Key result
Patients with a progressive orthostatic hypotension pattern exhibited the greatest reduction in systolic blood pressure and the highest rate of symptom development requiring early termination of the head-up tilt test (42.1%, p<0.001).
Why the study?
Do patterns of blood pressure changes during a 10-minute head-up tilt test correlate with clinical characteristics and autonomic function test results in patients with orthostatic hypotension?
Observational (n=151)
No
Do patterns of blood pressure changes during a 10-minute head-up tilt test correlate with clinical characteristics and autonomic function test results in patients with orthostatic hypotension?
p-value: p=<0.001
Extending the head-up tilt test to 10 minutes reveals distinct patterns of orthostatic hypotension that correlate with different underlying autonomic dysfunctions and symptom severities.
Pattern-specific responses during 10-min tilt may refine symptom risk assessment; leaves open utility for autonomic phenotyping.
BACKGROUND AND PURPOSE: The objective of this study was to determine the patterns of blood pressure (BP) changes during the head-up tilt (HUT) test, particularly in terms of its clinical significance for patients with orthostatic hypotension (OH). METHODS: OH was divided into four categories based on systolic BP changes occurring within the first 10 minutes of the HUT test: sustained orthostatic hypotension (SOH), progressive orthostatic hypotension (POH), orthostatic hypotension with partial recovery (OHPR), and transient orthostatic hypotension (TOH). RESULTS: In total, 151 patients were analyzed: 65 with SOH, 38 with POH, 21 with OHPR, and 27 with TOH. POH patients exhibited the greatest reduction in systolic BP after HUT and were also the most likely to develop symptoms requiring early termination of the HUT test (42.1%, p<0.001). Additionally, SOH patients exhibited smaller heart-rate variation with deep breathing values (p=0.003) and Valsalva ratios (p=0.022) compared to POH patients. The sweat volume was greatest in OHPR patients. CONCLUSIONS: Clinical characteristics, including the findings of autonomic function tests, differed between the OH patient groups. This might reflect differences in the underlying pathophysiologic mechanisms. Determining the patterns of BP changes during the HUT test may facilitate the development of effective management strategies in patients with OH.
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Seok et al. (2018) conducted an observational in Orthostatic hypotension (n=151). Progressive orthostatic hypotension (POH) pattern vs. Other orthostatic hypotension patterns (SOH, OHPR, TOH) was evaluated on Symptom development requiring early termination of the head-up tilt test (p=<0.001). Patients with a progressive orthostatic hypotension pattern exhibited the greatest reduction in systolic blood pressure and the highest rate of symptom development requiring early termination of the head-up tilt test (42.1%, p<0.001).
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