Orthostatic Systolic Hypotension and the Reflection Pressure Wave

Tabara, Yasuharu; Nakura, Jun; Kondo, Ikuko; Miki, Tetsuro; Kohara, Katsuhiko

doi:10.1291/hypres.28.537

Cited by 29 publications

(19 citation statements)

References 32 publications

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“…The magnitude of BP reduction was more prominent in the aorta (-3.3±6.7%) than the brachial artery (-3.0±6.3%, p= 0.020). We have reported a similar phenomenon in orthostatic BP decline (22). A postural decline of the reflection component of pulse pressure, represented as a reduced AIx, has been thought to be a principal reason for the larger orthostatic decline in the aortic pressure.…”

Section: Discussionsupporting

confidence: 62%

Hypotension Associated with Prone Body Position: A Possible Overlooked Postural Hypotension

et al. 2005

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Section: Discussionsupporting

confidence: 62%

Hypotension Associated with Prone Body Position: A Possible Overlooked Postural Hypotension

et al. 2005

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“…[21][22][23] In this study, peripheral SBP and aortic SBP significantly decreased after changing to a prone position in association with AI. Surprisingly, the relationship between aortic SBP and radial SBP2 was not changed in the prone Radial SBP2 and aortic SBP K Kohara et al position.…”

Section: Radial Sbp2 and Aortic Sbp K Kohara Et Alsupporting

confidence: 46%

Clinical usefulness of the second peak of radial systolic blood pressure for estimation of aortic systolic blood pressure

et al. 2009

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Central aortic blood pressure (BP), obtained from radial arterial waveform using the transfer function method (TFM), has been shown to have prognostic value independently of brachial BP. In this study, the relationship between peripheral systolic BP (SBP) and aortic SBP was evaluated. We further investigated whether TFMderived aortic SBP can be estimated by information obtained from the radial waveform. The radial waveform was analysed to obtain the first peak of radial SBP (SBP1), second peak of radial SBP (SBP2), radial augmentation index (AI) (radial (SBP2ÀDBP)/(SBP1ÀDBP) Â 100 and aortic SBP and AI using TFM in 233 subjects in the supine position. Measurements were repeated after changing position to the prone position. The constructed equation was validated in 149 community residents with different backgrounds. Radial SBP2 was closer to TFMderived aortic SBP compared with brachial SBP. TFMderived aortic SBP was approximated by the equation: aortic SBP ¼ 18.9-radial SBP2À0.03 Â HR-0.214 Â radial AI (r 2 ¼ 0.992). The equation was also applicable to predicting aortic SBP in the prone position as well as in different populations (mean difference between predicted aortic SBP and TFM-derived aortic SBP: À0.01 ± 1.34 and 1.05 ± 1.47 mm Hg, respectively). Radial arterial waveform analysis can be used for estimation of TFM-derived aortic SBP.

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“…The decline of the reflection component of pulse pressure is also recognized to be related to orthostatic hypotension (27). Counter-regulatory mechanisms to avoid an exaggerated hypotensive response are modulated by activation of the baroreceptor response, an increase of vascular tone by sympathetic nervous activation and an increase of heart rate by vagal suppression.…”

Section: Blood Pressure Fall Immediately After Standing and Autonomicmentioning

confidence: 99%

Impairment of Instantaneous Autonomic Regulation Relates to Blood Pressure Fall Immediately after Standing in the Elderly and Hypertensives

et al. 2006

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The relation between changes in blood pressure and changes in autonomic activity over a very short period of time has not been reported thus far. To examine this relation, we here introduced a new method of power spectrum analysis with wavelet transformation, which has very fine time resolution and is able to assess changes in autonomic activity quantitatively even during movement. Our subjects were 15 hypertensive and 17 normotensive subjects. A head-up tilt test was performed in all subjects, and during the test, electrocar-

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Orthostatic Systolic Hypotension and the Reflection Pressure Wave

Abstract: Orthostatic hypotension (OH) is

Cited by 29 publications

References 32 publications

Hypotension Associated with Prone Body Position: A Possible Overlooked Postural Hypotension

Hypotension Associated with Prone Body Position: A Possible Overlooked Postural Hypotension

Clinical usefulness of the second peak of radial systolic blood pressure for estimation of aortic systolic blood pressure

Impairment of Instantaneous Autonomic Regulation Relates to Blood Pressure Fall Immediately after Standing in the Elderly and Hypertensives

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