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When Blood Pressure Increases with Standing: Consensus Definition for Diagnosing Orthostatic Hypertension

Jordan, J. and Biaggioni, I. and Grassi, G. and Fedorowski, A. and Kario, K. (2023) When Blood Pressure Increases with Standing: Consensus Definition for Diagnosing Orthostatic Hypertension. Blood Pressure, 32 (1), p. 2161871. Taylor & Francis. doi: 10.1080/08037051.2022.2161871. ISSN 0803-7051.

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Official URL: https://dx.doi.org/10.1080/08037051.2022.2161871


When changing from the supine to the standing position approximately 500–1000 ml blood is pooled below the diaphragm and hydrostatic pressure forces fluids from the intravascular to the interstitial compartment. These changes impose a major hemodynamic burden on the cardiovascular system. Baroreflex-mediated withdrawal of cardiac parasympathetic activity and sympathetic activation maintain standing blood pressure in healthy persons. Orthostatic hypotension occurs when these counterregulatory mechanisms fail. Conversely, some patients have a paradoxical increase in upright blood pressure to hypertensive levels, presumably due to sympathetic activation overshoot. This orthostatic hypertension is not a benign condition because it is associated with increased cardiovascular morbidity and mortality independently of traditional risk factors.Citation1,Citation2 Yet, there has not been a uniform definition of orthostatic hypertension and the entity is not covered in current hypertension guidelines. Because diagnostic criteria vary profoundly between studies, data on epidemiology, associated health risks, and management of orthostatic hypertension in the existing literature is difficult to interpret.

Item URL in elib:https://elib.dlr.de/199813/
Document Type:Article
Title:When Blood Pressure Increases with Standing: Consensus Definition for Diagnosing Orthostatic Hypertension
AuthorsInstitution or Email of AuthorsAuthor's ORCID iDORCID Put Code
Jordan, J.UNSPECIFIEDhttps://orcid.org/0000-0003-4518-0706UNSPECIFIED
Biaggioni, I.Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University School of Medicine, NashvilleUNSPECIFIEDUNSPECIFIED
Grassi, G.Clinical Medica, School of Medicine and Surgery, Milano-Bicocca University;IRCCS Multimedica, Sesto San Giovanni, Milan, ItalyUNSPECIFIEDUNSPECIFIED
Fedorowski, A.Department of Clinical Sciences, Lund University, Malmö, SwedenUNSPECIFIEDUNSPECIFIED
Kario, K.Department of Cardiology, Jichi University School of Medicine, Tochigi, JapanUNSPECIFIEDUNSPECIFIED
Date:January 2023
Journal or Publication Title:Blood Pressure
Refereed publication:Yes
Open Access:Yes
Gold Open Access:Yes
In ISI Web of Science:Yes
Page Range:p. 2161871
Publisher:Taylor & Francis
Keywords:definition; diagnosis; orthostatic hypertension; sympathetic nervous system
HGF - Research field:Aeronautics, Space and Transport
HGF - Program:Space
HGF - Program Themes:Research under Space Conditions
DLR - Research area:Raumfahrt
DLR - Program:R FR - Research under Space Conditions
DLR - Research theme (Project):R - CardioBrain, R - Bone metabolism and structural adaptation
Location: Köln-Porz
Institutes and Institutions:Institute of Aerospace Medicine
Institute of Aerospace Medicine > Leitungsbereich ME
Deposited By: Schrage, Larissa
Deposited On:05 Dec 2023 15:22
Last Modified:05 Dec 2023 15:22

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