{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T23:07:33Z","timestamp":1772060853987,"version":"3.50.1"},"reference-count":25,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T00:00:00Z","timestamp":1603065600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Hyperbaric oxygen therapy (HBOT) is widely used to treat several pathologies. The hemodynamic changes during HBOT, particularly the magnitude of arterial blood pressure (ABP) increase, are not completely understood. No clinical predictors for HBOT-induced ABP increase have been described. The purpose of this study was to quantify ABP changes in patients undergoing HBOT and to examine their predictors. This retrospective longitudinal cohort study examined 3291 elective HBOT sessions. Non-invasive ABP was recorded before and after each session. The primary outcome was to quantify the HBOT-induced ABP rise. The secondary outcome was to determine the ABP-rise predictors among demographic and clinical variables. Overall, ABP increased significantly after HBOT; this finding was more evident in the hypertensive subgroup compared to the normotensive one (+6 vs. +16.2 mmHg). Clinical predictors of significant post-HBOT ABP change were history of hypertension and pre-session baseline ABP classification. This study demonstrates an absolute HBOT-induced ABP rise. This change is clinically relevant in patients with history of hypertension. A higher baseline ABP seems a risk factor for clinically relevant ABP change. Pre-session ABP should be used clinically as an indicator for strict ABP monitoring during HBOT; future studies are recommended to explore the ABP optimization before starting an HBO treatment.<\/jats:p>","DOI":"10.3390\/ijerph17207586","type":"journal-article","created":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T09:36:28Z","timestamp":1603100188000},"page":"7586","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Magnitude and Clinical Predictors of Blood Pressure Changes in Patients Undergoing Hyperbaric Oxygen Therapy: A Retrospective Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3609-9201","authenticated-orcid":false,"given":"Simone","family":"Schiavo","sequence":"first","affiliation":[{"name":"Hyperbaric Medicine Unit, Department of Anesthesiology and Pain Medicine, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carine","family":"Djaiani","sequence":"additional","affiliation":[{"name":"Hyperbaric Medicine Unit, Department of Anesthesiology and Pain Medicine, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian","family":"DeBacker","sequence":"additional","affiliation":[{"name":"Hyperbaric Medicine Unit, Department of Anesthesiology and Pain Medicine, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Albertini","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4361-1656","authenticated-orcid":false,"given":"Daniel","family":"Santa Mina","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5G 2C4, Canada"},{"name":"Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON M5G 2C4, Canada"},{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON M5G 2C4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Buryk-Iggers","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5G 2C4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus Vinicius","family":"De Moraes","sequence":"additional","affiliation":[{"name":"Hyperbaric Medicine Unit, Department of Anesthesiology and Pain Medicine, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Kanj","sequence":"additional","affiliation":[{"name":"Hyperbaric Medicine Unit, Department of Anesthesiology and Pain Medicine, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Katznelson","sequence":"additional","affiliation":[{"name":"Hyperbaric Medicine Unit, Department of Anesthesiology and Pain Medicine, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada"},{"name":"Department of Anesthesiology and Pain Management, University Health Network, Toronto General Hospital, University of Toronto, Toronto, ON M5G 2C4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,19]]},"reference":[{"key":"ref_1","unstructured":"Moon, R.E. (2019). Hyperbaric Oxygen Therapy Indications, Best Publishing Company. [14th ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Jain, K.K. (2017). Indications, Contraindications, and Complications of HBO Therapy. Textbook of Hyperbaric Medicine, Springer.","DOI":"10.1007\/978-3-319-47140-2_8"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Shupak, A., and Gilbey, P. (2008). Effects of Pressure. Physiology and Medicine of Hyperbaric Oxygen Therapy, Elsevier.","DOI":"10.1016\/B978-1-4160-3406-3.50027-5"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1089\/wound.2016.0718","article-title":"Hyperbaric Oxygen Therapy: Side Effects Defined and Quantified","volume":"6","author":"Heyboer","year":"2017","journal-title":"Adv. Wound Care"},{"key":"ref_5","first-page":"393","article-title":"Middle ear barotrauma in hyperbaric oxygen therapy","volume":"41","author":"Heyboer","year":"2014","journal-title":"Undersea Hyperb. Med."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Mathieu, D., Favory, R., Collet, F., Linke, J.-C., and Wattel, F. (2006). Physiologic Effects of Hyperbaric Oxygen on Hemodynamics and Microcirculation. Handbook on Hyperbaric Medicine, Springer.","DOI":"10.1007\/1-4020-4448-8_6"},{"key":"ref_7","first-page":"1357","article-title":"Increased adrenal epinephrine and norepinephrine in spontaneously hypertensive rats treated with hyperbaric oxygen","volume":"30","author":"Nakada","year":"1984","journal-title":"Hinyokika Kiyo."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"93","DOI":"10.22462\/3.4.2017.2","article-title":"Effect of hyperbaric oxygen therapy on blood pressure in patients undergoing treatment","volume":"44","author":"Wojcik","year":"2017","journal-title":"Undersea Hyperb. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1152\/japplphysiol.00625.2013","article-title":"Baroreflex-mediated cardiovascular responses to hyperbaric oxygen","volume":"115","author":"Demchenko","year":"2013","journal-title":"J. Appl. Physiol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Bove, A.A. (2008). Cardiovascular Aspects of Hyperbaric Oxygen Therapy. Physiology and Medicine of Hyperbaric Oxygen Therapy, Elsevier.","DOI":"10.1016\/B978-1-4160-3406-3.50030-5"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1152\/ajplegacy.1946.146.1.61","article-title":"The Cardiovascular Responses to the Breathing of 100 per Cent Oxygen at Normal Barometric Pressure","volume":"146","author":"Whitehorn","year":"1946","journal-title":"Am. J. Physiol. Leg. Content"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/j.1748-1716.1948.tb00491.x","article-title":"Cardiovascular and Respiratory Changes in Man during Oxygen Breathing","volume":"15","author":"Alveryd","year":"1948","journal-title":"Acta Physiol. Scand."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1152\/japplphysiol.00865.2002","article-title":"Pressure (\u22644 ATA) increases membrane conductance and firing rate in the rat solitary complex","volume":"95","author":"Mulkey","year":"2003","journal-title":"J. Appl. Physiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1152\/jappl.1999.87.4.1428","article-title":"Hyperbaric bradycardia and hypoventilation in exercising men: Effects of ambient pressure and breathing gas","volume":"87","author":"Linnarsson","year":"1999","journal-title":"J. Appl. Physiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1016\/0002-9149(65)90350-4","article-title":"Cardiovascular and blood gas responses to hyperbaric oxygenation","volume":"15","author":"Whalen","year":"1965","journal-title":"Am. J. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1152\/japplphysiol.91012.2008","article-title":"Arterial and pulmonary arterial hemodynamics and oxygen delivery\/extraction in normal humans exposed to hyperbaric air and oxygen","volume":"107","author":"Weaver","year":"2009","journal-title":"J. Appl. Physiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/j.arcmed.2006.05.009","article-title":"Influences of Hyperbaric Oxygen on Blood Pressure, Heart Rate and Blood Glucose Levels in Patients with Diabetes Mellitus and Hypertension","volume":"37","author":"Butler","year":"2006","journal-title":"Arch. Med. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e127","DOI":"10.1016\/j.jacc.2017.11.006","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"71","author":"Whelton","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1038\/nm718","article-title":"Nitric oxide in the human respiratory cycle","volume":"8","author":"McMahon","year":"2002","journal-title":"Nat. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1152\/jappl.1972.32.2.223","article-title":"Hemodynamic effects of oxygen at 1 and 2 Ata pressure in healthy subjects","volume":"32","author":"Kenmure","year":"1972","journal-title":"J. Appl. Physiol."},{"key":"ref_21","unstructured":"Shenouda, M.B.M., Lakdawala, S., Sung, J., Warhul, Z., Bosco, G., and Camporesi, E.M. (2020, January 18\u201320). Quality Review for Hypertensive Patients Receiving HBO2. Proceedings of the UHMS Annual Scientific Meeting 2020, Virtual Meeting, San Diego, CA, USA."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"635","DOI":"10.22462\/10.12.2019.8","article-title":"Hyperbaric oxygenation affects acetylcholine-induced relaxation in female diabetic rats","volume":"46","author":"Manojlovic","year":"2019","journal-title":"Undersea Hyperb. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"7406027","DOI":"10.1155\/2018\/7406027","article-title":"Acute Hyperbaric Oxygenation, Contrary to Intermittent Hyperbaric Oxygenation, Adversely Affects Vasorelaxation in Healthy Sprague-Dawley Rats due to Increased Oxidative Stress","volume":"2018","author":"Mihaljevic","year":"2018","journal-title":"Oxid. Med. Cell Longev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"H1988","DOI":"10.1152\/ajpheart.00145.2006","article-title":"Vascular reactivity and endothelial NOS activity in rat thoracic aorta during and after hyperbaric oxygen exposure","volume":"291","author":"Hink","year":"2006","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"g1072","DOI":"10.1136\/bmj.g1072","article-title":"Retrospective cohort studies: Advantages and disadvantages","volume":"348","author":"Sedgwick","year":"2014","journal-title":"BMJ Br. Med. J."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/20\/7586\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:23:39Z","timestamp":1760178219000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/20\/7586"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,19]]},"references-count":25,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2020,10]]}},"alternative-id":["ijerph17207586"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17207586","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,19]]}}}