Degeneration of the autonomic nervous system.
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Biomedical subjects
Publications and source records attributed to R Bannister.
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A discussion of progressive autonomic failure in man. This is one of the few neurological diseases disrupting cardiovascular function. Both central and peripheral pathways are involved. Means of diagnosing defects in autonomic reactions are described. Abnormalities in responses due to multiple system atrophy (MSA) are discussed most extensively.
Blood pressure variation over 24 h was studied in twelve subjects with suspected or established autonomic failure using ambulatory intra-arterial monitoring. Three subjects who had been previously diagnosed as having orthostatic hypotension due to autonomic failure were found to have normal circulatory reflexes. A generally consistent circadian variation of blood pressure was seen in the other nine subjects, pressure rising gradually from its lowest point early in the morning to a peak during the early part of the night; this pattern was also found during bed rest in four subjects. Supine hypertension (an hourly mean blood pressure of greater than 170/90 mmHg) not suspected from sphygmomanometric readings was observed in four subjects, generally during the night. Heart rate variability was reduced in six subjects while short-term blood pressure variability was markedly increased.