TY - JOUR
T1 - Management of initial orthostatic hypotension: lower body muscle tensing attenuates the transient arterial blood pressure decrease upon standing from squatting
T2 - lower body muscle tensing attenuates the transient arterial blood pressure decrease upon standing from squatting
AU - Krediet, C. T. Paul
AU - Go-Schön, Ingeborg K.
AU - Kim, Yu-Sok
AU - Linzer, Mark
AU - van Lieshout, Johannes J.
AU - Wieling, Wouter
PY - 2007/11
Y1 - 2007/11
N2 - IOH (initial orthostatic hypotension) comprises symptoms of cerebral hypoperfusion caused by an abnormally large transient MAP (mean arterial pressure) decrease 5-15 s after arising from a supine, sitting or squatting position. Few treatment options are available. In the present study, we set out to test the hypothesis that LBMT (lower body muscle tensing) attenuates IOH after rising from squatting and its symptoms in daily life. A total of 13 IOH patients (nine men; median age, 27 years) rose from squatting twice, once with LBMT and once without. In addition, seven healthy volunteers (five men; median age, 27 years) were studied in a cross-over study design. They stood up from the squatting position three times, once combined with LBMT. Blood pressure (Finometer) was measured continuously, and CO (cardiac output) by Modelflow and TPR (total peripheral resistance) were computed. MAP, CO and TPR were compared without and with LBMT Using a questionnaire, the perceived effectiveness of LBMT in the patients' daily lives was evaluated. With LBMT, the minimal MAP after standing up was higher in both groups (19 mmHg in patients and 13 mmHg in healthy subjects). In healthy subjects, the underlying mechanism was a blunted TPR decrease (to 47% compared with 60%; P <0.05), whereas in the patients no clear CO or TPR pattern was discernible. During follow-up, eight out of ten patients using LBMT reported fewer IOH symptoms. In conclusion, LBMT is a new intervention to attenuate the transient blood pressure decrease after standing up from squatting, and IOH patients should be advised about the use of this mancieuvre
AB - IOH (initial orthostatic hypotension) comprises symptoms of cerebral hypoperfusion caused by an abnormally large transient MAP (mean arterial pressure) decrease 5-15 s after arising from a supine, sitting or squatting position. Few treatment options are available. In the present study, we set out to test the hypothesis that LBMT (lower body muscle tensing) attenuates IOH after rising from squatting and its symptoms in daily life. A total of 13 IOH patients (nine men; median age, 27 years) rose from squatting twice, once with LBMT and once without. In addition, seven healthy volunteers (five men; median age, 27 years) were studied in a cross-over study design. They stood up from the squatting position three times, once combined with LBMT. Blood pressure (Finometer) was measured continuously, and CO (cardiac output) by Modelflow and TPR (total peripheral resistance) were computed. MAP, CO and TPR were compared without and with LBMT Using a questionnaire, the perceived effectiveness of LBMT in the patients' daily lives was evaluated. With LBMT, the minimal MAP after standing up was higher in both groups (19 mmHg in patients and 13 mmHg in healthy subjects). In healthy subjects, the underlying mechanism was a blunted TPR decrease (to 47% compared with 60%; P <0.05), whereas in the patients no clear CO or TPR pattern was discernible. During follow-up, eight out of ten patients using LBMT reported fewer IOH symptoms. In conclusion, LBMT is a new intervention to attenuate the transient blood pressure decrease after standing up from squatting, and IOH patients should be advised about the use of this mancieuvre
KW - Adolescent
KW - Adult
KW - Blood Pressure Monitoring, Ambulatory
KW - Cardiac Output
KW - Case-Control Studies
KW - Cross-Over Studies
KW - Follow-Up Studies
KW - Humans
KW - Hypotension, Orthostatic/prevention & control
KW - Leg
KW - Male
KW - Middle Aged
KW - Muscle Contraction/physiology
KW - Muscle, Skeletal/physiopathology
KW - Posture
KW - Vascular Resistance
U2 - https://doi.org/10.1042/CS20070064
DO - https://doi.org/10.1042/CS20070064
M3 - Article
C2 - 17561808
SN - 0143-5221
VL - 113
SP - 401
EP - 407
JO - Clinical science (London, England
JF - Clinical science (London, England
IS - 9-10
ER -