Document Detail


Differences in overshoot of blood pressure after head-up tilt in two groups with chronic autonomic failure: pure autonomic failure and multiple system atrophy.
MedLine Citation:
PMID:  15654557     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
On head down tilt to the supine horizontal position (tilt reversal) after head up tilt (HUT), patients with orthostatic hypotension may show an increase in blood pressure (BP) relative to baseline readings. We assessed this BP overshoot in 8 patients with pure autonomic failure (PAF, 64+/-13 years) and 8 patients with multiple system atrophy (MSA, 66+/-10 years). BP was intermittently measured during pre-tilt supine, HUT (60 degrees , 10 min), and post-tilt supine periods. In addition, beat-to-beat BP was measured continuously using the Portapres model 2 device to calculate stroke volume (SV), cardiac output (CO) and total peripheral resistance (TPR). There was systolic BP overshoot of > or = 15 mmHg after tilt reversal in 5 out of 8 PAF, but in only one of 8 MSA. A mean increase of systolic BP in PAF was significantly higher than that in MSA (p<0.01). TPR increased over baseline level after tilt reversal, although there was no significant difference. SV and CO levels during the post-tilt supine period were similar to baseline levels. In conclusion, BP overshoot was prominent in the PAF group but not in the MSA group. The phenomenon of BP overshoot while supine, especially in PAF, may have implications for long term cardiac and vascular damage in such patients.
Authors:
Masato Asahina; Tim M Young; Katharine Bleasdale-Barr; Christopher J Mathias
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurology     Volume:  252     ISSN:  0340-5354     ISO Abbreviation:  J. Neurol.     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-17     Completed Date:  2005-04-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0423161     Medline TA:  J Neurol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  72-7     Citation Subset:  IM    
Affiliation:
Department of Neurology, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan. asahina@faculty.chiba-u.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Autonomic Nervous System / physiopathology
Autonomic Nervous System Diseases / diagnosis,  physiopathology*
Blood Pressure / physiology
Cardiac Output / physiology
Female
Humans
Hypertension / diagnosis,  etiology*,  physiopathology*
Male
Middle Aged
Multiple System Atrophy / diagnosis,  physiopathology*
Posture / physiology
Stroke Volume / physiology
Tilt-Table Test

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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