Intra-Abdominal Pressure, Anti-Shock Garments (and exercises?), Abdominal Aortic Aneurysm, And Arterial Blood Pressure Regulation

Hi! Folks,

I woke up yesterday thinking about intra-abdominal pressure, and how little I knew about it. When it comes to abdominal aortic aneurysms (AAA), pressure is really what it is all about. If the blood pressure in the abdomen was the same as the pressure in the distal aorta, then AAAs would probably never form, or at least they would burst less frequently or later in their life span. But if this were the case this blood-delivery system wouldn’t function, as there has to be a higher pressure in the aorta than in the other abdominal components in order to permit blood flow from the aorta into theĀ  viscera. Understanding such a system is a typical engineering problem!

So! I searched for articles on intra-abdominal pressure using a couple of trusty search engines, Google and PubMed. [Aside: These search engines are free, would you believe, but then Google is watching us to make money and PubMed is spending our taxes, but in a very good way!] I found the most interesting thing. Intra-abdominal pressure has been manipulated using an anti-shock garment to improve survival from ruptured AAA on the way to the hospital (Schou et al., 1997). It turns out that intra-abdominal pressure is a big deal for AAA, with collapsing intra-abdominal pressure being a serious adverse event following trans-abdominal AAA repair. There is a lot of literature on this issue, but of course this made me think of my old studies of Iron Shirt Chi Kung!! What else would I think about?

[Another aside: when I searched in PubMed I couldn’t find any literature on Iron Shirt Chi Kung! How odd!!!]

Iron Shirt was a massive core workout as far as I was concerned, not being very tuned into the spirituality aspects at that time, but I was young! And what else is a core workout but the building of an ‘iron body shirt,’ and I bet that works on abdominal pressure, but in a highly controllable way. I use a very simple set of core exercises as part of my training, which I found on the Web, and it certainly helps stabilize my trunk, and especially my lower abdomen and pelvis. I propose, therefore, that we AAA-people (about a million of us in the US apparently), athletes or not, include plenty of core work in our training programs. That said, some of the exercise programs recommended for core building, including free weights (Behm 2010, Core Intra-Abd Pressure), must be approached very cautiously by AAA-athletes. Regulation of intra-abdominal pressure is complex, and it is countered in the aorta by an equally complex set of reflexes, that are described nicely by Fadel (2008), and by Raven (2008) from which I extracted the diagram below:

Raven 2008, Baroreflex Model Diagram

Raven 2008, Baroreflex Model Diagram

I love this stuff, and it is certainly perfect for mathematical modeling, which might help me to sort out my bizarre post-AAA-stent severe blood pressure issue (see previous post). It would be great to have a cardiologist, a vascular physiologist, and a sports medicine expert explore this proposal and come up with a safe set of core exercises for people with a range of intra-abdominal vascular risks.

Well! Carpe diem, and by the way the “seize the day” thing is nicely addressed in the third book of the Golden Compass series by Philip Pullman, a series I like a lot because it ‘makes you think,’ whatever your philosophy.’

OK! Off to the pool.




  1. Pauline Watson says

    You don’t mean Philip Pulman for the Golden Compass series do you? or is their another one? I’m trying to contact a cardiologist (retired) that I know, a long time runner who might have some answers to our many questions. I’ll take your advice about easing into intervals, thanks.


  2. Hi! Pauline,

    How did I make that mistake? I have no idea, but I fixed it. Thanks! Guess I was reading the wrong book cover. I really like that series.

    When it comes to intervals, I am busy doing them right now, and I have been collecting blood pressure data (BP) as I go along. The results are pretty interesting, and I suspect that we are all slightly different on the load/BP response, and the ramp up time needed to optimize our ability to pile on load as we warm up. My monitor is giving the same results as Debs, which is a standard issue purchased at the student store for doctors and nurses, which uses a stethoscope and pressure cuff, so I trust my data. Just don’t move your arm while you take the measurement, which you can do on your trainer as you ride.

    I recommend that you generate your own personal data, and make decisions based on that!

    I am at last getting back in training. Thank goodness!



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Disclaimer: As a veterinarian, I do not provide medical advice for human animals. If you undertake or modify an exercise program, consult your medical advisors before doing so. Undertaking activities pursued by the author does not mean that he endorses your undertaking such activities, which is clearly your decision and responsibility. Be careful and sensible, please.