Delayed orthostatic hypotension

@article{Gibbons2006DelayedOH,
  title={Delayed orthostatic hypotension},
  author={Christopher H. Gibbons and Roy Freeman},
  journal={Neurology},
  year={2006},
  volume={67},
  pages={28 - 32}
}
Objective: To investigate the prevalence, symptoms, and neurophysiologic features of delayed orthostatic hypotension (OH). Methods: Blood pressures (BP) were measured at 1-minute intervals on 230 patients during 60° head-up tilt for 45 minutes and standing for 5 minutes. OH was defined as a sustained fall in BP (≥20 mm Hg systolic or ≥10 mm Hg diastolic) and delayed OH as a sustained BP fall occurring beyond 3 minutes of standing or upright tilt table testing. Beat-to-beat BP, tests of… 

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References

SHOWING 1-10 OF 21 REFERENCES

Delayed orthostatic intolerance.

It is concluded that orthostatic hypotension occurring after more than 10 minutes of standing is a potentially debilitating and often correctable disorder.

What is the minimum duration of head-up tilt necessary to detect orthostatic hypotension?

One minute of HUT will detect OH in the great majority (88%) of patients and three minutes will detect the balance, suggesting Orthostatic stress beyond 2 minutes is necessary to detect the pattern of progressive OH.

Autoregulation of cerebral blood flow in orthostatic hypotension.

The most common patterns of cerebral response to OH are autoregulatory failure with a flat flow-pressure relationship or intactAutoregulation with an expanded autoreGulated range, which is the least common pattern.

Cerebral Autoregulation in Orthostatic Intolerance

There is no evidence of impaired dynamic cerebral autoregulation, as measured by standard linear transfer‐function analysis, in patients with NMS and some patients with exaggerated postural tachycardia (POTS) have been found to have an excessive decrease in CBV during head‐up tilt.

Comparison of the active standing test and head-up tilt test for diagnosis of syncope in childhood and adolescence

The results indicated the AS test caused cardiac sympathetic activation associated with an initial pressure drop, and was more prone to induce syncope with a greater HR increase in some patients.

Deterioration of cerebral autoregulation during orthostatic stress: insights from the frequency domain.

The damping effects of autoregulation on variations inCBF velocity are diminished during orthostatic stress in association with substantial falls in steady-state CBF velocity, suggesting that these changes may contribute in part to the development of presyncope.

Hypotension‐induced vasopressin release distinguishes between pure autonomic failure and multiple system atrophy with autonomic failure

Measurement of baroreceptor-mediated vasopressin release appears to provide a clear marker to differentiate between patients with PAF and patients with MSA, indicating that afferent and central barore receptor pathways involved in vasoppressin release are normal in patients withPAF but are impaired in patientswith MSA.

Sustained increases in sympathetic outflow during prolonged lower body negative pressure in humans.

The purpose of this study was to determine whether prolonged unloading of cardiopulmonary baroreceptors with lower body negative pressure (LBNP) causes constant increases in sympathetic outflow to