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Assessment of cardiovascular reflexes: influence of posture and period of preceding rest
Authors:Ten Harkel, A. D.   Van Lieshout, J. J.   Van Lieshout, E. J.   Wieling, W.
Affiliation:Department of Medicine, Academic Medical Centre, Amsterdam, The Netherlands.
Abstract:The aim of the present study was to investigate the effects of a pretest redistribution of blood volume and of a change in the neurohumoral condition on the blood pressure (BP) and heart rate (HR) responses to three commonly used cardiovascular reflex tests: standing up, forced breathing, and the Valsalva maneuver in 10 healthy male subjects. Base-line conditions were altered by changing posture and the duration of rest preceding the test stimulus. A continuous recording of finger BP was obtained noninvasively by a Finapres. The main observations from this study are with respect to standing up: lengthening the period of preceding rest from 1 to 20 min enlarges the initial BP (systolic/diastolic) decrease (from 8 +/- 10/9 +/- 4 to 27 +/- 8/19 +/- 4 mmHg, P less than 0.01) and the subsequent BP overshoot (from 17 +/- 10/12 +/- 7 to 31 +/- 10/18 +/- 7 mmHg, P less than 0.05); to forced breathing: inspiratory-expiratory changes in BP but not in HR are larger in the upright posture (P less than 0.05); and to the Valsalva maneuver: change in posture from supine to standing increases the phase II BP decrease (from 18 +/- 12/8 +/- 6 to 45 +/- 16/21 +/- 9 mmHg), phase IV systolic BP overshoot (from 26 +/- 16 to 71 +/- 17 mmHg), delta HRmax (from 30 +/- 10 to 47 +/- 12 beats/min), and the Valsalva ratio (HRmax/HRmin), from 2.0 +/- 0.3 to 2.6 +/- 0.7, all significant at P less than 0.01.(ABSTRACT TRUNCATED AT 250 WORDS)
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