Are heart rate responses reproducible in the tilt-table test?

Abstract

Measurement of blood pressure and heart rate in active orthostasis has proven to be effective in the diagnosis of autonomic regulatory dysfunctions. The following study was carried out in order to clarify to what extent reproducible heart rate reactions also occur in passive orthostasis. 61 people with normal results in five standardized tests were examined. All 61 test persons had individually differing courses of heart rate. After an initial increase of frequency an almost straight line results from a superimposed projection of the graphs. In 20 of these cases the tilt-table test was repeated in order to detect intra-individual regularities. Even when the test was repeated, no reproducible intraindividual heart rate reactions occurred. And here as well, projection of the graphs produced an almost straight line. We could not find any quotient, such as the 30/15 ratio in active orthostasis, during our tests with the tilt-table.

Reliability of orthostatic responses in healthy men aged between 65 and 75 years

“…In addition, these findings are in agreement with Patel et al (1993) who reported that asymptomatic postural reductions in systolic blood pressure in response to HUT were reproducible 1 week after initial testing in younger, middle-aged and older individuals. However, these results are in conflict with others, who have suggested that the HR (Giaconi et al 1987;Jost et al 1994) and AP (Giaconi et al 1987;Piha, 1991;Ward & Kenny, 1996) responses during HUT are unreliable, and show marked variation across days. The discrepant findings of the present and previous studies (Ward & Kenny, 1996) are most probably explained by differences in the subject population.…”

“…Additionally, orthostatic testing has been used extensively to assess the age‐associated increase in postural hypotension (Maclennan et al 1980; Lye et al 1990; Tonkin et al 1991; Gabbett et al 2000, 2001 b ). While orthostatic testing has been used extensively, the reliability of these procedures has been questioned (Lightfoot et al 1991; Jost et al 1994; Ward & Kenny, 1996; Herpin & Ragot, 1997). It has been demonstrated that duplicate lower body negative pressure tests produce reliable cardiovascular responses (Lightfoot et al 1991).…”

“…Furthermore, the medium‐term (1 week) and long‐term (1 year) baroreflex responses have also proven to be reliable ( r = 0.54–0.87) in healthy, young adults (Herpin & Ragot, 1997). However, others have suggested that the HR (Giaconi et al 1987; Jost et al 1994; Ward & Kenny, 1996) and AP (Giaconi et al 1987; Jost et al 1994; Piha, 1991; Ward & Kenny, 1996) responses during HUT are unreliable, and in fact show marked variation across days.…”

Orthostatic hypotension: framework of the syndrome

“…While some studies have observed gross reproducibility of OH, 43 58 others, on detailed examination, have shown uneven results on repeated challenges. [59][60][61][62][63][64][65][66][67] In one study utilising HUTT, asymptomatic orthostatic falls in SBP were reproducible 1 week after initial testing. 47 In another study in healthy volunteers, medium-term (1 week) and long-term (1 year) baroreflex responses proved to be reliable (r = 0.54-0.87).…”

“…67 68 Observations have suggested the existence of day-to-day variability in blood pressure reactivity to postural stress. [59][60][61][62][63][64][65] In one representative study performed in a morning outpatient clinic, 40 elderly persons presenting with postural symptoms of dizziness, falls or syncope were recruited. All patients had a symptomatic drop in orthostatic SBP of .20 mm Hg documented in the clinic.…”