Complaint recognition during tilt testing in classical orthostatic hypotension was associated with a larger blood pressure fall compared to asymptomatic cases (49.2 vs 37.3, p=0.043).
Observational (n=77)
Does the magnitude of blood pressure fall correlate with symptom recognition in patients with classical orthostatic hypotension?
Symptom recognition during tilt testing in classical orthostatic hypotension is associated with a larger blood pressure fall and less total peripheral resistance increase, highlighting a complex pathophysiological relationship.
Absolute Event Rate: 49.2% vs 37.3%
p-value: p=0.043
Abstract Purpose Previous research regarding the association between blood pressure (BP) fall and symptoms yielded inconsistent results in classical orthostatic hypotension (cOH), with some studies proposing specific cut-off values and others reporting only weak or absent correlations. This study examined clinical cOH symptoms in relation to changes in BP and the haemodynamic parameters determining BP. Methods We retrospectively analysed 77 tilt test records showing cOH and selected 40 with and 37 without complaint recognition during the test. We compared absolute values of haemodynamic parameters as well as the differences and ratios compared to supine baseline at three different times during tilt. We also explored relationships between relative haemodynamic changes and symptoms with the log-ratio method. Results There was a larger blood pressure fall in the group with complaint recognition compared (49.2 vs 37.3, p = 0.043). The log-ratio analysis showed less total peripheral resistance increase and a larger blood pressure decrease in the symptomatic group. Conclusion Recognised complaints were related to a larger BP fall, while in previous studies complaints were either not related to BP or to minimum BP. These contrasts suggest that the pathophysiology of orthostatic complaints is complex. The chain of events from low BP to awareness of complaints contains multiple links, of which cerebral perfusion is probably a critical one. We suggest that the pathway contains so much variability that we should not expect the relation between low blood pressure and complaints in cOH to be simple.
Gagaouzova et al. (Tue,) conducted a observational in Classical orthostatic hypotension (n=77). Complaint recognition during tilt test vs. No complaint recognition was evaluated on Blood pressure fall (p=0.043). Complaint recognition during tilt testing in classical orthostatic hypotension was associated with a larger blood pressure fall compared to asymptomatic cases (49.2 vs 37.3, p=0.043).