Blood pressure reduction cut-points for orthostatic hypotension in stroke survivors using a sit-up test: a multicentre cross-sectional study

Oyake, Kazuaki; Tateishi, Takaki; Murayama, Jun; Shijima, Naoki; Sekizuka, Tasuku; Otaka, Yohei; Momose, Kimito

doi:10.1097/hjh.0000000000003305

Cited by 2 publications

(1 citation statement)

References 40 publications

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“…Performing the sit-up test involves two assessors to simultaneously lift the head and torso while shifting the legs so the patient remains passive and avoids skeletal muscle contractions that may alter the BP response to this orthostatic challenge. The transition to the seated position should be accomplished within 30-seconds and the individual must be supported in the seated position for at least 3minutes (9). Individuals with SCI have impaired autonomic nervous system function, which adversely affects sympathetic vasomotor control, leading to an increased prevalence of OH (10,11).…”

Section: Introductionmentioning

confidence: 99%

The Sit-Up Test to Assess Orthostatic Hypotension in Individuals with Spinal Cord Injury: Validity and Reliability

Wecht,

Maher,

Lirshblum

et al. 2024

Preprint

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Due to decentralized autonomic nervous system function, individuals with spinal cord injury (SCI) are reported to have an increased prevalence of orthostatic hypotension (OH). Diagnosis of OH is made with active standing or tilt table testing, with limited the use in individuals with SCI. An alternative approach to assess OH is the sit-up test which involves passive repositioning from the supine to the seated position. The purpose of this study was to determine the reliability and validity of the sit-up test in a large, diverse group of individuals with SCI. A total of 166 participants completed two sit-up tests, 119 individuals with SCI and 47 uninjured controls and 36 individuals who completed the sit-up tests also underwent a head-up tilt test. The mean difference in change in BP from sit-up test 1 to sit-up test 2 was not significant for either SBP or DBP, and neither level nor severity of injury contributed significantly to the reliability assessments. However, the reliability assessments showed disappointing results with generally low interclass correlation coefficients (ICC) values and large standard error of measurement (SEM). Comparison of the BP responses between the sit-up test and the head up tilt showed good sensitivity and specificity, with positive predictive values of 75% for both SBP and DBP. Prevalent BP instability likely contributed to the poor reliability of the sit-up test, but the test is easy to perform with good sensitivity and specificity and a high likelihood ratio for the valid assessment of OH in individuals with SCI.

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Section: Introductionmentioning

confidence: 99%

The Sit-Up Test to Assess Orthostatic Hypotension in Individuals with Spinal Cord Injury: Validity and Reliability

Wecht,

Maher,

Lirshblum

et al. 2024

Preprint

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Risk factors for stroke recurrence in young patients with first-ever ischemic stroke: A meta-analysis

Xia,

Liu,

Zhu

2023

World J Clin Cases

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Fasting during the month of Ramadan is one of the five fundamental principles of Islam, and it is obligatory for healthy Muslim adults and adolescents. During the fasting month, Muslims usually have two meals a day, suhur (before dawn) and iftar (after dusk). However, diabetic patients may face difficulties when fasting, so it is important for medical staff to educate them on safe fasting practices. Prolonged strict fasting can increase the risk of hypoglycemia and diabetic ketoacidosis, but with proper knowledge, careful planning, and medication adjustment, diabetic Muslim patients can fast during Ramadan. For this review, a literature search was conducted using PubMed and Google Scholar until May 2023. Articles other than the English language were excluded. Current strategies for managing blood sugar levels during Ramadan include a combination of patient education on nutrition, regular monitoring of blood glucose, medications, and insulin therapy. Insulin therapy can be continued during fasting if properly titrated to the patients’ needs, and finger prick blood sugar levels should be assessed regularly. If certain symptoms such as hypoglycemia, hyperglycemia, dehydration, or acute illness occur, or blood glucose levels become too high (> 300 mg/dL) or too low (70 mg/dL), the fast should be broken. New insulin formulations such as pegylated insulin and medications like tirzepatide, a dual agonist of gastric-inhibitory peptideand glucagonlike-peptide 1 receptors, have shown promise in managing blood sugar levels during Ramadan. Non-insulin-dependent medications like sodium-glucose-cotransporter-2 inhibitors, including the Food and Drug Administration-approved ertugliflozin, are also being used to provide additional cardiovascular benefits in patients with type 2 diabetes.

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Blood pressure reduction cut-points for orthostatic hypotension in stroke survivors using a sit-up test: a multicentre cross-sectional study

Cited by 2 publications

References 40 publications

The Sit-Up Test to Assess Orthostatic Hypotension in Individuals with Spinal Cord Injury: Validity and Reliability

The Sit-Up Test to Assess Orthostatic Hypotension in Individuals with Spinal Cord Injury: Validity and Reliability

Risk factors for stroke recurrence in young patients with first-ever ischemic stroke: A meta-analysis

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