Individual changes of central blood pressure in response to upright posture: different hemodynamic phenotypes. 2021

Lauri J Suojanen, and Jenni K Koskela, and Matias Wilenius, and Manoj Kumar Choudhary, and Elina J Hautaniemi, and Jari Viik, and Jukka T Mustonen, and Ilkka H Pörsti
Faculty of Medicine and Health Technology, FI-33014 Tampere University.

Most studies about upright regulation of blood pressure have focused on orthostatic hypotension despite the diverse hemodynamic changes induced by orthostatic challenge. We investigated the effect of passive head-up tilt on aortic blood pressure. Noninvasive peripheral and central hemodynamics in 613 volunteers without cardiovascular morbidities or medications were examined using pulse wave analysis, whole-body impedance cardiography and heart rate variability analysis. In all participants, mean aortic SBP decreased by -4 (-5 to -3) mmHg [mean (95% confidence intervals)] and DBP increased by 6 (5--6) mmHg in response to upright posture. When divided into tertiles according to the supine-to-upright change in aortic SBP, two tertiles presented with a decrease [-15 (-14 to -16) and -4 (-3 to -4) mmHg, respectively] whereas one tertile presented with an increase [+7 (7-- 8) mmHg] in aortic SBP. There were no major differences in demographic characteristics between the tertiles. In regression analysis, the strongest explanatory factors for upright changes in aortic SBP were the supine values of, and upright changes in systemic vascular resistance and cardiac output, and supine aortic SBP. In participants without cardiovascular disease, the changes in central SBP during orthostatic challenge are not uniform. One-third presented with higher upright than supine aortic SBP with underlying differences in the regulation of systemic vascular resistance and cardiac output. These findings emphasize that resting blood pressure measurements give only limited information about the blood pressure status.

UI MeSH Term Description Entries
D010641 Phenotype The outward appearance of the individual. It is the product of interactions between genes, and between the GENOTYPE and the environment. Phenotypes
D011187 Posture The position or physical attitude of the body. Postures
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D002307 Cardiography, Impedance A type of impedance plethysmography in which bioelectrical impedance is measured between electrodes positioned around the neck and around the lower thorax. It is used principally to calculate stroke volume and cardiac volume, but it is also related to myocardial contractility, thoracic fluid content, and circulation to the extremities. Impedance, Transthoracic,Plethysmography, Impedance, Transthoracic,Impedance Cardiography,Impedance Plethysmography, Transthoracic,Plethysmography, Transthoracic Impedance,Transthoracic Impedance Plethysmography,Cardiographies, Impedance,Impedance Cardiographies,Impedance Plethysmographies, Transthoracic,Impedances, Transthoracic,Plethysmographies, Transthoracic Impedance,Transthoracic Impedance,Transthoracic Impedance Plethysmographies,Transthoracic Impedances
D006339 Heart Rate The number of times the HEART VENTRICLES contract per unit of time, usually per minute. Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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