Sympathetic Neural Mechanisms Underlying Attended and Unattended Blood Pressure Measurement

Abstract

[Figure: see text].

Keywords: blood pressure; heart rate; hypertension; muscle; sympathetic nervous system.

Figure 1.

Schematic drawing of the study design. The sequence of unattended/attended session was variable between patients. BP indicates blood pressure; MSNA, muscle sympathetic nerve traffic; and SSNA, skin sympathetic nerve traffic.

Figure 2.

Beat-to-beat finger systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) values recorded before and during unattended (dashed lines, open circles) and attended (continuous lines, closed circles) automatic blood pressure measurement session. Left parts refer to the session during which muscle sympathetic nerve traffic was recorded during the unattended and attended BP measurement, whereas the right ones to the session during which skin sympathetic nerve traffic was recorded during unattended or attended BP measurement. The arrows indicate the time in each session during which automated BP measurement started in presence or absence of the doctor. Data are shown as means±SEM. Asterisks (*P<0.04, **P<0.01) refer to the level of statistical significance between values obtained during unattended or attended BP measurement and baseline values.

Figure 3.

Muscle sympathetic nerve traffic (MSNA), expressed as bursts frequency over time (bursts/min) and skin sympathetic nerve traffic (SSNA), expressed as bursts frequency over time (bursts/min), recorded before and during the unattended (dashed lines, open circles) and attended (continuous lines, closed circles) automatic blood pressure measurement session. The arrows indicate the time in each session during which automated BP measurement started in presence or in absence of the doctor. Data are shown as means±SEM. Asterisks (*P<0.04, **P<0.01) refer to the level of statistical significance between values obtained during unattended or attended BP measurement and baseline values.