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Functional tests in the diagnosis

In the basis of differential diagnostics of changes in blood pressure first of all are carefully assembled history and a full clinical examination. However, a significant addition to this could be the use of specific functional tests. Considering that the basis of Hyper - and hypotensive States is a violation of the functional state of vasomotor centers, in both cases, can be used similar samples. The essence of the study of the functional state of the device that regulates blood pressure, is to define its response to certain physiological processes (sample with the definition of a residual pressure) and on a number of artificial stimuli (water from +1 C to +4 C With a cold the sample and the increased content of carbon dioxidein the blood during the test breath).
The term "residual pressure" suggested L. Gallavadin (1920).
It is well known that the level of blood pressure in healthy people unstable and fluctuates throughout the day depending on various factors. These fluctuations do not exceed 10 mm RT. Art. with regard to persons with increased excitability vasomotor centers, they have these fluctuations much more and are less stable. This gave grounds to call once a blood pressure measurement "random". It consists of a residual, i.e. stable blood pressure and extension, varying depending on various situations. Residual pressure can be determined at any time of the day, after 15-20 minutes of rest. For the subject of this offer to go, at this point include a stopwatch to measure blood pressure. Then it is measured at the end of every 3 minutes for 30 minutes the lowest pressure, obtained by repeating the measurement is called the residual. The difference between random and residual called incremental blood pressure. The term "principal" ("basal") blood pressure refers to the same residual pressure, but measured in terms of basic currency.
Based on the re-measurement of basal and accidental pressure in healthy individuals Smir R. (1944) and J. Kilpatrik (1948) concluded that basal pressure is physiological constant for each person and represents the extent to which decreases blood pressure during sleep, in the absence of endogenous or exogenous irritants. In healthy people with normal blood pressure at measurement of the residual pressure reducing incidental to the level of residual occurs within 6-9 minutes (if it was measured every 3 min) or within 5 to 10 minutes (if measured every 5 min)with the largest reduction for both systolic and diastolic, in the opinion of the majority of authors, does not exceed 5 - 10 mm RT. Art. the Time required to achieve the levels residual pressure, the athlete with increased reactivity less than patient with essential hypertension. The amount of the additional pressure determines the level of excitability of nervous system, regulates blood pressure. The more marked degree of anxiety, the greater the amount of the additional pressure. In healthy individuals with good resistance vasomotor centers no decline in blood pressure for 30 minutes studies does not occur, and then random and incremental pressure equal. Usually, until the subject is lying, residual pressure is kept steady." Any changes during measurement reveal a violation of the functions of vasomotor centers. The study residual pressure helps to distinguish hypertensive reaction from steadfastly high blood pressure and to determine the extent of this reaction.