A14339 Impaired systolic blood pressure recovery after standing is associated with arterial stiffening and baroreceptor dysfunction in patients with life-style related disease

Abstract

Objectives: To investigate whether arterial stiffening and baroreceptor dysfunction is associated with impaired blood pressure recovery after standing, which is considered to be a severe condition of orthostatic hypotension (OH). Methods: A total of 1056 patients with life-style related disease were included in the study. During the sit-to-stand test (consist of sitting position, 30 seconds [initial phase] and 90 seconds [late phase] after standing up), we measured blood pressure and heart rate variability (HRV) as an index of baroreceptor function (LF and HF: low and high frequency component). The patients were divided into 4 groups according to the response of orthostatic systolic blood pressure (SBP) change (Non-OH: SBP change > -20 both in the initial and the late phase, late-OH: SBP change ≤ -20 only in the late phase, initial-OH: SBP change ≤ -20 only in the initial phase, sustained-OH: SBP change ≤ -20 both in the initial and the late phase). We measured cardio-ankle vascular index (CAVI) as an index of arterial stiffness. Results: Mean age of the patients was 66.5 ± 11.9 years. Initial-OH and sustained-OH showed significant higher CAVI compared with non-OH (9.03 ± 1.25 versus 8.65 ± 1.48, p = 0.024; 9.35 ± 1.17 versus 8.65 ± 1.48, p = 0.010, respectively). Sustained-OH showed significant lower LF than non-OH both in the initial and the late phase (2.10 ± 0.50 versus 2.31 ± 0.44, p = 0.008; 1.67 ± 0.52 versus 1.95 ± 0.53, p = 0.005, respectively). Sustained-OH showed significant lower HF than non-OH in the late phase (1.39 ± 0.60 versus 1.68 ± 0.58, p = 0.005). Conclusion: Impaired SBP recovery after standing was associated with arterial stiffening and blunted autonomic nervous response. Patients with impaired SBP recovery after standing should be aware of severe arterial stiffening and baroreceptor dysfunction.