Aging steepens the slope of power spectrum density of 30-minute continuous blood pressure recording in healthy human subjects

Neurodegenerative diseases and blood pressure variability: A comprehensive review from HOPE Asia

Asia has an enormous number of older people and is the primary contributor to the rise in neurodegenerative diseases such as Alzheimer's and Parkinson's disease. The therapy of many neurodegenerative diseases has not yet progressed to the point where it is possible to alter the course of the disease. Mid-life hypertension is an important predictor of later-life cognitive impairment and brain neurodegenerative conditions. These findings highlight the pivotal role of preventing and managing hypertension as a risk factor for neurodegenerative disease. Autonomic dysfunction, neuropsychiatric and sleep disturbances can arise in neurodegenerative diseases, resulting in blood pressure variability (BPV). The BPV itself can worsen the progression of the disease. In older people with neurodegenerative disease and hypertension, it is critical to consider 24-h blood pressure monitoring and personalized blood pressure therapy.

Very short-term beat-by-beat blood pressure variability in the supine position at rest correlates well with the nocturnal blood pressure variability assessed by ambulatory blood pressure monitoring

Blood pressure variability (BPV) is an important indicator in risk stratification for hypertension. Among the daily BPVs assessed using a 24-h ambulatory blood pressure (BP) monitor nocturnal systolic BPV has been suggested to predict cardiovascular risks. We hypothesized that very short-term BPV at rest would correlate with nocturnal BPV because of the shared autonomic BP regulatory system under no daily exertion. Thirty untreated normotensive and hypertensive adults underwent 30-min continuous beat-by-beat BP recordings in the supine position, followed by 24-h ambulatory blood pressure monitoring (ABPM). The relationship between very short-term BPV (standard deviation (SD), coefficient of variation (CV)) and daytime and nocturnal BPV (SD, CV, average real variability (ARV), and standardized ARV (CV-ARV)) was assessed with Pearson's correlation coefficients. Very short-term BPV correlated significantly with nocturnal BPV (ARV, r = 0.604, p < 0.001) but not with daytime BPV. These trends were more pronounced with the increasing data length of continuous beat-by-beat BP recording. Using a data segment from the last 10 min of a 30-min continuous beat-by-beat BP recording resulted in a stronger correlation between very short-term BPV and nocturnal BPV than using earlier segments. The findings of this study suggest that very short-term BPV in the supine position at rest may predict nocturnal BPV. Since the burden of ABPM for patients has hindered clinical dissemination, very short-term BPV has the potential to develop a novel index of BPV.

Closed-Loop Identification of Baroreflex Properties in the Frequency Domain

The arterial baroreflex system plays a key role in maintaining the homeostasis of arterial pressure (AP). Changes in AP affect autonomic nervous activities through the baroreflex neural arc, whereas changes in the autonomic nervous activities, in turn, alter AP through the baroreflex peripheral arc. This closed-loop negative feedback operation makes it difficult to identify open-loop dynamic characteristics of the neural and peripheral arcs. Regarding sympathetic AP controls, we examined the applicability of a nonparametric frequency-domain closed-loop identification method to the carotid sinus baroreflex system in anesthetized rabbits. This article compares the results of an open-loop analysis applied to open-loop data, an open-loop analysis erroneously applied to closed-loop data, and a closed-loop analysis applied to closed-loop data. To facilitate the understanding of the analytical method, sample data files and sample analytical codes were provided. In the closed-loop identification, properties of the unknown central noise that modulated the sympathetic nerve activity and the unknown peripheral noise that fluctuated AP affected the accuracy of the estimation results. A priori knowledge about the open-loop dynamic characteristics of the arterial baroreflex system may be used to advance the assessment of baroreflex function under closed-loop conditions in the future.