What is your blood pressure?

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

What is your blood pressure?

Postby David1949 » Thu Apr 05, 2012 6:23 pm

What is your blood pressure?

Mine typically runs between 120/70 to 140/80.
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Re: What is your blood pressure?

Postby PointsNorth » Thu Apr 05, 2012 7:19 pm

High blood pressure, I control w. Meds.
Albany 2010. Brooklyn 2011
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Hurry up and wait.
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Re: What is your blood pressure?

Postby PointsNorth » Thu Apr 05, 2012 7:20 pm

High blood pressure, I control w. meds.
Albany 2010. Brooklyn 2011
Calcitriol+D3 2013-
Hurry up and wait.
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Re: What is your blood pressure?

Postby Cece » Thu Apr 05, 2012 7:21 pm

Low blood pressure. Can't remember the numbers but it's always commented upon.
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Re: What is your blood pressure?

Postby David1949 » Thu Apr 05, 2012 8:37 pm

BTW For info this chart shows what the numbers mean.
http://www.vaughns-1-pagers.com/medicin ... essure.htm
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Re: What is your blood pressure?

Postby jackD » Thu Apr 05, 2012 9:17 pm

Mine would run around 220/120 but after 60 days in the hospital for High Blood Pressue and Congestive Heart Failure (ie fluid in lungs caused by the high BP) I got it down to 150/92. It is nice to be home and have almost normal BP.

What saved me was the new once a week PATCH MED - Transdermal "Clonidine" 0.1 mg/day.

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Re: What is your blood pressure?

Postby cheerleader » Thu Apr 05, 2012 11:12 pm

we've had this discussion a few times.
Blood pressure is all over the place in CCSVI....Dr. Dake told us it is not part of Jeff's equation, but it might be for others. Jeff's always had perfect BP 120/80 Mine is low, 100/70 (many times 90/60)....and I don't have MS or CCSVI.

Here are just a few of the times we've talked about BP in relation to CCSVI--you can always search the forums to see if something's been discussed before.

chronic-cerebrospinal-venous-insufficiency-ccsvi-f40/topic12136.html

chronic-cerebrospinal-venous-insufficiency-ccsvi-f40/topic9618.html

chronic-cerebrospinal-venous-insufficiency-ccsvi-f40/topic15067.html
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Re: What is your blood pressure?

Postby 1eye » Thu Apr 05, 2012 11:18 pm

BP in the arm is very different from BP in the brain. That is what plethysmography is for.

A stenosis in a neck vein will raise BP in the brain, independently of the arm BP.
================================================================================================

Unequal sharing of vein drainage:
-----------------------------------------

I have read that fluid flowing in pipes follows Ohm's Law (V = I times R), where voltage, V, is equivalent to the fluid's pressure (P), current, I, is equivalent to the fluid's flow (F), and resistance, R, is equivalent to fluid resistance to flow, again we'll call it R.

Again, V == P
I == F
R == R

Ohm's Law for electricity ===========> V = I x R
Ohm's Law for fluid in pipes ===========> P = F(rate) x R


Pressure is Flow (rate) times Resistance.

Any time you want to increase only the Flow rate, you have to increase the Pressure in by the same proportion. The increase in Pressure will be lost as the pipe's Resistance is overcome, resulting in a drop in Pressure as fluid flows through the pipe.

Any time you increase only the Resistance of the pipe to Flow of fluid, you get less Pressure in the fluid exiting the pipe, by the same proportion.

Etc. See http://alturl.com/3fqqn (or http://webpages.charter.net/griche/pt/u4s2prb.htm) for examples of various transformations.

We could be so bold as to assign units: Pressure in pounds per square inch (PSI)
Flow in Gallons per Minute (GPM)
Resistance in PSI/GPM. That is why in electricity, they're just called Ohms.

Think of a garden hose - think of a smaller garden hose attached to it. Now attach a third hose, the same as the first one, to that. Now the hoses go Big, Small, Big, and you're watering through them In Series. They are Series-Connected. In series, Rtotal = R1 + R2 + R3.

Take my word for the fact that the smaller a hose gets, the more Resistance to Flow it has, and Vice Versa.

So let's let P, Pressure drop from inlet of tube to outlet = 10 PSI (pounds/square in)
F, Flow rate of fluid in tube = 10 GPM (gallons/minute)
R, Resistance to flow through the tube = F/P = 10/10 = 1 PSI/GPM

Things get slightly tricky when pipes are in parallel, as in veins and collaterals. Resistance is reduced to something always smaller than the Resistance of the pipe with the least Resistance.

1/Rtotal = 1/R1 + 1/R2 + 1/R3 ...

Each new pipe (collateral vein) added in parallel makes the Resistance of the combination smaller, stealing from the total flow. The largest resistance you can have, if you can only add in parallel, is the largest pipe alone. The Flow will preferentially go to the pipe with the least Resistance.

Resistance depends on several variables, independent of Pressure or Flow rate.

Resistance is higher proportional to the friction of the pipe, and similarly to the drag or viscosity of the fluid.

But Resistance is lower, the larger the pipe's diameter, by a factor of the 4th power of its diameter.

e.g.,
When we doubled the diameter, Flow Resistance 2, RF2, became lower than Flow Resistance 1, RF1.
Vein Diameter 2, DV2, is 2 times as large as Vein Diameter 1, DV1.

RF2 = RF1 times (DV1/DV2)^^4

Let RF1 = 2 PSI/GPM
And DV1 = 1 inch, DV2 = 2 inches
So RF2 = ? PSI/GPM

Because of doubling DV1, RF2 = RFI times ((DV1/DV2)^^4) = 1 x (1/2)^^4 = 1/16 PSI/GPM

Said another way, Resistance to flow is Very, Very, Very, Very sensitive to the diameter of the pipe. That is why ballooning a vein is so tricky. It is why choosing the balloon's size, and how you blow it up, is so important. It is also why collateral veins disappear on the fluoroscope. The dye prefers the largest vein by a factor of the fourth power of the ratio of the vein diameters (which is the same proportion as the CSAs, if the veins are round). This number can get very different very quickly, as diameters change. If stenosis occurs, same thing.

The sharing of drainage by veins of different diameters is very, very, very, very unequal.

Brain blood pressure is directly (and potentially gravely) influenced by stenosis of the largest neck veins.
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Re: What is your blood pressure?

Postby munchkin » Fri Apr 06, 2012 7:30 am

My concern is that our blood flow is affected through out our bodies due to the restriction in our jugulars and other veins. My blood pressure ranges from 110/70 to 90/60, I have blood pooling in my fingers, toes, and from what Dr.Sclafani saw; in my renal vein. He anticipated a nutcracker but it wasn't there.
If our bodies are regulating blood flow into or out of our brains then it might also be regulating how the blood flows through the rest of our bodies so there isn't an overload of blood in a particular organ. Our blood flow is ultimately a closed system.
From my understanding there are only a couple of Dr's who are noticing similarities to Superior Vena Cava Syndrome (Drs' Dake and Hernandez). When my veins clotted I got the speeded up version of MS and this included (but far from limited to) my arms being particularily affected, breathing difficulties (struggling for oxygen), altered voice tone, fingers/hands/toes/legs being cold to frozen and not changing colour as per raynaud's. They stay red. The u/s tech who checked me for PAD said that to get an appropriate toe reading he had to get the blood flowing. My GP said microcirculation.
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Re: What is your blood pressure?

Postby 1eye » Fri Apr 06, 2012 8:27 am

Blood pressure in the arm is not influenced by neck veins, since blood from the head is pumped almost immediately by the heart, which will send it to your lungs before it reaches your arm, and re-equalize pressure somewhat. It will by then have oxygen in it and be at much higher pressure. By the time of pumping out to the lungs, the content of the blood will be mixed with other venous blood from the rest of the body, and may be quite different (although in a fairly consistent way) from the blood trying to get out of the brain.

The arm and leg problems can come via the brain, in electrical form, or you may have a stenosis outside the neck. Azygos drains spine and lungs. Don't know about arms and legs. I think one key to all this is how handedness either changes or doesn't change, in people with a one-sided jugular problem.
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Re: What is your blood pressure?

Postby munchkin » Fri Apr 06, 2012 9:08 am

I am trying to understand the relationship and the jugulars flow through these other veins first. If our blood flow system is like a pump wouldn't the lesser flow of blood affect the ability of the other veins to draw blood back out to the heart from that part of the system ie: arms. If blood is sitting in the renal veins this might affect the flow from the lower extremities. From my poor memory I think Dr.Sclafani has noticed renal blood flow to be important in some situations. In my case, I have small VV so this route isn't as useful to me as it is to others.
Extrajugular pathways of human cerebral venous blood drainage assessed by duplex ultrasound
The main jugular blood drainage pathway leads from the superior sagittal and the transverse sinuses via the sigmoid sinuses into the IJVs, which meet the superior cava vein via the brachiocephalic vein.
.
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Re: What is your blood pressure?

Postby David1949 » Fri Apr 06, 2012 12:09 pm

I agree it would be nice to know the blood pressure in the head, but we don't. Most of us have had our blood pressure in the arm taken many times, but few have it taken in the head or neck.

1eye it sounds like you're an engineer, as i am. Yeah veins and arteries are like pipes but they're strange pipes. They can stretch under higher pressure. That increases the diameter which as you point out has a huge affect on resistence. Also the flow is not steady but pulses with the heart beat. And some of the arteries can change diameter to increase or decrease resistance as a means of regulating blood flow to certain organs, as explained in this article http://www.cvphysiology.com/Blood%20Flow/BF004.htm.

I think there is also a means by which the body directs blood flow to where it is needed. If we eat a big meal the body send blood flow to the digestive system. Other parts may then be getting less so we feel tired. If we're hot the body sends more blood to the skin so it can be cooled, except for those of us with MS that part may not be working right.
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Re: What is your blood pressure?

Postby Cece » Fri Apr 06, 2012 12:12 pm

I appreciate the engineering-style posts, even as I struggle to understand them!
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Re: What is your blood pressure?

Postby 1eye » Fri Apr 06, 2012 5:16 pm

David1949 wrote:I agree it would be nice to know the blood pressure in the head, but we don't. Most of us have had our blood pressure in the arm taken many times, but few have it taken in the head or neck.

1eye it sounds like you're an engineer, as i am. Yeah veins and arteries are like pipes but they're strange pipes. They can stretch under higher pressure. That increases the diameter which as you point out has a huge affect on resistence. Also the flow is not steady but pulses with the heart beat. And some of the arteries can change diameter to increase or decrease resistance as a means of regulating blood flow to certain organs, as explained in this article http://www.cvphysiology.com/Blood%20Flow/BF004.htm.

I think there is also a means by which the body directs blood flow to where it is needed. If we eat a big meal the body send blood flow to the digestive system. Other parts may then be getting less so we feel tired. If we're hot the body sends more blood to the skin so it can be cooled, except for those of us with MS that part may not be working right.
Dr. Haacke has graphed instantaneous flow rate in neck veins of CCSVI, and it sometimes goes negative, indicating reflux. He has also shown permanent stretching of brain veins above a stenosis. Veins are floppy compared to arteries, so they do change a tad with every pulse,

I agree the body's smooth muscle control of diameters of veins and arteries is fantastic. Poiseuille's law and fluid dynamics are integral to health, thanks to this evolution.

Any vein or artery which has a healthy smooth muscle layer and a healthy endothelium can adjust diameter, and thus flow rate. The level of temperature control achieved in our bodies (3 digits of accuracy) is excellent. We ignore the 4th power of the vein's diameter, at our peril. It comes from the resistance being proportional to the diameter squared, and to the CSA, at one time. It's a 4D quantity. The 4th dimension here is time. It is resistance to flow rate.

Everybody has seen jugulars and forehead veins adjust diameters in response to brain pressure and/or temperature. The diameters do not adjust to instantaneous changes (except by stretching from chronic high venous pressure). You must average the flow rate, pressure, and resistance over several heartbeats at least. Even arm BP measurements do that. On the Doppler Ultrasound you can see and/or hear the heartbeats.

The energy demand of contracting and expanding veins and arteries must be a big part of our expenditure. That's maybe why there is Chronic and Acute Fatigue.

Even microcirculation vessels do flow control, though not with smooth muscles.
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