Samme Sez

I'm never wrong- and I can prove it!

Standing Up & Heart Failure: Orthostatic Hypotension

Orthostatic hypotension occurs when a person’s blood pressure drops when standing up from a reclining position. Sometimes the sudden dip causes a brief dizzy spell or head rush; in severe cases it may cause a person to faint. Recent research indicates that persons with orthostatic hypotension were nearly 50% more likely to later develop heart failure.

Results of a 20-year research project around the possible link between orthostatic hypotension and heart failure were published this year in the medical journal Hypertension. The 20-year study followed more than 12,000 middle-aged adults for nearly two decades. At the start of the study, researchers measured blood pressure while people were lying down and then several times over a two-minute period after they stood.  “If the top number, the systolic number, fell by 20 or more points, or the bottom number, the diastolic blood pressure, fell by 10 or more points, then it was defined as orthostatic hypotension,” says Christine D. Jones, MD, an internist at the University of North Carolina at Chapel Hill. “Sometimes people can have the condition and not feel a thing,” Jones says.

About 600 people had the telltale blood pressure shift at the start of the study;  some of that extra risk appeared to be explained by high blood pressure. It was noted that people with orthostatic hypotension were also more likely to have high blood pressure, which is known to contribute to heart failure.

However, when researchers excluded people with high blood pressure from their analysis, those whose blood pressure dropped when they stood were still 34% more likely to develop heart failure.  In heart failure, the heart loses its ability to pump blood effectively to the rest of the body. Medications and lifestyle changes can help control the condition if it’s spotted early.

The risk appeared to be highest for younger adults. Those who were younger than 55 when they were diagnosed with the positional change in blood pressure were nearly twice as likely as those with steady blood pressure to go on to develop heart failure.

Researchers caution that their study can only show associations. It doesn’t prove that falling blood pressures cause heart failure or even explain how the two problems may be linked.  The researchers believe that a common disease process, like atherosclerosis, which causes arteries to become hard and stiff, may be behind both.

When arteries harden, they can’t contract as easily to raise blood pressure. Stiff arteries around the heart muscle can weaken its ability to pump. “Maybe this is an [indicator] of early atherosclerotic disease,” Jones says.

August 16, 2012 - Posted by | The latest in medicine, Uncategorized | , ,

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