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Blood Pressure Monitoring in Cerebrovascular Accidents (CVA)
Invasive Blood Pressure Monitoring Using the Caudal Ventral Artery (CVA) in Rats
In rodent experiments, the caudal ventral artery (CVA) is often used for blood pressure (BP) measurement. However, research indicates that CVA measurements may not accurately reflect true BP values. A study comparing invasive arterial BP measurements in rats via the CVA and the common carotid artery (CCA) found significant discrepancies, especially when the rats were subjected to cooling of the head or tail. The pressure difference was more pronounced in the tail cooling group, attributed to frequent angiospasms in the CVA upon cooling. Histological analysis supported these findings, showing a larger tunica media area in the CVA compared to the CCA. This suggests that CVA pressure is highly susceptible to environmental changes and may not provide accurate BP readings without a strictly controlled environment.
Spontaneous Cyclic Vasomotor Activity (CVA) and Blood Pressure Variability
Spontaneous cyclic vasomotor activity (CVA) has been observed in both large and small arteries in humans and rats. This activity can interfere with the evaluation of sympathetic activity through spectral analysis of blood pressure. Studies have shown that CVA is enhanced by nitric oxide release and abolished by inhibitors of nitric oxide or cyclic GMP synthesis. A specific potassium channel plays a crucial role in the genesis of CVA. The frequency of CVA falls within the 'low frequencies' band of power spectral analysis of blood pressure, which is typically considered an index of sympathetic activity. This indicates that CVA might contribute to blood pressure variability independently of autonomic nervous system activity, potentially influencing the low-frequency peak in both rats and humans.
Systolic Blood Pressure Variability (SBPV) and Cardiovascular Events (CVE)
Research has established a significant association between systolic blood pressure variability (SBPV) and the development of cardiovascular events (CVE) such as angina pectoris, myocardial infarction, cerebrovascular accident (CVA), and cardiovascular death (CVD) in hypertensive patients. A study involving 300 hypertensive patients over a 60-month follow-up period found that higher SBPV values were significantly related to the occurrence of CVE. Specifically, SBPV values above 14.08 mmHg were predictive of future cardiovascular events, while values above 16.13 mmHg were predictive of cardiovascular death. This suggests that monitoring SBPV could be a useful marker for predicting CVE and CVD in hypertensive patients.
Visit-to-Visit Blood Pressure Variability and Cardiovascular Risk
A systematic review and meta-analysis have shown that visit-to-visit variability (VVV) of blood pressure is associated with an increased risk of cardiovascular disease (CVD) and all-cause mortality. The analysis included data from 23 publications and found that VVV of systolic blood pressure (SBP) was significantly associated with outcomes such as all-cause mortality, CVD incidence, CVD mortality, coronary heart disease (CHD) incidence, and stroke incidence. These findings highlight the importance of standardized monitoring of VVV in high-risk populations, including patients with cardiac infarction, diabetes, stroke, and chronic kidney disease, to better understand and manage their prognosis.
Conclusion
In summary, accurate blood pressure monitoring is crucial in both experimental and clinical settings. The caudal ventral artery in rats may not provide reliable BP readings due to environmental susceptibility. Spontaneous cyclic vasomotor activity can influence BP variability independently of the autonomic nervous system. High systolic blood pressure variability is a significant predictor of cardiovascular events and mortality in hypertensive patients. Therefore, consistent and standardized monitoring of blood pressure variability is essential for predicting and managing cardiovascular risks.
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