TY - JOUR
T1 - Patterns of orthostatic blood pressure changes in patients with orthostatic hypotension
AU - Seok, Hung Youl
AU - Kim, Yoo Hwan
AU - Kim, Hayom
AU - Kim, Byung Jo
N1 - Funding Information:
This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean Government (MSIP; no. NRF-2015R1A5A7037674) and the Technology Innovation Program (or the Industrial Strategic Technology Development Program) (10049743, “Es-tablishing a medical device development open platform, as a hub for accelerating close firm-hospital communication”) funded by the Ministry of Trade, Industry and Energy (MI, Korea). In addition, we would like to thank Nam-Joon Jeon, MT (Department of Neurology, Korea University Medical Center), for his dedication and technical assistance.
Funding Information:
This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean Government (MSIP; no. NRF-2015R1A5A7037674) and the Technology Innovation Program (or the Industrial Strategic Technology Development Program) (10049743, “Establishing a medical device development open platform, as a hub for accelerating close firm-hospital communication”) funded by the Ministry of Trade, Industry and Energy (MI, Korea).
Publisher Copyright:
© 2018 Korean Neurological Association.
PY - 2018/7
Y1 - 2018/7
N2 - Background and Purpose The objective of this study was to determine the patterns of blood pressure (BP) changes during the head-up tilt (HUT) test, particularly in terms of its clinical significance for patients with orthostatic hypotension (OH). Methods OH was divided into four categories based on systolic BP changes occurring within the first 10 minutes of the HUT test: sustained orthostatic hypotension (SOH), progressive orthostatic hypotension (POH), orthostatic hypotension with partial recovery (OHPR), and transient orthostatic hypotension (TOH). Results In total, 151 patients were analyzed: 65 with SOH, 38 with POH, 21 with OHPR, and 27 with TOH. POH patients exhibited the greatest reduction in systolic BP after HUT and were also the most likely to develop symptoms requiring early termination of the HUT test (42.1%, p<0.001). Additionally, SOH patients exhibited smaller heart-rate variation with deep breathing values (p=0.003) and Valsalva ratios (p=0.022) compared to POH patients. The sweat volume was greatest in OHPR patients. Conclusions Clinical characteristics, including the findings of autonomic function tests, differed between the OH patient groups. This might reflect differences in the underlying pathophysiologic mechanisms. Determining the patterns of BP changes during the HUT test may facilitate the development of effective management strategies in patients with OH.
AB - Background and Purpose The objective of this study was to determine the patterns of blood pressure (BP) changes during the head-up tilt (HUT) test, particularly in terms of its clinical significance for patients with orthostatic hypotension (OH). Methods OH was divided into four categories based on systolic BP changes occurring within the first 10 minutes of the HUT test: sustained orthostatic hypotension (SOH), progressive orthostatic hypotension (POH), orthostatic hypotension with partial recovery (OHPR), and transient orthostatic hypotension (TOH). Results In total, 151 patients were analyzed: 65 with SOH, 38 with POH, 21 with OHPR, and 27 with TOH. POH patients exhibited the greatest reduction in systolic BP after HUT and were also the most likely to develop symptoms requiring early termination of the HUT test (42.1%, p<0.001). Additionally, SOH patients exhibited smaller heart-rate variation with deep breathing values (p=0.003) and Valsalva ratios (p=0.022) compared to POH patients. The sweat volume was greatest in OHPR patients. Conclusions Clinical characteristics, including the findings of autonomic function tests, differed between the OH patient groups. This might reflect differences in the underlying pathophysiologic mechanisms. Determining the patterns of BP changes during the HUT test may facilitate the development of effective management strategies in patients with OH.
KW - Blood pressure
KW - Orthostatic intolerance
KW - Tilt table test
UR - http://www.scopus.com/inward/record.url?scp=85051097779&partnerID=8YFLogxK
U2 - 10.3988/jcn.2018.14.3.283
DO - 10.3988/jcn.2018.14.3.283
M3 - Article
AN - SCOPUS:85051097779
VL - 14
SP - 283
EP - 290
JO - Journal of Clinical Neurology (Korea)
JF - Journal of Clinical Neurology (Korea)
SN - 1738-6586
IS - 3
ER -