Hemodynamic characterization of hypertensive patients with an exaggerated orthostatic blood pressure variation
| Autor: | Margarita S. Morales, Marcelo A. Rada, Jessica Barochiner, Lucas S. Aparicio, Carlos R. Galarza, Marcos J. Marín, Rocío Martínez, José Alfie, Gabriel Waisman, Paula E. Cuffaro |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Physiology Diastole Hemodynamics Blood Pressure 030204 cardiovascular system & hematology Cardiography Impedance 03 medical and health sciences Orthostatic vital signs Hypotension Orthostatic 0302 clinical medicine Heart Rate Internal medicine Heart rate Internal Medicine medicine Supine Position Humans Aged Aged 80 and over medicine.diagnostic_test business.industry General Medicine Middle Aged Impedance cardiography medicine.anatomical_structure Blood pressure Anesthesia Hypertension Vascular resistance Cardiology Female Vascular Resistance Orthostatic hypertension medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Clinical and experimental hypertension (New York, N.Y. : 1993). 40(3) |
| ISSN: | 1525-6006 |
| Popis: | Exaggerated orthostatic blood pressure variation (EOV) is a poorly understood phenomenon related to high cardiovascular risk. We aimed to determine whether hypertensive patients with EOV have a distinct hemodynamic pattern, assessed through impedance cardiography. METHODS In treated hypertensive patients, we measured the cardiac index (CI), systemic vascular resistance index (SVRI), blood pressure (BP), and heart rate (HR) in the supine and standing (after 3 minutes) positions, defining three groups according to BP variation: 1) Normal orthostatic BP variation (NOV): standing systolic BP (stSBP)-supine systolic BP (suSBP) between -20 and 20 mmHg and standing diastolic BP (stDBP)-supine diastolic BP (suDBP) between -10 and 10 mmHg; 2) orthostatic hypotension (OHypo): stSBP-suSBP≤-20 or stDBP-suDBP≤-10 mmHg; 3) orthostatic hypertension (OHyper): stSBP-suSBP≥20 or stDBP-suDBP≥10 mmHg. We performed multivariable analyses to determine the association of hemodynamic variables with EOV. RESULTS We included 186 patients. Those with OHyper had lower suDBP and higher orthostatic SVRI variation compared to NOV. In multivariable analyses, orthostatic HR variation (OR = 1.06 (95%CI 1.01-1.13), p = 0.03) and orthostatic SVRI variation (OR = 1.16 (95%CI 1.06-1.28), p = 0.002) were independently related to OHyper. No variables were independently associated with OHypo. CONCLUSION Patients with OHyper have a distinct hemodynamic pattern, with an exaggerated increase in SVRI and HR when standing. |
| Databáze: | OpenAIRE |
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