Why the study?
Does orthostasis (50-degree head up tilt) affect vascular resistance differently in patients with borderline versus sustained essential hypertension compared to normotensive controls?
Does orthostasis (50-degree head up tilt) affect vascular resistance differently in patients with borderline versus sustained essential hypertension compared to normotensive controls?
Patients with borderline hypertension exhibit abnormal autonomic nervous control of vascular resistance during orthostasis, distinct from both sustained hypertension and normotensive states.
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May indicate distinct autonomic vascular responses in borderline hypertension; leaves open prospective validation and clinical relevance.
Changes in hemodynamic parameters following 50-degree head up tilt were studied in a population of 78 males, including 30 patients with sustained essential hypertension, 30 patients with borderline hypertension, and 18 normotensive controls of the same age. The increase in vascular resistance following tilt was significantly higher in hypertensive subjects. In patients with sustained hypertension, baseline vascular resistance was significantly higher than in normotensive controls, and it was strongly correlated with its change following orthostasis. In patients with borderline hypertension, baseline vascular resistance was similar to that of normotensive controls and did not correlate with its change following orthostasis. The latter result suggests an abnormality in the autonomic nervous control in patients with borderline hypertension, possibly mediated by cardiopulmonary mechanoreceptors in the low pressure system.
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London et al. (1988) studied this question.
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