• for: sleep apnea - blood pressure comparison, dipping vs nondipping

• interesting fact: sleep apnea

  • dipping and non-dipping
  • normal person relaxes blood pressure at night (dipping)
  • sleep apnea patient has elevated blood pressure at night (non-dipping)

• for: Progress trap - mouthwash, mouthwash - blood pressure

DuPont, C. M., Pressman, S., Reed, R. G., Marsland, A., Manuck, S. N., & Gianaros, P. J. (2021). An Online Trier Social Stress Paradigm to Evoke Affective and Cardiovascular Responses [Preprint]. PsyArXiv. https://doi.org/10.31234/osf.io/fcyqd

That's not a large enough sample to draw conclusions out subtypes. Interesting nonetheless.

Blood Thinners, Blood Pressure Meds May Improve COVID-19 Survival Rate. (2020, August 27). Healthline. https://www.healthline.com/health-news/blood-thinners-blood-pressure-meds-may-improve-covid-19-survival-rate

Liothyronine does not raise blood pressure despite the rise in heart rate. The reason that respiratory rate (RR) was not changed may be because the increased cardiac output compensates for the increased oxygen demand.

This is a great recommendation.

This is precisely the results I would expect. However, I completely disagree with their interpretation.

People with high blood pressure (BP) can tolerate a reduction in BP without instigating compensatory mechanisms. People with normal or low BP would invoke compensation by the sympathetic nervous system in response to alpha blockade. This would counteract the depressant effects of adrenergic antagonism. Indeed, adrenaline and noradrenaline elevate in response to standing, which I find to be an obvious prediction. Thus, the lack of benefit from prazosin in these subjects may be mediated by an increase in adrenergic receptor activation other than the apha1-adrenoreceptor; in particular, the beta-adrenergic receptors are likely at fault. Propranolol, a beta-blocker, is used for PTSD, so this mechanism seems well substantiated.

The study apparently found benefit for patients with BP over 110 (with more benefit for higher BP). Thus, I would conclude that systolic pressure below 110 induce compensation.

Post-exercise, diastolic pressure is higher than baseline; compression garments exaggerate this effect

Thus, compression garments may prevent circumstantial hypotension. In this case, one possibility is that the compression is delivering blood to the heart that would otherwise be shunted to the skin for heat dissipation.

These trained athletes have a BP of about 100/60 at rest. This is substantially lower than the roughly 120/80 BP that I've seen elsewhere. This likely limits the drop in BP seen post-exercise.

This is important because it implies that syncope or incomplete syncope as a result of vasodilators may not be dependent on actual blood pressure. It means that it is theoretically possible that vasodilators will acutely increase blood flow despite a drop in BP, depending on the body's level of compensation via increased cardiac output.

Alternatively, it could have been nocturnal hypotension that was causing the sleep disruption.

While the title of this report does not really imply anything to contradict the results of the testing of the theory, the content of the report itself leaves room for interpretation as to what these results mean and who it applies to. The main study referenced conducted by the University of Rome (Loffredo) does show that the participants who were given dark chocolate showed a higher acute result than those who were given milk chocolate, their study was made up of a small group of 20. It could also be pointed out that they did not establish a portion of their group who were tested without the ingestion of chocolate to establish a better baseline for their results. Participants endurance on a treadmill was used to measure the effects of the chocolate, but there is no indication of how or if the participants increase in ambulatory movement, or having “warmed up” with their baseline test day may have contributed to the improved results after the chocolate was administered. Another point to note is where the author mentions a previous report she submitted (Aubrey) covering the similarity of the results of the chocolate study to a study on the affects of meditation on the body. While the result may be considered similar, the way the results were achieved were very different. The wording in the studies referenced for the benefits of meditation reflect a psychological improvement as a means for a physical response, while the chocolate experiment was testing a chemical application for a physiological response. This article, although not wrong or misrepresenting the study, simplifies much of the work and applies it to the general public. The author does manage to address that the study is incomplete, as an afterthought and could easily be interpreted as having less weight than the argument for chocolate treatment by simply being under represented or under explained. Further investigation is definitely needed to understand the “how and why” of the affects of chocolate/polyphenols on our bodies before we can set any sort of prescription in place. The study would need to be much more comprehensive or added to others that test this same result on other demographics to determine if the affects can be replicated on everyone, or to narrow down if they only get this result with those who have PAD.

Aubrey, A. (2008, August 21). To Lower Blood Pressure, Open Up And Say 'Om'. Retrieved November 09, 2017, from https://www.npr.org/2008/08/21/93796200/to-lower-blood-pressure-open-up-and-say-om MPH, M. G. (2014, March 01). Meditation for Psychological Stress and Well-being. Retrieved November 09, 2017, from https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1809754 Loffredo, L., Perri, L., Catasca, E., Pignatelli, P., Brancorsini, M., Nocella, C., . . . Violi, F. (2014, August 21). Dark Chocolate Acutely Improves Walking Autonomy in Patients With Peripheral Artery Disease. Retrieved November 09, 2017, from http://jaha.ahajournals.org/content/3/4/e001072

The question becomes, then, do beta blockers impair sleep when exogenous melatonin is administered concurrently?

We have found different results in the research that we have done.