Association between blood pressure instability and health-related quality of life in people with spinal cord injury.

STUDY

DESIGN

Observational cohort

OBJECTIVE

The Blood Pressure Dysregulation (BPD) Measurement System (BPD-MS) was developed to assess the impact of BPD on health-related quality of life (HRQoL) and activities of daily living (ADL) in individuals with SCI. Association between BPD-MS scores and blood pressure (BP) measurements has not been reported.

SETTING

Academic Medical Center and Department of Veterans Affairs Medical Center

METHODS

Sixty-five participants were enrolled, five had missing data and were not included in analyses. Data are reported in 60 participants with SCI at or above T6. Outcomes include 7-day home BP monitoring with end-of-day (EOD) BPD-MS t-scores on three BPD-MS surveys: (1) Low BP (LBP) HRQoL (LBP-HRQoL), (2) Autonomic Dysreflexia HRQoL (AD-HRQoL), and (3) impact of LBP on ADL (LBP-ADL). Higher scores on these surveys indicate more BPD-related health concerns. Between-person and within-person associations between BPD-MS scores and the average (Avg) and standard deviations (Std) for systolic BP (SBP) and diastolic BP (DBP) are reported.

RESULTS

Weekly Avg SBP and DBP were not associated with scores on any of the BPD-MS surveys. Weekly Std SBP and Std DBP were significantly associated with between-subject LBP-HRQoL and LBP-ADL scores (all p ≤ 0.02). Associations between Std SBP and Std DBP with scores on the AD-HRQoL were not significant.

CONCLUSION

Significant between-person effects suggest that individuals with more/less BP instability (Std) had greater/less negative impact on HRQoL and ADL. The findings indicate that the BPD-MS can be used to screen individuals who are more likely to be experiencing adverse health consequences of low BP instability.