Management of Blood Pressure Disorders in Individuals with Spinal Cord Injury
Article Sidebar
Main Article Content
Abstract
Spinal cord injury (SCI) often results in complex autonomic dysfunctions, particularly blood pressure (BP) disorders, due to impaired neural regulation. These include chronic hypotension, orthostatic hypotension (OH), and episodes of autonomic dysreflexia (AD), depending on the level and severity of the injury. This review explores the pathophysiology, clinical implications, diagnostic strategies, and management approaches for BP dysregulation in individuals with SCI. A multidisciplinary approach involving pharmacologic, non-pharmacologic, and rehabilitative strategies is essential to mitigate morbidity and enhance quality of life.
Metrics
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
All open access articles published in the journal are distributed under the terms of the CC-BY-NC-SA 4.0 license (Creative Commons Attribution-Non-commercial-ShareAlike 4.0 International License) which permits unrestricted use, distribution, and reproduction in any medium, for non-commercial purposes, provided the original work is properly cited and distributed under the same license (ShareAlike). Under Creative Commons, authors retain copyright in their articles.
References
McDaid D, Park AL, Gall A, Purcell M, Bacon M. Understanding and modelling the economic impact of spinal cord injuries in the United Kingdom. Spinal Cord. 2019;57(9):778–88.
Wulf MJ, Tom VJ. Consequences of spinal cord injury on the sympathetic nervous system. Front Cell Neurosci. 2023;17:999253.
Nightingale TE, Zheng MMZ, Sachdeva R, Phillips AA, Krassioukov AV. Diverse cognitive impairment after spinal cord injury is associated with orthostatic hypotension symptom burden. Physiol Behav. 2020;213:112742.
Use of droxidopa for BP augmentation after acute SCI. Acute Crit Care. 2021;36(2):217–24.
Lakra C, Swayne O, Christofi G, Desai M. Autonomic dysreflexia in spinal cord injury. Pract Neurol. 2021;21(6):532–8.
Evaluation and management of autonomic functions in patients with SCI. J Spinal Cord Med. 2025 Feb; [Review].
Kulkarni S, Jenkins D, Dhar A, Mir F. Treating lows: management of orthostatic hypotension. J Cardiovasc Pharmacol. 2024;84(3):303–15.
Krassioukov A, Linsenmeyer TA, Beck LA, Elliott S, Grimm DR, Johns JS, et al. Evaluation and management of autonomic dysfunctions after spinal cord injury. J Spinal Cord Med. 2021;44(4):631–83.
Philips AA, Krassioukov AV. Contemporary cardiovascular concerns after spinal cord injury: mechanisms, maladaptations, and management. J Neurotrauma. 2021;38(12):1685–702.
Kulkarni S, Jenkins D, Dhar A, Mir F. Treating lows: management of orthostatic hypotension. J Cardiovasc Pharmacol. 2024;84(3):303–15.
Zheng AC, Fong KT, Kline I, Curtis J, Raj SR. Real-world droxidopa or midodrine persistence in patients with neurogenic orthostatic hypotension. Auton Neurosci. 2020;225:102–9.
OpenHeart Editorial Team. Pyridostigmine in the management of orthostatic hypotension. Open Heart. 2025;12(1):e003106.
Kiser T, Lindberg R, Adeogba S. Management of acute autonomic dysreflexia: spinal cord injury guidelines 2022. UAMS Brain Injury Program. Published July 2022. Available from: https://pva.org
Lakra C, Swayne O, Christofi G, Desai M. Autonomic dysreflexia in spinal cord injury. Pract Neurol. 2021;21(6):532–8.
Krassioukov A, Warburton DE, Teasell R, Eng JJ. Autonomic dysreflexia in spinal cord injury: Clinical practice guidelines for management. Spinal Cord. 2021;59(12):1209–22.
Singh R, Roy S, Ghildiyal A, Verma S. Association of Anthropometry With Nerve Conduction Parameters of Median Nerve: A Cross-Sectional Study in a North Indian Medical University Hospital. Cureus. 2024 Jul 6;16(7):e63946. doi: 10.7759/cureus.63946. PMID: 39105004; PMCID: PMC11299048.
Tiwari R, Singh S, Bajpai M, Verma N, Verma S. Impact of Osteocalcin on Glycemic Regulation and Insulin Sensitivity in Type 2 Diabetes Mellitus Patients. Cureus. 2024 Oct 17;16(10):e71675. doi: 10.7759/cureus.71675. PMID: 39553160; PMCID: PMC11568420.
Tiwari R, Singh N, Singh S, Bajpai M, Verma S. Interplay of Adiponectin With Glycemic and Metabolic Risk Metrics in Patients With Diabetes. Cureus. 2024 Sep 30;16(9):e70543. doi: 10.7759/cureus.70543. PMID: 39479098; PMCID: PMC11524515.
Tiwari R, Verma S, Verma N, Verma D, Narayan J. Correlation of serum uric acid levels with certain anthropometric parameters in prediabetic and drug-naive diabetic subjects. Ann Afr Med. 2024 Jan-Mar;23(1):13-18. doi: 10.4103/aam.aam_40_22. PMID: 38358165; PMCID: PMC10922179.
Verma S, Tiwari R, Verma N, Singh S, Sharma A. Anthropometry and blood biomarkers of diabetes and their possible association with obesity and metabolic syndrome. J Diabetes Metab Disord. 2023 Oct 11;23(1):509-517. doi: 10.1007/s40200-023-01276-4. PMID: 38932840; PMCID: PMC11196461.
Solinsky R, Burns K, Tuthill C, Hamner JW, Taylor JA. Transcutaneous spinal cord stimulation and its impact on cardiovascular autonomic regulation after spinal cord injury. Am J Physiol Heart Circ Physiol. 2024;326(1):H116–22.