Regulation of blood pressure is a complex interplay between several haemodynamic mechanisms, but only resting blood pressure and heart rate are commonly measured in clinical practice to determine a patient s haemodynamic status. However, the value of single blood pressure measurements as diagnostic tests has recently been questioned. In addition, changes in for example arterial compliance, endothelial function, or the regulation of vascular resistance can already be measured before clinical manifestations of cardiovascular disease. The aim of the present study was to test the repeatability and reproducibility of a comprehensive haemodynamic measurement protocol in both supine position and during head-up tilt. In addition, the effects on two largely endothelium-dependent agents, inhaled salbutamol and intravenous L-arginine, and one endothelium independent agent, sublingual nitroglycerin, were investigated, and the haemodynamic mechanism of nitrate-induced presyncope were examined. Moreover, the age-related haemodynamic changes, supine and upright, in normotensive subjects were clarified. Finally, the application was tested in patients with either essential hypertension or metabolic syndrome.
Non-invasive haemodynamic measurements were performed by applying whole body impedance cardiography, continuous pulse wave analysis and plethysmographic finger blood pressure measurements in supine position and during head-up tilt. Thus, peripheral and central blood pressure, indices of pulse wave reflection, pulse wave velocity, vascular resistance, and cardiac function could be simultaneously assessed. Repeated measurements were performed to test the repeatability and reproducibility of the method, and to study the drug effects in a placebo-controlled manner. All study subjects, except for the subjects included in the testing of the method s clinical application, were normotensive and had no medication affecting cardiovascular status.
Die Inhaltsangabe kann sich auf eine andere Ausgabe dieses Titels beziehen.