What question did this study set out to answer?

This study aims to investigate the relationship between standing blood pressure rise and autonomic dysfunction in individuals with orthostatic hypertension compared to healthy controls.

May 14, 2026Physiology

Association between standing blood pressure and autonomic dysfunction in orthostatic hypertension

Q: What are the key findings of this study?

Individuals with orthostatic hypertension exhibited significantly lower supine cardiovagal baroreflex sensitivity compared to healthy controls (7.4 vs 17.8 msec/mmHg; P<0.05).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Orthostatic hypertension (n=135). Intervention: Orthostatic hypertension (OHT) vs. Healthy controls, pseudo-OHT, and resting hypertension. Primary outcome: Supine cardiovagal baroreflex sensitivity (CBRS) (p=<0.05).

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Key result

Orthostatic hypertension linked to ~58% lower supine cardiovagal baroreflex sensitivity versus healthy controls.

P<0.05
n=135

Why the study?

It was unclear whether an orthostatic rise in systolic blood pressure itself, independent of the absolute level of standing systolic blood pressure, reflects autonomic dysfunction.

Does orthostatic hypertension with or without high standing SBP indicate autonomic dysfunction in individuals without known cardiovascular disease?

Population

135 individuals without known cardiovascular diseases

Comparison

Control vs pseudo-OHT vs OHT vs supine HT

Authors

THTakuto HamaokaPennsylvania State University ULUrs LeuenbergerPenn State Milton S. Hershey Medical Center MHMami HamaokaPennsylvania State University

Discussion

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Implication

Whether ΔSBP independently signals autonomic dysfunction beyond standing SBP remains unclear; leaves open refined OHT phenotyping for future studies.

Key Points

This study aims to investigate the relationship between standing blood pressure rise and autonomic dysfunction in individuals with orthostatic hypertension compared to healthy controls.
135 individuals recruited without known cardiovascular diseases underwent a standing test after supine rest.
Continuous beat-by-beat blood pressure and heart rate were recorded, with analyses of heart rate variability and baroreflex sensitivity.
Participants classified into four groups based on standing blood pressure and its increase upon standing.
Lower supine parasympathetic HRV parameters in OHT and HT groups compared to Control and p-OHT (P < 0.05).
No significant differences in autonomic function between HT and OHT groups; however, HT group's RMSSD was significantly higher (P < 0.05).
BPV parameters in OHT group were similar to Control and p-OHT, suggesting no increased autonomic impairment.

Study Design

Type

Cross-Sectional (n=135)

Structured PICO

Does orthostatic hypertension with or without high standing SBP indicate autonomic dysfunction in individuals without known cardiovascular disease?

Population

135 individuals without known cardiovascular diseases (some with hypertension), mean age 41 ± 15 years.

Intervention

Orthostatic hypertension (OHT: ∆SBP ≥ 10 mmHg, supine SBP < 130mmHg, and standing SBP ≥ 130 mmHg) and Pseudo-OHT (∆SBP ≥ 10 mmHg and standing SBP < 130 mmHg)

Comparator

Control (10 >∆SBP > -5mmHg and standing SBP < 130 mmHg) and supine HT (10 >∆SBP > -5mmHg and supine SBP ≥ 130 mmHg)

Outcome

Autonomic function measured by heart rate variability (HRV), SBP variability (BPV), and spontaneous cardiovagal baroreflex sensitivity (CBRS)surrogate

Main Result

Absolute Event Rate: 7.4% vs 17.8%

p-value: p=<0.05

Both an orthostatic increase in BP and an absolute standing SBP ≥ 130 mmHg are associated with impaired autonomic function, suggesting standing BP assessment may help identify concealed autonomic dysfunction.

Cite This Study

Hamaoka et al. (2026) conducted a cross-sectional in Orthostatic hypertension (n=135). Orthostatic hypertension (OHT) vs. Healthy controls, pseudo-OHT, and resting hypertension was evaluated on Supine cardiovagal baroreflex sensitivity (CBRS) (p=<0.05). Individuals with orthostatic hypertension exhibited significantly lower supine cardiovagal baroreflex sensitivity compared to healthy controls (7.4 vs 17.8 msec/mmHg; P<0.05).

synapsesocial.com/papers/6a0566fba550a87e60a1ef54 https://doi.org/10.1152/physiol.2026.41.s1.2294264

Topics

Cardiac Rehabilitation and Lifestyle Interventions Hypertension management

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Implication

Whether ΔSBP independently signals autonomic dysfunction beyond standing SBP remains unclear; leaves open refined OHT phenotyping for future studies.

Association between standing blood pressure and autonomic dysfunction in orthostatic hypertension

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Association between standing blood pressure and autonomic dysfunction in orthostatic hypertension

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

Also Consider