Prevalence of Abnormal Systemic Hemodynamics in Veterans with and without Spinal Cord Injury

Arch Phys Med Rehabil, 2015 · DOI: 10.1016/j.apmr.2015.01.018 · Published: June 1, 2015

Spinal Cord Injury Cardiovascular Science Rehabilitation

Simple Explanation

This study investigates heart rate (HR) and blood pressure (BP) abnormalities in veterans with and without spinal cord injury (SCI). The goal was to assess how SCI affects cardiovascular health. The study compared veterans with different levels of SCI to see if the severity of the injury correlated with the prevalence of abnormal HR and BP readings. They also considered the influence of other health factors. The findings aim to provide a better understanding of cardiovascular issues in the SCI population. This knowledge is crucial for developing effective treatments and improving their overall well-being.

Study Duration

Not specified

Participants

62 veterans with SCI and 160 veterans without SCI

Evidence Level

Not specified

Key Findings

1
SCI status contributes to the prevalence of cardiac acceleration (CA), systolic and diastolic hypotension (HYPO). The American Spinal Injury Association (AIS) classification and injury duration did not have any effects.
2
The diagnosis of hypertension (HTN) and the use of anti-HTN medications were reduced in individuals with higher cord lesions. This suggests that the level of SCI impacts cardiovascular regulation.
3
The prevalence of orthostatic hypotension (OH) appears to be increased in veterans with and without SCI at an earlier age than previously reported. This indicates a potential need for earlier screening and intervention.

Research Summary

The study assessed heart rate (HR) and blood pressure (BP) abnormalities in veterans with and without spinal cord injury (SCI) to determine prevalence rates for cardiac acceleration (CA), systolic and diastolic hypotension (HYPO), and orthostatic hypotension (OH). The data suggest that SCI status, but not AIS classification or duration of injury, contributes to the prevalence of CA, systolic and diastolic HYPO, and to the reduced prevalence of the diagnosis of HTN and the use of anti-HTN medications in those with higher cord lesions. The findings provide a foundation for the development of a national registry describing cardiovascular parameters in the veteran population, and suggests that increased prevalence of cardiac acceleration and persistent and episodic hypotension in the SCI population should be a priority for clinical investigations.

Practical Implications

Targeted Interventions

Develop tailored cardiovascular management strategies for veterans with SCI based on their lesion level to address specific risks like hypotension or hypertension.

Early Screening

Implement routine screening for orthostatic hypotension in veterans, including those without SCI, to identify and manage the condition early and prevent related complications.

National Registry

Establish a national registry to collect and analyze cardiovascular data in the veteran population. This will enable better monitoring, research, and ultimately, improved care for veterans with and without SCI.

Study Limitations

1
No assessment of autonomic dysreflexia (AD) in veterans with SCI.
2
Data were calculated from average BP recordings during a single clinical visit, and may not adequately reflect overall cardiovascular hemodynamics.
3
Groups were recruited from a convenience sample and were not matched for demographic data or medical history; therefore group comparisons should be interpreted with caution.

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