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Thread: Blood pressure...

  1. #1

    Blood pressure...

    What can be a "normal" blood pressure for a quadriplegic?

    For years, it seemed my usual was about 90/60, occasionally lower, occasionally higher.

    But yesterday, my doctor took it several times and it was 60s/40s while I was a little dizzy, but I attributed that to being tilted back for a good while and not adjusting quickly when upright again. Later, when I wasn't dizzy, I asked if he'd check it again and it was 70/45 (upright).

    My doctor said if I was able-bodied, he would've thought I was anemic (I think that's what he said) but considering my quadriplegia, he wondered if it was an autonomic issue. He checked around my eyes, my hands (fingers?) and said I was pink, indicating I have enough blood, but still, I thought my BP was a bit low.

    I'm wondering if it's cause for concern, or what can be "normal" for quads?

    Thanks.
    Wheelchair users -- even high-level quads... WANNA BOWL?

    I'm a C1-2 with a legit 255 high bowling game.

  2. #2
    Junior Member Ambisinister's Avatar
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    I'm pretty close to your norm most of the time, but I'd say my norm is 100/65. But it's not uncommon for me to be in the 80/50 range.

  3. #3
    Bill, those are a little lower than most people with tetraplegia run, but if you are perfusing, and not fainting or being confused at those blood pressures, they are OK. Do you take Midodrine or any other meds for orthostatic hypotension??

    (KLD)

  4. #4
    Your pressure is similar to mine and it has kept me going for 57+ years. Don't worry about it. The biggest problem is convincing nurses that their reading is correct after they have tried 3-4 different blood pressure cuffs. Lol Mine usually hits the low end after my bowel program, when I am too warm, dehydrated, and after meals.
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  5. #5
    KLD, by "perfusing" do you mean, in layman's terms, having adequate circulation? Can you determine adequate "perfusing" on your own or do you need a medical examination to determine adequate "perfusing"?

    I am C6/7 complete and have OH (Orthostatic Hypotension) which is low blood pressure caused by position or posture. The blood pressure is adequate when I am lying down, but drops significantly enough to cause dizziness, breathlessness and a general feeling of unease when I am sitting up. I take Midodrine during the day and am careful to time the last dose of the day to get me through a bowel program, sitting on a commode chair at night, but have the drug wearing off before I lie down so I don't have a dangerous spike in blood pressure. It is a delicate balance. I have tried drinking large quantities of water before getting up and slowly elevating my bed from lying down to sitting up before I transfer, but these techniques have not been effective for me. I do wear an abdominal binder or support. Compression stockings have not worked for me either.

    One of the most simple explanations I have read for Orthostatic Hypotension in spinal cord injury is:
    Postural hypotension after a SCI occurs since the blood vessels do not decrease in size, in response to lowered blood pressure, due to the altered function of the autonomic nervous system. Because of this, blood pools in the pelvic region or legs while you are sitting. Postural hypotension usually occurs when you are initially placed in your wheelchair or on the tilt table.

    I also have post prandial hypotension, which is a drop in blood pressure after eating.

    All the best,
    GJ

  6. #6
    Actually, blood pooling is not a real significant problem. The low blood pressure in SCI is due to lack of peripheral resistance in the legs and abdomen arteries. Normally, when a person sits or stands up, their brain sends a message down their spinal cord (through sympathetic pathways) to cause constriction of the arteries in the legs and abdomen. If a SCI interrupts this pathway, the messages cannot get through. Increased peripheral resistance maintains a sufficient blood pressure to keep blood flowing to your brain. This comes off the cord between about T6 and T12, so those with lesions above this have the worst problems with this.

    While not being dehydrated is important, fluids alone will not correct this in someone with SCI. Sometimes this is done by paramedics at the scene of an accident when the person has a SCI, since this is what would be done for hypovolemic (low blood volumn) shock and hypotension. In someone with SCI, they can fill you up with IV fluids, and your blood pressure will generally not come up as a result (due to the lack of peripheral resistance). Instead, the person can be fluid overloaded. I have seen people with acute SCI put into serious pulmonary edema like this.

    Poor perfusion (blood circulation in the small capillaries) can be detected by such symptoms as confusing or even loss of consciousness, blue lips and areas around the mouth, blue fingertips or nail beds, and lack of a quick blanche/blood refill when fingers or nails are pinched. Lack of urine production can also occur. These are how this would be initially assessed by a physician or nurse.

    (KLD)

  7. #7
    Senior Member alan's Avatar
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    I've been at 65/45 on occasion, and felt fine. Shocked the heck out of the medical professional who took it those times. "How are you conscious and having a conversation with me?"

    I'm usually around 90/60 or lower when sitting upright, little higher when tilted (I now tilt for BP at doctor visits or visiting nurse visits.) Close to 120/80 in bed.
    Alan

    Proofread carefully to see if you any words out.

  8. #8
    Thank you all for the replies.

    I've never heard of BP dropping after eating, but that could be part of it. I typically sleep during the day and had to get up "early" for the afternoon appointment, so I brought & ate breakfast at my doctor's office while waiting.

    KLD, I don't take any BP medication, and I wasn't confused even when I was a little dizzy (I was able to keep talking appropriately with my doctor; the dizziness "side effect" for me is my vision gets a bit splotchy). My body typically tolerates sitting up in my chair well, and also doing a tilt table well. But I hadn't really ever heard my nurse or doctor telling me that my BP was close to 60/40 before. It got my attention.

    But, before going to sleep this morning, my BP was 102/65. That could be mild dysreflexia for me.

    Anyway, my previous BP cuff died, so I'll get a new one so we can monitor it better and determine what seems to be normal for me.

    Thanks.
    Wheelchair users -- even high-level quads... WANNA BOWL?

    I'm a C1-2 with a legit 255 high bowling game.

  9. #9
    Quote Originally Posted by BillMiller823 View Post
    Thank you all for the replies.
    But, before going to sleep this morning, my BP was 102/65. That could be mild dysreflexia for me.
    Keep in mind when you are lying down (getting ready for sleep) your blood pressure goes up.

    All the best,
    GJ

  10. #10
    Quote Originally Posted by alan View Post
    I've been at 65/45 on occasion, and felt fine. Shocked the heck out of the medical professional who took it those times. "How are you conscious and having a conversation with me?"

    I'm usually around 90/60 or lower when sitting upright, little higher when tilted (I now tilt for BP at doctor visits or visiting nurse visits.) Close to 120/80 in bed.
    Alan, that sounds quite a bit like me, except I probably don't get as high a reading in bed.

    The first time I did a tilt table session, the therapist kept taking my BP at each level with an automatic cuff. There were actually two people working together, and you can imagine the looks on their faces when they couldn't get a BP reading of any kind, even though my color was good and I was talking coherently with them.

    Thanks.
    Wheelchair users -- even high-level quads... WANNA BOWL?

    I'm a C1-2 with a legit 255 high bowling game.

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