Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

The relative contribution of hemodynamic parameters to blood pressure decrease in classical orthostatic hypotension

Gagaouzova, Boriana S ; van der Stam, Amber ; Johansson, Madeleine LU orcid ; Van Rossum, Ineke A ; Kerkhof, Fabian I ; Reijntjes, Robert ; van Houwelingen, Marc ; Thijs, Roland D ; Fedorowski, Artur LU orcid and Dijk, J Gert van (2025) In Journal of Hypertension 43(3). p.436-444
Abstract

PURPOSE: We studied the relative contributions of total peripheral resistance (TPR), stroke volume (SV) and heart rate (HR) to low blood pressure in classical orthostatic hypotension (cOH) on group and individual levels.

METHODS: We retrospectively analyzed tilt test records from cOH patients and age/sex-matched controls. We quantified relative effects of HR, SV and TPR on mean arterial pressure (MAP) with the log-ratio method. We studied relations of changes of HR, SV or TPR with the change of MAP across patients and variability of contributions of HR, SV and TPR to MAP. We also explored neurogenic vs. nonneurogenic causes.

RESULTS: MAP responded to tilt with a decrease in patients (n = 80) and an increase in controls (n =... (More)

PURPOSE: We studied the relative contributions of total peripheral resistance (TPR), stroke volume (SV) and heart rate (HR) to low blood pressure in classical orthostatic hypotension (cOH) on group and individual levels.

METHODS: We retrospectively analyzed tilt test records from cOH patients and age/sex-matched controls. We quantified relative effects of HR, SV and TPR on mean arterial pressure (MAP) with the log-ratio method. We studied relations of changes of HR, SV or TPR with the change of MAP across patients and variability of contributions of HR, SV and TPR to MAP. We also explored neurogenic vs. nonneurogenic causes.

RESULTS: MAP responded to tilt with a decrease in patients (n = 80) and an increase in controls (n = 80). A too small TPR-increase contributed most to cOH, followed by a too large SV-decrease; both effects were partially corrected by a larger increase of HR. Only TPR changes consistently affected MAP change in patients and controls. TPR decreased almost exclusively in patients, most in those with severe cOH. Contributions of HR, SV and TPR to MAP did not differ between probable neurogenic and nonneurogenic causes.

CONCLUSION: HR, SV and TPR all contributed to cOH, with a key role for TPR; a decrease of TPR was almost unique to patients and may be due to hyperventilation. The lack of differences between neurogenic and nonneurogenic causes needs further study.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
orthostatic hypotension, hemodynamics, Blood pressure
in
Journal of Hypertension
volume
43
issue
3
pages
436 - 444
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85208663443
  • pmid:39440925
ISSN
1473-5598
DOI
10.1097/HJH.0000000000003832
language
English
LU publication?
yes
id
a7ad3dcd-3685-4151-a4c0-e0a4a2f29736
date added to LUP
2024-10-25 19:01:21
date last changed
2025-07-01 03:01:19
@article{a7ad3dcd-3685-4151-a4c0-e0a4a2f29736,
  abstract     = {{<p>PURPOSE: We studied the relative contributions of total peripheral resistance (TPR), stroke volume (SV) and heart rate (HR) to low blood pressure in classical orthostatic hypotension (cOH) on group and individual levels.</p><p>METHODS: We retrospectively analyzed tilt test records from cOH patients and age/sex-matched controls. We quantified relative effects of HR, SV and TPR on mean arterial pressure (MAP) with the log-ratio method. We studied relations of changes of HR, SV or TPR with the change of MAP across patients and variability of contributions of HR, SV and TPR to MAP. We also explored neurogenic vs. nonneurogenic causes.</p><p>RESULTS: MAP responded to tilt with a decrease in patients (n = 80) and an increase in controls (n = 80). A too small TPR-increase contributed most to cOH, followed by a too large SV-decrease; both effects were partially corrected by a larger increase of HR. Only TPR changes consistently affected MAP change in patients and controls. TPR decreased almost exclusively in patients, most in those with severe cOH. Contributions of HR, SV and TPR to MAP did not differ between probable neurogenic and nonneurogenic causes.</p><p>CONCLUSION: HR, SV and TPR all contributed to cOH, with a key role for TPR; a decrease of TPR was almost unique to patients and may be due to hyperventilation. The lack of differences between neurogenic and nonneurogenic causes needs further study.</p>}},
  author       = {{Gagaouzova, Boriana S and van der Stam, Amber and Johansson, Madeleine and Van Rossum, Ineke A and Kerkhof, Fabian I and Reijntjes, Robert and van Houwelingen, Marc and Thijs, Roland D and Fedorowski, Artur and Dijk, J Gert van}},
  issn         = {{1473-5598}},
  keywords     = {{orthostatic hypotension; hemodynamics; Blood pressure}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{436--444}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Journal of Hypertension}},
  title        = {{The relative contribution of hemodynamic parameters to blood pressure decrease in classical orthostatic hypotension}},
  url          = {{http://dx.doi.org/10.1097/HJH.0000000000003832}},
  doi          = {{10.1097/HJH.0000000000003832}},
  volume       = {{43}},
  year         = {{2025}},
}