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Extra info for Blood Pressure - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References
Local reflexes including myogenic, metabolic and veno-arteriolar will be sorted out through use of supine testing designed to specifically stimulate a specific reflex (limb hang, large pressure step and reactive hyperemia) and measuring peripheral resistance. 3) Cardiac autonomic findings are secondary to circulatory changes. Thus, tachycardia relates to vagal withdrawal because of circulatory insufficiency. CFS patients will be treated with midodrine or placebo in a cross-over study. Using supine and low angle tilt experiments, circulatory measurements and psychological instruments will be combined to demonstrate that circulatory abnormalities, autonomic abnormalities and symptoms correct in a subgroup of CFS patients with low resting peripheral resistance.
This proposal will combine novel measurement of oscillations in cerebral blood flow with advanced signal processing techniques to quantify the relationship among oscillations of heart rate, oscillations of blood pressure, and oscillations of cerebral blood flow. By representing heart rate, blood pressure, and cerebrovascular blood flow as dynamic quantities, if may be possible to model their 24 Blood Pressure relation to each other in a more useful way. This approach may provide the necessary and thus far unavailable foundation for an effective neuroprotective clinical strategy.
It would be advantageous, therefore, to develop a human model where the increase in blood pressure produced by systemic NOS inhibition reflects selective endothelial NO inhibition, unrestrained by baroreflex buffering. Patients with pure autonomic failure represent such a human model. Similarly, we can induce transient autonomic failure by blocking neurotransmission at the level of autonomic ganglia with trimethaphan. We propose to use these models to test the hypothesis that endothelial nitric oxide is an important modulator of blood pressure under normal conditions, and that its impairment contributes to hypertension.