Unique Mechanisms of
Bilateral Blood Pressure
Control
Nicholas R. Uba, Lauren A. Naylor, Alyssa C. Watts, Michael E. Holmstrup,
Brock T. Jensen.
Slippery Rock University, Slippery Rock, PA

Introduction
Blood pressure (BP) measurement is used to aid in appropriate clinical
decision making
Inter-arm differences (IAD) in systolic BP exists in many individuals at rest
≥10 mmHg between arms
► Linked with hypertension, peripheral vascular disease, arterial
stiffness, and premature morbidity and mortality.
At rest, BP should be measured in both arms to determine which is most
appropriate for future use
During exercise, it is also suggested that bilateral BP is measured, if possible

Active/Passive Bicep Curl
►

12-lead EKG preparation and electrode placement

►

Simultaneous BP monitoring with two automated,
auscultatory BP monitors

► Exercise Pressor Reflex
► Active Bicep Curl
► Mechanical and Metabolic receptors
► Passive Bicep Curl
► Metabolic Receptors

Cold pressor test (CPT)
Non-invasively excites
sympathetic nervous system
► Nociceptors
Raises systolic and diastolic
BP
Normal increase in SBP=
15-20 mmHg

Purpose and Hypotheses
To examine the effects of ALM, PLM, andthe CPT on IAD in systolic BP
Hypotheses
► CPT will induce significant changes in the IAD in systolic BP and
provide insight into novel aspects of nervous system control on blood
pressure regulation
► PLM in the upper limbs will stimulate the exercise pressor reflex and
alter IAD
► ALM in the upper limbs will stimulate NO release and alter IAD

Methods- Visit One
Informed Consent
Body Composition
Height, weight, BMI, SECA
Cholestech Panel
Total, high-density,
low-density cholesterol and
glucose
Pre-test instructions for
follow-up:
4 hour fast, 24-hour
abstinence from exercise,
caffeine, alcohol

Methods- Visit Two
Order of intervention randomized

Active/Passive Contraction Protocol
CON 1

REST

15

1

2

3

1

2

3

CON 4 Passive Recovery

CON 3

CON 2

1

2

3

1

2

3

BP/HR (x3) 60 rpm, BP/HR at end of CON, 5-min washout

Time (min)

IMM

5

10

BP/HR (x1)

Methods- Visit Two
➢

Order of affected hand
randomized

Cold Pressor
Protocol
REST

15

Cold Pressor
Test (3-5°C)

1

2

Passive
Recovery

3

BP/HR (x3) BP/HR at :30 and
2:00

Time (min)

IMM

5

10

BP/HR (x1)

Data Analysis
IAD+, >10 mmHg IAD at rest
IAD-, <10 mm Hg IAD at rest
Descriptive statistics- calculated as mean ± SEM
A repeated-measures ANOVA was used to compare the relative IAD
response to the CPT between IAD+ and IAD- individuals at rest

Participant Demographics - Active/Passive
IAD- (n=7;
<10mmHg)

IAD+ (n=18;
>10mmHg)

193.1 ± 10.4

182.5 ± 10.3

High-Density Lipoprotein (mg/dL)

56.1 ± 4.0

55.9 ± 6.5

Low-Density Lipoprotein (mg/dL)

112.9 ± 7.9

108.9 ± 6.8

LDL/HDL Ratio

3.7 ± 0.3

3.5 ± 0.3

Blood Glucose (mg/dL)

90.6 ± 2.5

90.1 ± 1.9

Weight (kg)

77.0 ± 4.8

74.4 ± 4.2

Height (cm)

168.0 ± 2.6

168.6 ± 3.8

BMI (kg/m2)

27.2 ± 1.5

26.2 ± 1.4

Fat-Free Mass (kg)

54.1 ± 2.8

56.5 ± 3.7

29 ± 2.4

24 ± 3.4

Cholestech Panel:
Total Cholesterol (mg/dL)

Anthropometrics:

Body Fat Percentage (%)

Participant Demographics - CPT
IAD- (n=11;
<10mmHg)

IAD+ (n=12;
>10mmHg)

183.9 ± 11.2

201.2 ± 4.0

High-Density Lipoprotein (mg/dL)

53.8 ± 5.3

56.4 ± 2.4

Low-Density Lipoprotein (mg/dL)

96.9 ± 4.9

122.5 ± 3.1*

LDL/HDL Ratio

3.5 ± 0.3

3.7 ± 0.35

Blood Glucose (mg/dL)

91.2 ± 3.1

90.9 ± 2.8

Weight (kg)

73.8 ± 5.3

76.8 ± 2.7

Height (cm)

170.6 ± 3.4

165.5 ± 3.7

BMI (kg/m2)

25.1 ± 1.2

28.0 ± 1.7

Fat-Free Mass (kg)

55.7 ± 3.6

52.1 ± 2.1

24 ± 1.6

31 ± 1.9

Cholestech Panel:
Total Cholesterol (mg/dL)

Anthropometrics:

Body Fat Percentage (%)

Results - Active/Passive

Results - Active/Passive

Results - Active/Passive

Results - CPT

Conclusions - Active/Passive
Both passive and active limb movement mediated IAD
similarly in both IAD+ and IAD- participants

Conclusions - CPT
Similar to prior stimuli on the IAD response:
CPT augmented IAD response in IAD- individuals
IAD+ individuals had a blunted response to the CPT,
possibly indicating that suggested anatomical bases,
and physiological responses derived by sympathetic
means, deserve further investigation as potential
mechanisms behind resting and exercise IAD.

Acknowledgements
SRU Exercise Science Research Lab:
Ben McEldowney, Seth Markle
Slippery Rock University/PASSHE Funding Sources
2020 Norton Scholarship for Undergraduate Research
Summer Collaborative Research Experience (SCORE)