Objectives: To test the safety of the head-up tilt test (HUT) in older adults.
Design: Direct observation and measurements.
Setting: Tests performed in a quiet room with dim lighting in a laboratory setting.
Participants: One thousand ninety-six subjects aged 60 to 74; 873 aged 75 and older.
Measurements: Blood pressure and pulse at baseline for 10 minutes and 70 degrees tilt for maximum of 45 minutes. Subjects with unprovoked HUT had test repeated on a separate day after 800 mg glyceryl trinitrate (GTN).
Results: One thousand four hundred ninety-five drug-free and 474 GTN-provoked HUTs were studied. In those aged 60 to 74, the proportion of hypotensive unprovoked HUT was 16% (27% in those aged > or =75); this was higher with GTN provocation (43% in those aged 60-74, 44% in those aged > or =75; P<.01). Systolic blood pressure decreased during provoked HUT (lowest mean+/-standard deviation=67+/-20 in those aged 60-74, 63+/-24 in those aged > or =75; P<.01). There was one cardiovascular and no neurological complications.
Conclusion: This study included 10 times as many people as previous studies and demonstrates the safety of HUT in older people.
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http://dx.doi.org/10.1111/j.1532-5415.2004.52518.x | DOI Listing |
Front Cardiovasc Med
January 2025
Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Background: Painful left bundle branch block (LBBB) syndrome is an uncommon disease that is defined as intermittent episodes of angina associated with simultaneous LBBB changes on an electrocardiogram (ECG) with the absence of flow-limiting coronary artery disease or ischemia on functional testing. Vasovagal syncope (VVS) is the most common cause of syncope and can be provoked by sublingual nitroglycerin (NTG). Herein, we report a case of painful LBBB syndrome complicated with VVS, which was misdiagnosed as acute coronary syndrome and cardiogenic shock.
View Article and Find Full Text PDFJ Appl Physiol (1985)
January 2025
School of Kinesiology, Western University, London, Ontario, Canada.
The compliant nature of cerebral blood vessels may represent an important mechanical protection for sustained cerebral perfusion during reductions in arterial blood pressure (ABP). However, whether the rise in cerebrovascular compliance (Ci) with falling ABP persists and exhibits a threshold effect remains unknown. Therefore, we analyzed Ci changes during graded head-up tilt (HUT) in individuals with autonomic failure (AF), a group that tolerates graded and progressive reductions in ABP.
View Article and Find Full Text PDFAm J Physiol Heart Circ Physiol
January 2025
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Increased blood pressure upon standing is considered a cardiovascular risk factor. We investigated the reproducibility of changes in aortic blood pressure, heart rate, stroke volume, cardiac output, and systemic vascular resistance during three passive head-up tilts (HUT) in 223 participants without cardiovascular medications (mean age 46 years, BMI 28 kg/m2, 54% male). Median time gap between the first and the second HUT was 9 weeks and the second and the third HUT 4 weeks.
View Article and Find Full Text PDFEur Heart J
December 2024
Department of Cardiology, IRCCS Istituto Auxologico Italiano, Faint and Fall Research Centre, S. Luca Hospital, Piazzale Brescia 20, Milano 20149, Italy.
Background And Aims: Identifying the haemodynamic mechanism of autonomic syncope is the essential pre-requisite for effective and personalized therapy aimed at preventing recurrences. The present study assessed the diagnostic efficacy of a two-step assessment.
Methods: Multicentre prospective, cross-sectional, observational study.
J Clin Med
December 2024
Stichting CardioZorg, Kraayvel 5, 1171 JE Badhoevedorp, The Netherlands.
: While the diagnosis of postural orthostatic tachycardia syndrome (POTS) is based on heart rate (HR) and blood pressure (BP) criteria, the pathophysiology of POTS is not fully understood as multiple pathophysiological mechanisms have been recognized. Also, cardiac function, being dependent on preload, afterload, contractility, and HR, has not been properly studied. Preload and contractility changes can be inferred from stroke volume index (SVI) changes during a tilt test.
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