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Management of blood pressure disorders in individuals with spinal cord injury

Institution:	1. James J Peters VA Medical Center, Department of Research & Development, USA;2. Icahn School of Medicine Mount Sinai, Departments of Rehabilitation and Human Performance, and Medicine, USA;1. Unité Récepteurs-Canaux, Institut Pasteur, UMR 3571, CNRS, 75015, Paris, France;2. CNM Team, Université de Strasbourg, Centre National de La Recherche Scientifique, CAMB UMR 7199, Faculté de Pharmacie, 67401, Illkirch, France;3. University of Strasbourg Institute for Advanced Studies (USIAS), 67000, Strasbourg, France;1. Department of Endocrinology and Metabolism, Shenzhen People''s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China;2. Library of Department of Scientific Research, Shenzhen People''s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China;1. Laboratorio de Evolución Experimental de Virus, Institut Pasteur, Montevideo, Uruguay;2. Laboratorio de Virología Molecular, Centro de Investigaciones Nucleares, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay;1. Department of Neurological Surgery, The University of Miami Miller School of Medicine, Miami, FL 33136, USA;2. Department of Physical Medicine & Rehabilitation, The University of Miami Miller School of Medicine, Miami, FL 33136, USA;3. Department of Physical Therapy, The University of Miami Miller School of Medicine, Miami, FL 33136, USA;4. The Miami Project to Cure Paralysis, The University of Miami Miller School of Medicine, Miami, FL 33136, USA

Abstract:	Blood pressure regulation is impacted by a spinal cord injury (SCI) due to impaired descending sympathetic vascular control. Common blood pressure problems in the SCI population include persistently low blood pressure with bouts of orthostatic hypotension and autonomic dysreflexia, which are more prevalent in individuals with lesions above the sixth thoracic vertebral level; however, they may occur regardless of the neurological level of injury. Although blood pressure disorders adversely impact daily function and quality of life, most individuals with SCI do not acknowledge this association. Few pharmacological options have been rigorously tested for safety and efficacy to manage blood pressure disorders in the SCI population. Furthermore, clinical management of any one blood pressure disorder may adversely impact others, as such treatment is complicated and not often prioritized.

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