Hemodynamic characterization of hypertensive patients with an exaggerated orthostatic blood pressure variation
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 pa...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2018-04-01
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| Series: | Clinical and Experimental Hypertension |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/10641963.2017.1368539 |
| _version_ | 1797681377067401216 |
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| author | Jessica Barochiner Lucas S. Aparicio José Alfie Marcelo A. Rada Margarita S. Morales Carlos R. Galarza Paula E. Cuffaro Marcos J. Marín Rocío Martínez Gabriel D. Waisman |
| author_facet | Jessica Barochiner Lucas S. Aparicio José Alfie Marcelo A. Rada Margarita S. Morales Carlos R. Galarza Paula E. Cuffaro Marcos J. Marín Rocío Martínez Gabriel D. Waisman |
| author_sort | Jessica Barochiner |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-11T23:44:04Z |
| format | Article |
| id | doaj.art-6ba130b031c247d0aa298e472aa972b1 |
| institution | Directory Open Access Journal |
| issn | 1064-1963 1525-6006 |
| language | English |
| last_indexed | 2024-03-11T23:44:04Z |
| publishDate | 2018-04-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Clinical and Experimental Hypertension |
| spelling | doaj.art-6ba130b031c247d0aa298e472aa972b12023-09-19T15:19:26ZengTaylor & Francis GroupClinical and Experimental Hypertension1064-19631525-60062018-04-0140328729110.1080/10641963.2017.13685391368539Hemodynamic characterization of hypertensive patients with an exaggerated orthostatic blood pressure variationJessica Barochiner0Lucas S. Aparicio1José Alfie2Marcelo A. Rada3Margarita S. Morales4Carlos R. Galarza5Paula E. Cuffaro6Marcos J. Marín7Rocío Martínez8Gabriel D. Waisman9Hospital Italiano de Buenos AiresHospital Italiano de Buenos AiresHospital Italiano de Buenos AiresHospital Italiano de Buenos AiresHospital Italiano de Buenos AiresHospital Italiano de Buenos AiresHospital Italiano de Buenos AiresHospital Italiano de Buenos AiresHospital Italiano de Buenos AiresHospital Italiano de Buenos AiresExaggerated 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.http://dx.doi.org/10.1080/10641963.2017.1368539exaggeratedhemodynamichypertensionimpedance cardiographyorthostatic blood pressure variation |
| spellingShingle | Jessica Barochiner Lucas S. Aparicio José Alfie Marcelo A. Rada Margarita S. Morales Carlos R. Galarza Paula E. Cuffaro Marcos J. Marín Rocío Martínez Gabriel D. Waisman Hemodynamic characterization of hypertensive patients with an exaggerated orthostatic blood pressure variation Clinical and Experimental Hypertension exaggerated hemodynamic hypertension impedance cardiography orthostatic blood pressure variation |
| title | Hemodynamic characterization of hypertensive patients with an exaggerated orthostatic blood pressure variation |
| title_full | Hemodynamic characterization of hypertensive patients with an exaggerated orthostatic blood pressure variation |
| title_fullStr | Hemodynamic characterization of hypertensive patients with an exaggerated orthostatic blood pressure variation |
| title_full_unstemmed | Hemodynamic characterization of hypertensive patients with an exaggerated orthostatic blood pressure variation |
| title_short | Hemodynamic characterization of hypertensive patients with an exaggerated orthostatic blood pressure variation |
| title_sort | hemodynamic characterization of hypertensive patients with an exaggerated orthostatic blood pressure variation |
| topic | exaggerated hemodynamic hypertension impedance cardiography orthostatic blood pressure variation |
| url | http://dx.doi.org/10.1080/10641963.2017.1368539 |
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