Background: Cardiovascular measures in children with spinal cord injury (SCI) may vary depending on the child’s age and physical development in addition to injury-related factors. Developmental changes should be considered when addressing cardiovascular complications in this population. Objectives: To determine baseline blood pressure (BP) and heart rate (HR) measurements in youth with SCI, and to investigate differences in BP and HR in relation to age, gender, body mass index (BMI), and injury-related factors. Methods: Retrospective chart review was conducted for youth under 19 years who had been admitted for rehabilitation at 1 of 2 pediatric SCI programs. Systolic (SBP) and diastolic (DBP) blood pressures and HR were collected in the morning and afternoon on 3 consecutive days. Mean SBP, DBP, and HR were compared among 4 age groups (0-5 years, 6-12 years, 13-15 years, and 16-18 years) and by gender. Diurnal variations were determined according to level and severity of injury. Associations with BMI and injury-related factors were examined. Charts of 315 youths were reviewed: mean age was 12.3 years, 59% were male, 75% were Caucasian, 62% had complete injury, and 66% had paraplegia. Results: With increasing age, SBP and DBP increased and HR decreased. SBP and DBP were positively correlated with BMI. SBP was higher in males, those with incomplete injury, and those with paraplegia. HR was higher in females. There was no association between cardiovascular measures and injury duration. Conclusion: BP and HR are a function of age, BMI, and completeness and level of injury in youth with SCI. Awareness of baseline measures will allow for more effective management of cardiovascular complications, especially in youth presenting with atypical symptoms.

Teasell RW, Arnold MA, Krassioukov A, Delaney GA. Cardiovascular consequences of loss of supraspinal control of the sympathetic nervous system. Arch Phys Med Rehabil. 2000;81(4): 506–516.
,
Cardiovascular consequences of loss of supraspinal control of the sympathetic nervous system
,
Arch Phys Med Rehabil.
, vol.
81
(pg.
506
-
516
)
Mathias CJ. Orthostatic hypotension and paroxysmal hypertension in humans with high spinal cord injury. Prog Brain Res. 2006;152: 231–243.
,
Orthostatic hypotension and paroxysmal hypertension in humans with high spinal cord injury
,
Prog Brain Res.
, vol.
152
(pg.
231
-
243
)
Garstang SV, Miller-Smith SA. Autonomic nervous system dysfunction after spinal cord injury. Phys Med Rehabil Clin N Am. 2007;18(2): 275–296.
,
Autonomic nervous system dysfunction after spinal cord injury
,
Phys Med Rehabil Clin N Am.
, vol.
18
(pg.
275
-
296
)
Krassioukov A. Autonomic function following cervical spinal cord injury. Respir Physiol Neurobiol. 2009;169(2):157–164.
,
Autonomic function following cervical spinal cord injury
,
Respir Physiol Neurobiol.
, vol.
169
(pg.
157
-
164
)
Krassioukov A, Claydon VE. The clinical problem in cardiovascular control following spinal cord injury: an overview. Prog Brain Res. 2006;152:223–229.
,
The clinical problem in cardiovascular control following spinal cord injury: an overview
,
Prog Brain Res.
, vol.
152
(pg.
223
-
229
)
Nitsche B, Perschak H, Curt A, Dietz V. Loss of circadian blood pressure variability in complete tetraplegia. J Hum Hypertens. 1996;10(5):311–317.
,
Loss of circadian blood pressure variability in complete tetraplegia
,
J Hum Hypertens.
, vol.
10
(pg.
311
-
317
)
Furlan JC, Fehlings MG, Shannon P, Norenberg MD, Krassioukov AV. Descending vasomotor pathways in humans: correlation between axonal preservation and cardiovascular dysfunction after spinal cord injury. J Neurotrauma. 2003;20(12):1351–1363.
,
Descending vasomotor pathways in humans: correlation between axonal preservation and cardiovascular dysfunction after spinal cord injury
,
J Neurotrauma.
, vol.
20
(pg.
1351
-
1363
)
Howlin F, Brenner M. Cardiovascular assessment in children: assessing pulse and blood pressure. Paediatr Nurs. 2010;22(1):25–35.
,
Cardiovascular assessment in children: assessing pulse and blood pressure
,
Paediatr Nurs.
, vol.
22
(pg.
25
-
35
)
Gerber LM, Stern PM. Relationship of body size and body mass to blood pressure: sex-specific and developmental influences. Hum Biol. 1999;71(1):505–528.
,
Relationship of body size and body mass to blood pressure: sex-specific and developmental influences
,
Hum Biol.
, vol.
71
(pg.
505
-
528
)
National High Blood Pressure education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2):555–576.
,
The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents
,
Pediatrics.
, vol.
114
(pg.
555
-
576
)
Olle MM, Pivarnik JM, Klish WJ, Morrow JR. Body composition of sedentary and physically active spinal cord injured individuals estimated from total body electrical conductivity. Arch Phys Med Rehabil. 1993;74(7):706–710.
,
Body composition of sedentary and physically active spinal cord injured individuals estimated from total body electrical conductivity
,
Arch Phys Med Rehabil.
, vol.
74
(pg.
706
-
710
)
Kocina P. Body composition of spinal cord injured adults. Sports Med. 1997;23(1):48–60.
,
Body composition of spinal cord injured adults
,
Sports Med.
, vol.
23
(pg.
48
-
60
)
Andersson KE, Campeau L, Olshansky B. Cardiac effects of muscarinic receptor antagonists used for voiding dysfunction. Br J Clin Pharmacol. 2011;72(2):186–196.
,
Cardiac effects of muscarinic receptor antagonists used for voiding dysfunction
,
Br J Clin Pharmacol.
, vol.
72
(pg.
186
-
196
)
Li DP, Pan HL. Role of GABAB receptors in autonomic control of systemic blood pressure. Adv Pharmacol. 2010;58:257–286.
,
Role of GABAB receptors in autonomic control of systemic blood pressure
,
Adv Pharmacol.
, vol.
58
(pg.
257
-
286
)
Friedewald VE, Ram CV, Wesson DE, White WB, Williams GW, Roberts WC. Effect of nonsteroidal antiinflammatory drugs on blood pressure: the editor’s round table. Am J Cardiol. 2010;105(12):1759–1767.
,
Effect of nonsteroidal antiinflammatory drugs on blood pressure: the editor’s round table
,
Am J Cardiol.
, vol.
105
(pg.
1759
-
1767
)
Consortium for Spinal Cord Medicine. Acute management of autonomic dysreflexia: individuals with spinal cord injury presenting to health-care facilities. J Spinal Cord Med. 2002;25(suppl 1):S67–88.
,
Acute management of autonomic dysreflexia: individuals with spinal cord injury presenting to health-care facilities
,
J Spinal Cord Med.
, vol.
25
(pg.
S67
-
88
)
Hickey KJ, Vogel LC, Willis KM, Anderson CJ. Prevalence and etiology of autonomic dysreflexia among youth with spinal cord injury. J Spinal Cord Med. 2004;27(suppl 1):S54–60.
,
Anderson CJ. Prevalence and etiology of autonomic dysreflexia among youth with spinal cord injury
,
J Spinal Cord Med.
, vol.
27
(pg.
S54
-
60
)
Schottler J, Vogel LC, Chafetz R, Mulcahey MJ. Patient and caregiver knowledge of autonomic dysreflexia among youth with spinal cord injury. Spinal Cord. 2009;47(9):681–686.
,
Patient and caregiver knowledge of autonomic dysreflexia among youth with spinal cord injury
,
Spinal Cord.
, vol.
47
(pg.
681
-
686
)
McGinnis KB, Vogel LC, McDonald CM, et al.; Shriners Hospitals for Children Task Force on Autonomic Dysreflexia in Children with Spinal Cord Injury. Recognition and management of autonomic dysreflexia in pediatric spinal cord injury. J Spinal Cord Med. 2004;27(suppl 1):S61–74.
,
Shriners Hospitals for Children Task Force on Autonomic Dysreflexia in Children with Spinal Cord Injury. Recognition and management of autonomic dysreflexia in pediatric spinal cord injury
,
J Spinal Cord Med.
, vol.
27
(pg.
S61
-
74
)
Burns S, Biering-Sorensen F, Donovan W, et al. International Standards for Neurological Classification of Spinal Cord Injury, revised 2011. Top Spinal Cord Inj Rehabil. 2012;18(1):85–99.
,
International Standards for Neurological Classification of Spinal Cord Injury, revised 2011
,
Top Spinal Cord Inj Rehabil.
, vol.
18
(pg.
85
-
99
)
IBM SPSS Statistics 20. Somers, NY: IBM Corporation; 2011.
,
IBM SPSS Statistics 20. Somers,
Bauman WA, Spungen AM, Adkins RH, Kemp BJ. Metabolic and endocrine changes in persons aging with spinal cord injury. Assist Technol. 1999;11(2):88–96.
,
Metabolic and endocrine changes in persons aging with spinal cord injury
,
Assist Technol.
, vol.
11
(pg.
88
-
96
)
Liusuwan A, Widman L, Abresch RT, McDonald CM. Altered body composition affects resting energy expenditure and interpretation of body mass index in children with spinal cord injury. J Spinal Cord Med. 2004;27(suppl 1):S24–28.
,
Altered body composition affects resting energy expenditure and interpretation of body mass index in children with spinal cord injury
,
J Spinal Cord Med.
, vol.
27
(pg.
S24
-
28
)
McDonald CM, Abresch-Meyer AL, Nelson MD, Widman LM. Body mass index and body composition measures by dual x-ray absorptiometry in patients aged 10 to 21 years with spinal cord injury. J Spinal Cord Med. 2007;30(suppl 1):S97–104.
,
Body mass index and body composition measures by dual x-ray absorptiometry in patients aged 10 to 21 years with spinal cord injury
,
J Spinal Cord Med.
, vol.
30
(pg.
S97
-
104
)
Weise M, Eisenhofer G, Merke DP. Pubertal and gender-related changes in the sympathoadrenal system in healthy children. J Clin Endocrinol Metabol. 2002;87(11):5038–5043.
,
Pubertal and gender-related changes in the sympathoadrenal system in healthy children
,
J Clin Endocrinol Metabol.
, vol.
87
(pg.
5038
-
5043
)
Krishnan B, Jeffery A, Metcalf B, et al. Gender differences in the relationship between heart rate control and adiposity in young children: a cross-sectional study (Early Bird 33). Pediatr Diabetes. 2009;10(2):127–134.
,
Gender differences in the relationship between heart rate control and adiposity in young children: a cross-sectional study (Early Bird 33)
,
Pediatr Diabetes.
, vol.
10
(pg.
127
-
134
)
Munakata M, Kameyama J, Kanazawa M, Nunokawa T, Moriai N, Yoshinaga K. Circadian blood pressure rhythm in patients with higher and lower spinal cord injury: simultaneous evaluation of autonomic nervous system activity and physical activity. J Hypertens. 1997;15(12):1745–1749.
,
Circadian blood pressure rhythm in patients with higher and lower spinal cord injury: simultaneous evaluation of autonomic nervous system activity and physical activity
,
J Hypertens.
, vol.
15
(pg.
1745
-
1749
)
Mulcahey MJ, Gaughan J, Betz RR, Johansen KJ. The International Standards for Neurological Classification of Spinal Cord Injury: reliability of data when applied to children and youths. Spinal Cord. 2007;45(6):452–459.
,
The International Standards for Neurological Classification of Spinal Cord Injury: reliability of data when applied to children and youths
,
Spinal Cord.
, vol.
45
(pg.
452
-
459
)
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