American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2021, 9(1), 32-34
DOI: 10.12691/ajmcr-9-1-9
Open AccessArticle

Small Doses of Lorazepam Given at 3:30AM and at Bedtime Significantly Decrease early Morning Malignant Blood Pressure Spikes in Patients 65 Years and Older

Kevin M. Woog1 and Elizabeth M. Sabatella1,

1United States

Pub. Date: October 29, 2020

Cite this paper:
Kevin M. Woog and Elizabeth M. Sabatella. Small Doses of Lorazepam Given at 3:30AM and at Bedtime Significantly Decrease early Morning Malignant Blood Pressure Spikes in Patients 65 Years and Older. American Journal of Medical Case Reports. 2021; 9(1):32-34. doi: 10.12691/ajmcr-9-1-9

Abstract

This study builds upon a 9 year daily case study of a 71-80 year old Caucasian woman who documented at least 6 daily blood pressure readings per day, with a focus on the early morning malignant blood pressure spikes and the variety of blood pressure medications given to her by various physicians in several states. The documentation included time of day, duration of spike, and her perseverance in finding a prophylactic that ended these spikes. The pathophysiology of early morning malignant blood pressure spikes is not completely understood, but the primary cause of malignant blood pressure spikes in the morning may be a misdirected activation of the sympathetic nervous system due to a genetic mutation or deterioration due to age. There are contradictory opinions on the percentage of the elderly experiencing these spikes. Some research reports that these spikes are rare and usually found in men, African Americans and the poor. Other reports contradict these findings and state that malignant early morning spikes are common, but patients are not aware of them. All agree, however, that these early morning malignant spikes had a significant increased risk of cardio vascular event, stroke, heart attacks and death. This study was conducted because the older woman researched was knowledgeable about the human body [studied science, anatomy and physiology, and was a competitive athlete in her youth]. She was trained to know her body and could easily identify when the spikes began in early morning, timed the amount of time blood pressure went from normal to very high [2 minutes], and measured time it took for blood pressure to return to normal. Her way of coping with the 9 years of these stressful spikes was to conduct a research project and hopefully be able to help other senior citizens prolong their own lives.

Keywords:
blood pressure malignant spikes lorazapam senior citizens sympathetic nervous system

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References:

[1]  Cleveland Clinic Study, Jama Internalional Medicine, June 13, 2016.
 
[2]  Live Science, “Fight or Flight-The Sympathetic Nervous System”, Nicoletta Lanese, May 9, 2019.
 
[3]  Journal of Hypertension and Management, ISSN: 2474-3690.
 
[4]  Journal of Clinical Hypertension, Volume 22, Issue 9, September 2020.
 
[5]  Healthline, “Malignant Hypertension”. Feb. 12, 2019.
 
[6]  Mayo Clinic, Clinical Trials, Blood Pressure Tests, 2020.