A retrospective chart review of heart rate and blood pressure abnormalities in veterans with spinal cord injury.
OBJECTIVE
Autonomic impairment may lead to increased prevalence of heart rate (HR) and blood pressure (BP) abnormalities in veterans with spinal cord injury (SCI). In addition, comorbid medical conditions and prescription medication use may influence these abnormalities, including bradycardia, and tachycardia, hypotension, hypertension as well as autonomic dysreflexia (AD), and orthostatic hypotension (OH).


METHODS
A retrospective review of clinical and administrative datasets in veterans with SCI and compared the prevalence rates between clinical values and ICD-9 diagnostic codes in individuals with tetraplegia (T: C1-C8), high paraplegia (HP: T1-T6), and low paraplegia (LP: T7 and below).


RESULTS
The prevalence of clinical values indicative of a HR ≥ 80 beats per minute was higher in the HP compared to the LP and T groups. A systolic BP (SBP) ≤ 110 mmHg was more common in the T compared to the HP and LP groups, whereas the prevalence of a SBP ≥ 140 mmHg was increased in the LP compared to the HP and T groups. Diagnosis of hypertension was 39-60% whereas the diagnosis of hypotension was less than 1%. Diagnosis of AD and OH was highest in the T group, but remained below 10%, regardless of categorical lesion level. Antihypertensive medications were commonly prescribed (55%), and patients on these medications were less likely to have high BP. The odds ratio of higher SBP and DBP increased with age and body mass index (BMI).


CONCLUSIONS
In veterans with SCI, the prevalence of HR and BP abnormalities varied depending on level of lesion, age, BMI, and prescription medication use.
Department of Geriatrics and Palliative Medicine, James J. Peters VAMC, Bronx, NY, USA.
Carolyn
C
Zhu
Marinella
M
Galea
Elayne
E
Livote
Dan
D
Signor
Jill M
JM
Wecht
D000328:Adult; D020211:Autonomic Dysreflexia / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D001919:Bradycardia / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D007022:Hypotension / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D007024:Hypotension, Orthostatic / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D055553:Prescription Drugs; D015995:Prevalence; D011782:Quadriplegia / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D013610:Tachycardia / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D014728:Veterans / Q000706:statistics & numerical data*
D055553:Prescription Drugs