Relationship Between Orthostatic Blood Pressure Changes and Postural Sway When Standing up from a Chair in Older Adult Females

Abstract

s u m m a r y Background: Orthostatic reductions in blood pressure upon standing are common among the elderly. This orthostatic blood pressure changes may relate to the augmentation of postural sway and may be an important risk factor for falls. Thus, to clarify whether orthostatic blood pressure change on standing up from a chair is relevant to postural sway, we simultaneously measured changes in blood pressure and the movement of a weighted center upon standing. Methods: A total of 63 older adult females were investigated. Blood pressure [systolic blood pressure (SBP), diastolic BP] measured in a sitting position were defined as the baseline levels. The movement of center of pressure (COP) was measured using a stable force platform to quantify postural stability. Participants were instructed to stand up from a chair on the platform and maintain an upright position with their eyes open for 40 seconds. Upon standing, the participant's blood pressure and the movement of COP were recorded. Pearson's correlation was performed to determine relationships between the changes in BP and the movement of COP [distance of the movement of COP (LNG), envelopment area traced by the movement of COP (AREA)]. Results: SBP was reduced while maintaining an upright position for 40 seconds (e5.0 AE 8.6 mmHg), but not diastolic BP (0.6 AE 4.3 mmHg). Moreover, the change in SBP showed a negative relationship with LNG (r ¼ e0.43, p < 0.01) and AREA (r ¼ e0.31, p < 0.05). Conclusion: These results suggested that postural change influenced SBP, and that the drop of SBP was associated with augmentation of postural instability in older adult females.

Variation of blood pressure during change of posture

“…In the study by Olufsen, Murata blood pressure was significantly decreased when posture was changed from sitting to standing. 8,9 In our study the blood pressure also decreased when posture was changed from sitting to standing position, but the changes were not statistically significant.…”

Orthostatic Intolerance in Older Persons: Etiology and Countermeasures

“…Musculoskeletal activities of the lower limbs during standing have primarily been studied in relation to the central postural control system which generates proper balance corrections in the upright stance by coordinating sensory-motor control components (somatosensory, visual ocular, vestibular) to naturally optimize body positioning (Dichgans and Diener, 1989 ). However, the resultant slight postural sway during standing also serves as an important contributor in promoting venous return (Inamura et al, 1996 ; Murata et al, 2012 ; Blaber et al, 2013 ). Surprisingly, despite it being long known that the skeletal muscle pump helps in the maintenance of blood pressure (Guyton et al, 1962 ), cardiovascular and postural reflexes have been investigated as independent control mechanisms (Winter, 1995 ; Fadel, 2008 ).…”

Significant role of the cardiopostural interaction in blood pressure regulation during standing

“…It is well recognized that the skeletal muscle pump plays a major role in blood pressure regulation under orthostatic stress especially in patients with autonomic failure who have difficulties elevating vascular resistance (66). In addition, the slight postural sway during standing resulted from lower limb muscle activities also serves as an important contributor in promoting venous return (1,29,50).…”