Tags

Type your tag names separated by a space and hit enter

Predicting outcomes on head-up tilt based on orthostatic hypotension patterns.
J Hypertens. 2006 Jun; 24(6):1033-9.JH

Abstract

OBJECTIVE

To assess the frequency of different orthostatic hypotension (OH) patterns in patients having supine hypertension with OH ('SHOH') versus patients with OH and normal supine blood pressure ('OH alone'); and to relate OH patterns with outcomes on head-up tilt.

METHODS

Consecutive patients with nonspecific dizziness were studied with a 10-min supine, 30-min head-up tilt test. Supine hypertension was diagnosed when supine systolic blood pressure (SBP) was at least 140 mmHg and/or supine diastolic blood pressure was at least 90 mmHg. OH was defined as SBP reduction of at least 20 mmHg within 3 min of tilt. OH patterns were identified corresponding to SBP time-curves during the initial 5 min of tilt: progressive, sustained and transient patterns.

RESULTS

Among 400 patients tested, 31 had 'SHOH' and 39 had 'OH alone'. Frequencies of OH patterns were similar in both groups. The progressive OH pattern predicted symptomatic hypotension, leading to early tilt termination in all 'SHOH' and 88% of 'OH alone' patients. In comparison, tilt was early terminated in 33-48% of patients with sustained OH, transient OH and without OH. Early tilt termination was unrelated to age, gender, magnitude of supine SBP, pulse pressure and nadir SBP within 5 min tilt.

CONCLUSIONS

Five minutes of postural challenge permitted assessing OH patterns. Outcome on protracted tilt was related to OH patterns, the worse outcome being likened to progressive OH, both in patients with 'SHOH' and in patients with 'OH alone'. Future studies will show whether OH patterns may serve as guidance for blood pressure therapy in selected patients.

Authors+Show Affiliations

Department of Internal Medicine A, The Bnai-Zion Medical Center, Haifa, Israel. Naschitz@tx.technion.ac.ilNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16685202

Citation

Naschitz, Jochanan E., et al. "Predicting Outcomes On Head-up Tilt Based On Orthostatic Hypotension Patterns." Journal of Hypertension, vol. 24, no. 6, 2006, pp. 1033-9.
Naschitz JE, Elias N, Slobodin G, et al. Predicting outcomes on head-up tilt based on orthostatic hypotension patterns. J Hypertens. 2006;24(6):1033-9.
Naschitz, J. E., Elias, N., Slobodin, G., Storch, S., & Rosner, I. (2006). Predicting outcomes on head-up tilt based on orthostatic hypotension patterns. Journal of Hypertension, 24(6), 1033-9.
Naschitz JE, et al. Predicting Outcomes On Head-up Tilt Based On Orthostatic Hypotension Patterns. J Hypertens. 2006;24(6):1033-9. PubMed PMID: 16685202.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predicting outcomes on head-up tilt based on orthostatic hypotension patterns. AU - Naschitz,Jochanan E, AU - Elias,Nizar, AU - Slobodin,Gleb, AU - Storch,Shimon, AU - Rosner,Itzhak, PY - 2006/5/11/pubmed PY - 2006/8/11/medline PY - 2006/5/11/entrez SP - 1033 EP - 9 JF - Journal of hypertension JO - J Hypertens VL - 24 IS - 6 N2 - OBJECTIVE: To assess the frequency of different orthostatic hypotension (OH) patterns in patients having supine hypertension with OH ('SHOH') versus patients with OH and normal supine blood pressure ('OH alone'); and to relate OH patterns with outcomes on head-up tilt. METHODS: Consecutive patients with nonspecific dizziness were studied with a 10-min supine, 30-min head-up tilt test. Supine hypertension was diagnosed when supine systolic blood pressure (SBP) was at least 140 mmHg and/or supine diastolic blood pressure was at least 90 mmHg. OH was defined as SBP reduction of at least 20 mmHg within 3 min of tilt. OH patterns were identified corresponding to SBP time-curves during the initial 5 min of tilt: progressive, sustained and transient patterns. RESULTS: Among 400 patients tested, 31 had 'SHOH' and 39 had 'OH alone'. Frequencies of OH patterns were similar in both groups. The progressive OH pattern predicted symptomatic hypotension, leading to early tilt termination in all 'SHOH' and 88% of 'OH alone' patients. In comparison, tilt was early terminated in 33-48% of patients with sustained OH, transient OH and without OH. Early tilt termination was unrelated to age, gender, magnitude of supine SBP, pulse pressure and nadir SBP within 5 min tilt. CONCLUSIONS: Five minutes of postural challenge permitted assessing OH patterns. Outcome on protracted tilt was related to OH patterns, the worse outcome being likened to progressive OH, both in patients with 'SHOH' and in patients with 'OH alone'. Future studies will show whether OH patterns may serve as guidance for blood pressure therapy in selected patients. SN - 0263-6352 UR - https://www.unboundmedicine.com/medline/citation/16685202/Predicting_outcomes_on_head_up_tilt_based_on_orthostatic_hypotension_patterns_ L2 - https://doi.org/10.1097/01.hjh.0000226192.13687.1d DB - PRIME DP - Unbound Medicine ER -