Beyond the injury: Uncovering the cardiovascular risks of spinal cord injury
By Dr Ryan Dorrian
Post-Doctoral Researcher, SpineLabs, Adelaide University
Did you know that your blood pressure changes every time you stand up?
For most of us, blood pressure quietly regulates itself automatically without us even noticing. This is thanks to a constant conversation between our brain and cardiovascular system through messages that travel in the spinal cord.
But what happens when someone has experienced a spinal cord injury?
Cardiovascular imbalances after SCI
SCI can interrupt these messaging pathways that regulate blood pressure, causing “cardiovascular imbalances”, where the body loses its ability to keep blood pressure steady.
These imbalances can show up in two opposite ways:
1.Orthostatic hypotension: a sudden drop in blood pressure when changing posture, causing dizziness, fainting, or fatigue
2.Autonomic dysreflexia: a dangerous increase in blood pressure, with serious consequences if untreated
Unfortunately, these are not rare events. They affect a large proportion of people living with SCI, with some experiencing these imbalances up to 40 times every day.
Why does this matter?
Not only do these events impact quality of life, but we are beginning to understand that they may have a long-term impact on health.
In particular, the severity and frequency of these imbalances may increase the risk of cardiovascular disease, which has now become one of the leading causes of death in people living with SCI.
It is for that reason that SpineLabs are aiming to better understand cardiovascular imbalances through the CIRCUIT study.
The CIRCUIT Study
CIRCUIT (Cardiovascular Imbalances and Risk Characterisation Using Integrated Technologies) is a world-first study running right here in Adelaide.
We will recruit participants with any severity, level of injury, or time post-SCI, and monitor the development of these imbalances over several years. From there, we aim to identify which factors may predict who is at risk of severe and frequent imbalances.
By understanding why some individuals are at greater risk than others, we can identify avenues to better manage these events to prevent their long-term consequences
Professor Ashish Diwan, chair of spinal surgery at the Royal Adelaide Hospital and head of SpineLabs, highlights the importance of this research:
“Our patients with SCI deal with numerous issues related to interacting and interfacing with their external environment in order to lead a productive and fruitful life; the one issue beyond their and the managing teams’ control is the imbalances of the cardio and vascular system as they have lost meaningful control mediated by the spinal cord.
Our CIRCUIT study will provide insights and enable a better control of those heart and blood vessel parameters improving life quality.”
Looking Ahead
The CIRCUIT study is anticipated to commence at the end of 2026. We are actively seeking input into the study from people who are impacted by SCI and cardiovascular imbalances.
Keen to be involved?
If you would like to participate in the study, have any questions, or want to offer your input into the study design, please contact the research team here.