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A practical guide to active stand testing and analysis using continuous beat-to-beat non-invasive blood pressure monitoring

Finucane, Ciarán ; van Wijnen, V. K. ; Fan, C. W. ; Soraghan, C. ; Byrne, L. ; Westerhof, B. E. ; Freeman, R. ; Fedorowski, A. LU orcid ; Harms, M. P.M. and Wieling, W. , et al. (2019) In Clinical Autonomic Research 29(4). p.427-441
Abstract

Purpose: The average adult stands approximately 50–60 times per day. Cardiovascular responses evoked during the first 3 min of active standing provide a simple means to clinically assess short-term neural and cardiovascular function across the lifespan. Clinically, this response is used to identify the haemodynamic correlates of patient symptoms and attributable causes of (pre-)syncope, and to detect autonomic dysfunction, variants of orthostatic hypotension, postural orthostatic tachycardia syndrome and orthostatic hypertension. Methods: This paper provides a set of experience/expertise-based recommendations detailing current state-of-the-art measurement and analysis approaches for the active stand test, focusing on beat-to-beat BP... (More)

Purpose: The average adult stands approximately 50–60 times per day. Cardiovascular responses evoked during the first 3 min of active standing provide a simple means to clinically assess short-term neural and cardiovascular function across the lifespan. Clinically, this response is used to identify the haemodynamic correlates of patient symptoms and attributable causes of (pre-)syncope, and to detect autonomic dysfunction, variants of orthostatic hypotension, postural orthostatic tachycardia syndrome and orthostatic hypertension. Methods: This paper provides a set of experience/expertise-based recommendations detailing current state-of-the-art measurement and analysis approaches for the active stand test, focusing on beat-to-beat BP technologies. This information is targeted at those interested in performing and interpreting the active stand test to current international standards. Results: This paper presents a practical step-by-step guide on (1) how to perform active stand measurements using beat-to-beat continuous blood pressure measurement technologies, (2) how to conduct an analysis of the active stand response and (3) how to identify the spectrum of abnormal blood pressure and heart rate responses which are of clinical interest. Conclusion: Impairments in neurocardiovascular control are an attributable cause of falls and syncope across the lifespan. The simple active stand test provides the clinician with a powerful tool for assessing individuals at risk of such common disorders. However, its simplicity belies the complexity of its interpretation. Care must therefore be taken in administering and interpreting the test in order to maximise its clinical benefit and minimise its misinterpretation.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Active stand, Autonomic dysfunction, Continuous blood pressure, Falls and syncope, Orthostatic hypotension
in
Clinical Autonomic Research
volume
29
issue
4
pages
427 - 441
publisher
Springer
external identifiers
  • scopus:85065697924
  • pmid:31076939
ISSN
0959-9851
DOI
10.1007/s10286-019-00606-y
language
English
LU publication?
yes
id
6b98e10e-707a-46db-8e00-6c1d4bead2d6
date added to LUP
2019-06-17 14:08:00
date last changed
2024-04-16 11:22:32
@article{6b98e10e-707a-46db-8e00-6c1d4bead2d6,
  abstract     = {{<p>Purpose: The average adult stands approximately 50–60 times per day. Cardiovascular responses evoked during the first 3 min of active standing provide a simple means to clinically assess short-term neural and cardiovascular function across the lifespan. Clinically, this response is used to identify the haemodynamic correlates of patient symptoms and attributable causes of (pre-)syncope, and to detect autonomic dysfunction, variants of orthostatic hypotension, postural orthostatic tachycardia syndrome and orthostatic hypertension. Methods: This paper provides a set of experience/expertise-based recommendations detailing current state-of-the-art measurement and analysis approaches for the active stand test, focusing on beat-to-beat BP technologies. This information is targeted at those interested in performing and interpreting the active stand test to current international standards. Results: This paper presents a practical step-by-step guide on (1) how to perform active stand measurements using beat-to-beat continuous blood pressure measurement technologies, (2) how to conduct an analysis of the active stand response and (3) how to identify the spectrum of abnormal blood pressure and heart rate responses which are of clinical interest. Conclusion: Impairments in neurocardiovascular control are an attributable cause of falls and syncope across the lifespan. The simple active stand test provides the clinician with a powerful tool for assessing individuals at risk of such common disorders. However, its simplicity belies the complexity of its interpretation. Care must therefore be taken in administering and interpreting the test in order to maximise its clinical benefit and minimise its misinterpretation.</p>}},
  author       = {{Finucane, Ciarán and van Wijnen, V. K. and Fan, C. W. and Soraghan, C. and Byrne, L. and Westerhof, B. E. and Freeman, R. and Fedorowski, A. and Harms, M. P.M. and Wieling, W. and Kenny, R.}},
  issn         = {{0959-9851}},
  keywords     = {{Active stand; Autonomic dysfunction; Continuous blood pressure; Falls and syncope; Orthostatic hypotension}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{427--441}},
  publisher    = {{Springer}},
  series       = {{Clinical Autonomic Research}},
  title        = {{A practical guide to active stand testing and analysis using continuous beat-to-beat non-invasive blood pressure monitoring}},
  url          = {{http://dx.doi.org/10.1007/s10286-019-00606-y}},
  doi          = {{10.1007/s10286-019-00606-y}},
  volume       = {{29}},
  year         = {{2019}},
}