Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Orthostatic blood pressure adaptations, aortic stiffness, and central hemodynamics in the general population: insights from the Malmö Offspring Study (MOS)

Johansson, Madeleine LU orcid ; Fedorowski, Artur LU orcid ; Jordan, Jens ; Engström, Gunnar LU ; Nilsson, Peter M LU and Hamrefors, Viktor LU orcid (2023) In Clinical Autonomic Research 33(1). p.29-40
Abstract
Purpose
Arterial stiffness is independently associated with orthostatic hypotension in older individuals. The relationship between orthostatic blood pressure adaptation and aortic stiffness has not been thoroughly examined in a younger population. We investigated the relationship between orthostatic blood pressure adaptations, central aortic hemodynamics, and aortic stiffness in a cohort of predominantly younger and middle-aged adults.

Methods
We analyzed an observational, population-based study of 5259 individuals living in Malmö, Sweden. We related aortic stiffness and central hemodynamics assessed by carotid–femoral pulse wave velocity and pulse wave analysis at the arteria radialis using Sphygmocor to orthostatic blood... (More)
Purpose
Arterial stiffness is independently associated with orthostatic hypotension in older individuals. The relationship between orthostatic blood pressure adaptation and aortic stiffness has not been thoroughly examined in a younger population. We investigated the relationship between orthostatic blood pressure adaptations, central aortic hemodynamics, and aortic stiffness in a cohort of predominantly younger and middle-aged adults.

Methods
We analyzed an observational, population-based study of 5259 individuals living in Malmö, Sweden. We related aortic stiffness and central hemodynamics assessed by carotid–femoral pulse wave velocity and pulse wave analysis at the arteria radialis using Sphygmocor to orthostatic blood pressure adaptation after 3 min standing.

Results
The mean age of the population was 41.9 ± 14.5 years, and 52.1% were women. We observed the highest aortic stiffness and central aortic blood pressure measurements in the lowest and highest quartiles of orthostatic systolic blood pressure differences (p < 0.001). Aortic stiffness and central aortic blood pressure gradually decreased across increasing quartiles of orthostatic diastolic blood pressure difference (p < 0.001). After full adjustment, orthostatic diastolic blood pressure remained significantly associated with aortic stiffness (p =  0.001) and central aortic blood pressure (p <  0.001), whereas orthostatic systolic blood pressure was significantly associated only with central aortic systolic blood pressure (p = 0.009). No significant associations were found between subclinical orthostatic hypotension, aortic stiffness, and central hemodynamics.
Conclusions
Our findings demonstrate that altered blood pressure responses to orthostatic challenges, both blood pressure reductions and blood pressure increases, are independently and inversely associated with markers of aortic stiffness (vascular aging) in a predominantly young to middle-aged population. (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
arterial stiffness, Orthostatic hypotension, Orthostatic blood pressure, central hemodynamics, Population studies, Aortic stiffness, Vascular ageing
in
Clinical Autonomic Research
volume
33
issue
1
pages
29 - 40
publisher
Springer
external identifiers
  • pmid:36473959
  • scopus:85143431985
ISSN
1619-1560
DOI
10.1007/s10286-022-00911-z
project
Vascular Ageing and Arterial Stiffness in the Swedish Population
language
English
LU publication?
yes
id
feb5e23d-7c11-4380-afd1-6d6153cdeb01
date added to LUP
2022-12-07 14:13:55
date last changed
2024-02-12 14:06:11
@article{feb5e23d-7c11-4380-afd1-6d6153cdeb01,
  abstract     = {{Purpose<br/>Arterial stiffness is independently associated with orthostatic hypotension in older individuals. The relationship between orthostatic blood pressure adaptation and aortic stiffness has not been thoroughly examined in a younger population. We investigated the relationship between orthostatic blood pressure adaptations, central aortic hemodynamics, and aortic stiffness in a cohort of predominantly younger and middle-aged adults.<br/><br/>Methods<br/>We analyzed an observational, population-based study of 5259 individuals living in Malmö, Sweden. We related aortic stiffness and central hemodynamics assessed by carotid–femoral pulse wave velocity and pulse wave analysis at the arteria radialis using Sphygmocor to orthostatic blood pressure adaptation after 3 min standing.<br/><br/>Results<br/>The mean age of the population was 41.9 ± 14.5 years, and 52.1% were women. We observed the highest aortic stiffness and central aortic blood pressure measurements in the lowest and highest quartiles of orthostatic systolic blood pressure differences (p &lt; 0.001). Aortic stiffness and central aortic blood pressure gradually decreased across increasing quartiles of orthostatic diastolic blood pressure difference (p &lt; 0.001). After full adjustment, orthostatic diastolic blood pressure remained significantly associated with aortic stiffness (p =  0.001) and central aortic blood pressure (p &lt;  0.001), whereas orthostatic systolic blood pressure was significantly associated only with central aortic systolic blood pressure (p = 0.009). No significant associations were found between subclinical orthostatic hypotension, aortic stiffness, and central hemodynamics.<br/>Conclusions<br/>Our findings demonstrate that altered blood pressure responses to orthostatic challenges, both blood pressure reductions and blood pressure increases, are independently and inversely associated with markers of aortic stiffness (vascular aging) in a predominantly young to middle-aged population.}},
  author       = {{Johansson, Madeleine and Fedorowski, Artur and Jordan, Jens and Engström, Gunnar and Nilsson, Peter M and Hamrefors, Viktor}},
  issn         = {{1619-1560}},
  keywords     = {{arterial stiffness; Orthostatic hypotension; Orthostatic blood pressure; central hemodynamics; Population studies; Aortic stiffness; Vascular ageing}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{29--40}},
  publisher    = {{Springer}},
  series       = {{Clinical Autonomic Research}},
  title        = {{Orthostatic blood pressure adaptations, aortic stiffness, and central hemodynamics in the general population: insights from the Malmö Offspring Study (MOS)}},
  url          = {{http://dx.doi.org/10.1007/s10286-022-00911-z}},
  doi          = {{10.1007/s10286-022-00911-z}},
  volume       = {{33}},
  year         = {{2023}},
}