Holter Blood Pressure Monitoring in Spinal Cord Injury

Trauma to the spinal cord often results in the loss of control of the autonomic (involuntary) nervous system over the cardiovascular system, which often lead to higher risk of cardiovascular mortality and morbidity.

Holter blood pressure monitoring gives information over and above conventional blood pressure measurement (CBPM) and it is a stronger predictor of cardiovascular risks than CBPM as well.

There are a number of obvious advantages that Holter blood pressure monitoring provides, including:

- repeated measurements are taken, therefore real blood pressure values are reflected more accurately
- measurements are taken outside medical environment, therefore identification of individuals with white coat hypertension is better
- measurements are taken over a 24-hour period, included nighttime, therefore identification of non-dipping patients, patients whose blood pressure does not reduce at nighttime is possible.

At patients with spinal cord injury, blood pressure patterns depend on the level of injury. According to a new study, tetraplegic patients, patients with paralysis of all their (four) limbs, have:

- a decreased daytime arterial blood pressure,
- loss of nighttime blood pressure dip,
- higher blood pressure variability.

In addition, these patients are exposed to higher risk of potentially life-threatening hypertensive episodes known as autonomic dysreflexia, which is the reaction of the autonomic nervous system to overstimulation and can be characterized by sudden onset of severe high blood pressure with severe headache, sweating, flushing. proper treatment involves administration of anti-hypertensives with immediate determination of the triggering stimuli.

Patients with spinal cord injury are exposed to adverse blood pressure changes and higher risk of cardiovascular morbidity and mortality due to: Holter blood pressure monitor

- the lost or decreased sympathetic neurons having control over the heart and blood vessels,
- the maladaptive changes within the spinal cord
- the general decrease of physical daily activity.

As holter blood pressure monitoring is a stronger predictor of cardiovascular risks than CBPM, it is also a better tool to monitor and assess the increased risks for cardiovascular diseases in patients with spinal cord injury.

Meditech Ltd. is committed to lower the risk of cardiovascular diseases by manufacturing accurate Holter blood pressure monitors and developing Holter software solutions since 1990.