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

Gabbett, Tim J.; Gass, G. C.

doi:10.1113/expphysiol.2005.030387

Cited by 9 publications

(7 citation statements)

References 24 publications

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“…The reported variability here is comparable to previous reports of autonomic function and BP measures [21,22] and is likely physiological in origin [23]. It is well-known that SBP, DBP and HR fluctuate considerably over a broad range of time scales i.e.…”

Section: Discussionsupporting

confidence: 88%

Reliability of orthostatic beat-to-beat blood pressure tests: implications for population and clinical studies

Finucane

Kenny

2017

Clin Auton Res

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ObjectiveTo assess the test-retest reliability of orthostatic beat-to-beat blood pressure responses to active standing and related clinical definitions of orthostatic hypotension. MethodsA random sample of community dwelling older adults from the pan-European Survey of Health, Ageing and Retirement in Europe, Ireland underwent a health assessment which mimicked that of the Irish Longitudinal Study on Ageing. An active stand test was performed using continuous blood pressure measurements. Participants attended a repeat assessment 4-12 weeks after the initial measurement. A mixed-effects regression model estimated the reliability and minimum detectable change while controlling for fixed observer and time of day effects. ResultsA total of 125 individuals underwent repeat assessment (mean age 66.2±7.5;55.6% women).Mean time between visits was 84.3±23.3 days. There was no significant mean difference in heart rate or blood pressure recovery variables between the first and repeat assessments.Minimum detectable change was noted for changes from resting values in systolic blood pressure(26.4mmHg) and diastolic blood pressure(13.7mmHg) at 110 seconds and for changes in heart rate(10.9bpm) from resting values at 30 seconds after standing. Intra-class correlation values ranged from 0.47 for nadir values to 0.80 for heart rate and systolic blood pressure values measured 110 seconds after standing. ConclusionContinuous orthostatic beat-to-beat blood pressure and related clinical definitions show moderate reliability and substantial natural variation over a 4-12 week period.Understanding variation in measures is essential for study design or estimating the effects of orthostatic hypotension, while clinically it can be used when evaluating longer term treatment effects.

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Section: Discussionsupporting

confidence: 88%

Reliability of orthostatic beat-to-beat blood pressure tests: implications for population and clinical studies

Finucane

Kenny

2017

Clin Auton Res

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“…2 The tilt- 3 and has demonstrated substantial day-to-day reliability in able-bodied individuals. 4 However, this particular test requires specialized equipment, and trained personnel, and therefore may not be applicable or available in many clinical settings. Claydon and Krassioukov 5 demonstrated the presence of OH in individuals with SCI using a sit-up test, a simple bedside procedure which involved passively moving the individuals to a seated position.…”

Section: Introductionmentioning

confidence: 99%

Reliability of the sit-up test in individuals with spinal cord injury

Currie

Wong

Krassioukov³

2015

The Journal of Spinal Cord Medicine

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Objective: To determine the day-to-day reliability of blood pressure responses during a sit-up test in individuals with a traumatic spinal cord injury (SCI). Design: Within-subject, repeated measures design. Setting: Community outpatient assessments at a research laboratory at the University of British Columbia. Participants: Five men and three women with traumatic SCI (age: 31 ± 6 years; C4-T11; American Spinal Injury Association Impairment Scale A-B; 1-17 years post-injury). Outcome measure: Maximum change in systolic (ΔSBP) and diastolic (ΔDBP) blood pressure upon passively moving from a supine to seated position. Results:The average values for ΔSBP were -11 ± 13 mmHg (range -38 to 3 mmHg) for visit 1, and −12 ± 8 mmHg (range −26 to −1 mmHg) for visit 2. The average values for ΔDBP were −9 ± 8 mmHg (range -21 to 0 mmHg) for visit 1, and -13 ± 8 mmHg (range -29 to -3 mmHg) for visit 2. The ΔSBP demonstrated substantial reliability with an intraclass correlation coefficient of 0.79 (P = 0.006; 95% CI 0.250-0.953), while the ΔDBP demonstrated almost perfect reliability with an intraclass correlation coefficient of 0.92 (P < 0.001; 95% CI 0.645-0.983). The smallest detectable differences in ΔSBP and ΔDBP were 7 mmHg and 6 mmHg, respectively. Conclusion: Blood pressure responses to the sit-up test are reliable in individuals with SCI, which supports its implementation as a practical bedside assessment for orthostatic hypotension in this at risk population.

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“…Though reproducibility of cerebral and circulatory responses to postural change in healthy subjects (Houtman et al. ), healthy older participants (Gabbett and Gass ), and patients with syncope (Sagristà‐Sauleda et al. ) have previously been reported, to the best of our knowledge, this is the first study to provide a detailed description of the cerebral and peripheral hemodynamic changes taking place during gradual HPP, including the reproducibility of key parameters before, during and after a gradual change in head positioning.…”

Section: Discussionmentioning

confidence: 84%

“…Again, these changes were reproducible over two visits. Though reproducibility of cerebral and circulatory responses to postural change in healthy subjects (Houtman et al 1999), healthy older participants (Gabbett and Gass 2005), and patients with syncope (Sagrist a-Sauleda et al 2002) have previously been reported, to the best of our knowledge, this is the first study to provide a detailed description of the cerebral and peripheral hemodynamic changes taking place during gradual HPP, including the reproducibility of key parameters before, during and after a gradual change in head positioning. Of considerable relevance, dCA was not affected by a change from 0°to 30°h ead position in this nonstroke control group, which is important for future longitudinal studies of such changes in a diseased population, including studies of AIS patients during the acute and recovery periods.…”

Section: Main Findingsmentioning

confidence: 79%

Does gradual change in head positioning affect cerebrovascular physiology?

et al. 2018

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We studied cerebral blood velocity (CBV), and associated hemodynamic parameters during gradual changes in head positioning in a nonstroke group. CBV (transcranial Doppler ultrasound), beat‐to‐beat blood pressure (BP, Finometer), and end‐tidal carbon dioxide (ETCO 2, capnography) were recorded between lying flat (0°) and sitting up (30°) head positions, in 18 volunteers (10 female, mean age, 57 ± 16 years), at two visits (12 ± 8 days). A significant reduction was found between 5‐min FLAT (0°) and 5‐min SIT (30°) positions in CBV (visit 1: 4.5 ± 3.3%, P = 0.006; visit 2: 4.1 ± 3.5%, P = 0.003), critical closing pressure (CrCP; visit 1: 15.5 ± 14.0%, P = 0.0002; visit 2: 14.1 ± 7.8%, P = 0.009) and BP (visit 1: 8.3 ± 7.4%, P = 0.001; visit 2: 11.0 ± 11.3%, P < 0.001). For 5 min segments of data, the autoregulation index and other hemodynamic parameters did not show differences either due to head position or visit. For 30 sec time intervals, significant differences were observed in the following: (BP, P < 0.001; dominant hemisphere (DH) CBV, P < 0.005; nondominant hemisphere (NDH) CBV, P < 0.005; DH CrCP, P < 0.001; NDH CrCP, P < 0.001; DH resistance area product (RAP), P = 0.002; NDH RAP, P = 0.033). Significant static changes in BP, CBV and CrCP, and large transient changes in key hemodynamic parameters occur during 0° to 30°, and vice versa, with reproducible results. Further studies are needed following acute ischemic stroke to determine if a similar responses is present.

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

Cited by 9 publications

References 24 publications

Reliability of orthostatic beat-to-beat blood pressure tests: implications for population and clinical studies

Reliability of orthostatic beat-to-beat blood pressure tests: implications for population and clinical studies

Reliability of the sit-up test in individuals with spinal cord injury

Does gradual change in head positioning affect cerebrovascular physiology?

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