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Use of lower abdominal compression to combat orthostatic hypotension in patients with autonomic dysfunction
Abstract
The aim of this study was to investigate in patients with neurogenic orthostatic hypotension the mechanism and usefulness of abdominal compression to increase standing blood pressure. In three protocols, 23 patients underwent abdominal compression. Protocol 1 evaluated in a 40-60 degrees head-up-tilt position, the effect of abdominal compression on caval vein and femoral diameter, arterial blood pressure and hemodynamics. Protocol 2 documented the relationship between the level of compression and the arterial pressure response. Protocol 3 investigated the ability to maintain standing blood pressure by an elastic binder. During head-up-tilt, compression (40 mm Hg) resulted in a reduction in diameter of the caval vein (mean -2.6mm, range -1.4 to 0.6), without a change in femoral vein diameter. Stroke volume increased by 14 % (range -1 to 23) and blood pressure (systolic/diastolic) by 30/14 mmHg (range 7/2 to 69/36), both p < 0.05; 40 mmHg compression was associated with a higher pressure response than 20 mmHg (mean 18/8 mmHg, range 6/2 to 43/20 vs. mean 9/4 mmHg, range -1/0 to 18/8, p < 0.05). Elastic abdominal binding increased standing blood pressure with 15/6 mmHg (range -3/3 to 36/14, p < 0.05). We conclude that in patients with neurogenic orthostatic hypotension, abdominal compression increases standing blood pressure to a varying degree by increasing stroke volume.
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“These measures increase venous return and lessen orthostatic tachycardia (105).”
From Postural Orthostatic Tachycardia Syndrome (2019) · cites this paper as [105]
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Metadata
- Authors
- Smit, A. J., Wieling, W., Fujimura, J., Denq, J., Opfer-Gehrking, T., Akarriou, M., Karemaker, J., & Low, P.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Mayo Clinic (US)
- ORCID
- Wieling, Wouter
- Venue
- Clinical Autonomic Research
- Published
- 2004-06
- Volume
- 14
- Issue
- 3
- Pages
- 167-75
- ISSN
- 0959-9851 (ISSN-L)
- 1619-1560
- OpenAlex
- W2084471340
- Cited by
- 153
- References
- 43
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 11 · 2023: 3 · 2022: 3 · 2021: 6 · 2020: 7 · 2019: 8 · 2018: 11 · 2017: 12 · 2016: 6 · 2015: 7 · 2014: 13 · 2013: 9 · 2012: 6
- FWCI
- 2.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Clinical Autonomic Research (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- National Aeronautics and Space Administration
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- National Institute of Neurological Disorders and Stroke (P01 NS 32352)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- orthostatic hypotension, neurogenic orthostatic hypotension, autonomic dysfunction, abdominal compression, head-up tilt, standing blood pressure, stroke volume, vein diameter, hemodynamics
- MeSH terms
- Abdomen, Adult, Aged, Autonomic Nervous System Diseases, Blood Pressure, Diabetic Neuropathies, Female, Gravity Suits, Heart Rate, Hemodynamics, Humans, Hypotension, Orthostatic, Male, Middle Aged, Rest, Veins, Supine Position, Blood Pressure Monitoring, Ambulatory
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