Blood pressure systolic

Finally, drug treatment in the elderly is of great importance and warrants special attention with regard to safety and tolerability, since systolic blood pressure is recognized as an important target for treatment, particularly in older persons. The benefits of antihypertensive treatment in the elderly and in patients with isolated systolic hypertension are greater than in younger persons. 

As a result of such studies hypertension has been operationally defined as the blood pressure level above which therapeutic intervention has clinical benefit. As increasingly aggressive intervention has continued to demonstrate benefits, this level has gradually reduced over time and is commonly defined as systolic blood pressure>l40 mmHg and/or diastolic blood pressure >90 mmHg (Table 1). Isolated systolic hypertension is defined as systolic blood pressure >140 mmHg and diastolic blood pressure <90 mmHg. 

Systolic pressure, or maximum blood pressure, occurs during left ventricular systole. Diastolic pressure, or minimum blood pressure, occurs during ventricular diastole. The difference between systolic and diastolic pressure is the pulse pressure. While diastolic blood pressure has been historically been used as the most relevant clinical blood pressure phenotype, it has now been clearly established that systolic blood pressure is the more important clinical predictor for cardiovascular morbidity and mortality. More recently, additional attention is focussed on the importance of pulse pressure, i.e. the blood pressure amplitude, as a predictive factor for cardiovascular disease. 

Headache, nausea, increased heart rate, increase in systolic blood pressure, palpitations, anginal and nonspecific chest pain Nausea, vomiting, ectopic beats, tachycardia, anginal pain, palpitations, hypotension, dyspnea Anxiety, insomnia, tenseness, restlessness, headache, light-headedness, dizziness, nausea, dysuria, pallor... 

Regardless of the actual numerical reading of the blood pressure, a progressive fall of the blood pressure is serious The nurse reports to the primary health care provider any progressive fall of the blood pressure, a fall in systolic blood pressure below 100 mm Hg, or any fall of 20 mm Hg or more of the patient s normal blood pressure. 

ADMINISTERING PROPRANOLOL. Cardiac monitoring is recommended when the drug is given IV because severe bradycardia and hypotension may be seen. The nurse obtains written instructions from the primary health care provider for propranolol administration. For example, tire primary health care provider may want the drug to be withheld for a systolic blood pressure less than 90 mm Hg or a pulse rate less than 50 bpm. 

The nurse takes Hie patient s vital signs before die drug is administered and frequentiy during administration of die antiaiiginals or die calcium channel blockers. If die heart rate is below 50 bpm or die systolic blood pressure is below 90 mm Hg, the drug is widiheld and die primary health care provider notified. A dosage adjusdnent may be necessary. 

Intoxication with amyl nitrite or butyl nitrite (i.e., poppers) is characterized by euphoria, warm feelings, change in perception of time, a sense of fullness in the head, relaxation of smooth muscle, vasodilatation, increased heart rate, and decreased systolic blood pressure. An increase in sexual drive and intensification of orgasm, poor judgment, and a reduction in inhibitions are... 

The antioxidant property of ferulic acid and related compounds from rice bran was reported by Kikuzaki et al, (2002). Their results indicated that these compounds elicit their antioxidant function through radical scavenging activity and their affinity with lipid substrates. Another recent study reported by Butterfield et al, (2002) demonstrated that ferulic acid offers antioxidant protection against hydroxyl and peroxyl radical oxidation in synaptosomal and neuronal cell culture systems in vitro. The effect of ferulic acid on blood pressure (BP) was investigated in spontaneously hypertensive rats (SHR). After oral administration of ferulic acid the systolic blood pressure (SBP) decreased in a dose-dependent manner. There was a significant correlation between plasma ferulic acid and changes in the SBP of the tail artery, suggesting... 

Bradycardia (heart rate <60 bpm), systolic blood pressure <100 mmHg, severe left ventricular dysfunction with pulmonary edema, second- or third-degree heart block, PR interval >0.24 s, evidence of hypoperfusion, active asthma... 

If presenting systolic blood pressure (SBP) is <90 mmHg or >30 mmHg below baseline MAP... 

Antihypertensive agents should be avoided unless the systolic blood pressure is >220 mmHg or the diastolic blood pressure is >120 mmHg (see Table 3.2 for management)... 

Systolic blood pressure (SBP) <220 mmHg or diastolic blood pressure (DBP) <120 mmHg... 

Monitor blood pressure every 15 min for the first 2 h, every 30 min for the next 6 h, and then every hour until 24 h after treatment. Increase frequency of monitoring if systolic blood pressure >180 mmHg or diastolic >105 mmHg... 

Systolic blood pressure (SBP) <90 mmHg or a mean arterial pressure (MAP) <60 mmHg for >1 h or hypotension requiring vasopressor pharmacotherapy... 

BP, blood pressure CCB, calcium channel blocker agent DBP, diastolic blood pressure SBP, systolic blood pressure. (Adapted from JNC 7 Modified from Saseen JJ, Carter BL. Hypertension. In DiPiro JT, Talbert RL, Yee GC, et al, (eds.) Pharmacotherapy A Pathophysiologic Approach. 6th ed. New York McGraw-Hill 2005 194, with permission.)... 

Elevated peripheral arterial resistance is a hallmark of primary hypertension. The increase in peripheral resistance typically observed may be due to a reduction in the arterial lumen size as a result of vascular remodeling. This remodeling, or change in vascular tone, may be modulated by various endothelium-derived vasoactive substances, growth factors, and cytokines. This increase in arterial stiffness or reduced compliance results in the observed increase in systolic blood pressure.9... 

To reduce deviations in blood pressure measurement in the clinic, the patient and clinician should not talk during blood pressure readings. The measurement arm is supported and positioned at heart level with the blood pressure cuff encircling at least 80% of arm circumference. If a mercury or aneroid device is used, then the palpatory method must be used first to estimate the systolic blood pressure.18 If an automated device is used, this is not necessary. After the patient s cuff is inflated above the systolic pressure, the mercury column should drop at a rate of 2 to 3 mm per second. A stethoscope placed over the brachial artery in the antecubital fossa identifies the first and last audible Korotkoff sounds, which should be taken as systolic and diastolic pressure, respectively. A minimum of two readings at least 1 minute apart are then averaged. If measurements... 

Apart from possible clinical differences between the P-block-ers approved for HF, selection of a p-blocker may also be affected by pharmacologic differences. Carvedilol exhibits a more pronounced blood pressure lowering effect and thus causes more frequent dizziness and hypotension as a consequence of its ar receptor blocking activity. Therefore, in patients predisposed to symptomatic hypotension, such as those with advanced LV dysfunction (LVEF less than 20%) who normally exhibit low systolic blood pressures, metoprolol succinate may be the most desirable first-line P-blocker. In patients with uncontrolled hypertension, carvedilol may provide additional antihypertensive efficacy. 

Dopamine is most commonly reserved for patients with low systolic blood pressures and those approaching cardiogenic shock. It may also be used in low doses (less than 3 mcg/kg per minute) to improve renal function in a patient with inadequate urine output despite high filling pressures and volume overload, although this indication is controversial. 

Dosing recommendations for milrinone include a loading dose of 50 mcg/kg, followed by an infusion beginning at 0.5 mcg/kg per minute (range 0.23 mcg/kg per minute for patients with renal failure up to 0.75 mcg/kg per minute). A loading dose is not necessary if immediate hemodynamic effects are not required or if patients have low systolic blood pressures (less than 90 mm Hg). Decreases in blood pressure during an infusion may necessitate dose reductions as well. 

Factors that predispose an individual to IHD are listed in Table 4—2. Hypertension, diabetes, dyslipidemia, and cigarette smoking are associated with endothelial dysfunction and potentiate atherosclerosis of the coronary arteries. The risk for IHD increases two-fold for every 20 mm Hg increment in systolic blood pressure and up to eight-fold in the presence of diabetes.5,6 Physical inactivity and obesity independently increase the risk for IHD, in addition to predisposing individuals to other cardiovascular risk factors (e.g., hypertension, dyslipidemia, and diabetes). 

CCS graduated compression stockings SBP systolic blood pressure... 

CHD, coronary heart disease DBP, diastolic blood pressure HDL, high-density lipoprotein SBP, systolic blood pressure. 

Major treatment goals in hypovolemic shock following fluid resuscitation are as follows arterial systolic blood pressure greater than 90 mm Hg within 1 hour, organ dysfunction reversal, and normalization of laboratory measurements as rapidly as possible (less than 24 hours). 

---