389 - Independent and interactive effects of preload and afterload on the pump function of th... 23434959 - Prevalence and associated risk factors of hypertension among people aged 50 years and m... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Stroke; a journal of cerebral circulation Volume: 26 ISSN: 0039-2499 ISO Abbreviation: Stroke Publication Date: 1995 Oct |
Date Detail:
|
Created Date: 1995-11-02 Completed Date: 1995-11-02 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 0235266 Medline TA: Stroke Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 1805-10 Citation Subset: IM |
Affiliation:
|
Neurochirurgische Abteilung, Donauspital, Vienna, Austria. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Aged Aged, 80 and over Blood Pressure* Cerebrovascular Disorders / etiology, physiopathology Circadian Rhythm* Cohort Studies Female Humans Hypertension / complications, physiopathology Incidence Intracranial Aneurysm / complications, physiopathology Male Middle Aged Myocardial Infarction / etiology, physiopathology Reproducibility of Results Risk Factors Subarachnoid Hemorrhage / etiology*, physiopathology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Phase relationship between cerebral blood flow velocity and blood pressure. A clinical test of autor...
Next Document: Postprandial and orthostatic cardiovascular changes after acute stroke.