The DOI matches its Crossref record; 37 of the 37 references it cites were found in a registry or an index.
Effect of standing on neurohumoral responses and plasma volume in healthy subjects
Abstract
Upright posture leads to rapid pooling of blood in the lower extremities and shifts plasma fluid into surrounding tissues. This results in a decrease in plasma volume (PV) and in hemoconcentration. There has been no integrative evaluation of concomitant neurohumoral and PV shifts with upright posture in normal subjects. We studied 10 healthy subjects after 3 days of stable Na+and K+intake. PV was assessed by the Evans blue dye method and by changes in hematocrit. Norepinephrine (NE), NE spillover, epinephrine (Epi), vasopressin, plasma renin activity, aldosterone, osmolarity, and kidney response expressed by urine osmolality and by Na+and K+excretion of the subjects in the supine and standing postures were all measured. We found that PV fell by 13% (375 ± 35 ml plasma) over ∼14 min, after which time it remained relatively stable. There was a concomitant decrease in systolic blood pressure and an increase in heart rate that peaked at the time of maximal decrease in PV. Plasma Epi and NE increased rapidly to this point. Epi approached baseline by 20 min of standing. NE spillover increased 80% and clearance decreased 30% with 30 min of standing. The increase in plasma renin activity correlated with an increase in aldosterone. Vasopressin increased progressively, but there was no change in plasma osmolarity. The kidney response showed a significant decrease in Na+and an increase in K+excretion with upright posture. We conclude that a cascade of neurohumoral events occurs with upright posture, some of which particularly coincide with the decrease in PV. Plasma Epi levels may contribute to the increment in heart rate with maintained upright posture.
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“However, levels of norepinephrine in POTS patients can increase more than threefold, exceeding 800 pg/ml in many cases, while the increase in healthy controls after assuming an upright position is much more modest at approximately 400-500 pg/ml (36, 43).”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [43]
In the citing paper
“In healthy subjects, the supine plasma norepinephrine level is approximately 200 pg/ml, and upon standing, it doubles before it plateaus after 7.5 min (43).”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [43]
Citations
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Furlan, R., Porta, A., Costa, F., Tank, J., Baker, L., Schiavi, R., Robertson, D., Malliani, A., & Mosqueda‐Garcia, R. (2000) · Circulation · doi:10.1161/01.cir.101.8.886 · Cited by 359
Self-citationThe Pressor Response to Water Drinking in Humans
Jordan, J., Shannon, J. R., Black, B. K., Ali, Y. S., Farley, M., da Costa, F. A. A., Diedrich, A., Robertson, R. M., Biaggioni, I., & Robertson, D. (2000) · Circulation · doi:10.1161/01.cir.101.5.504 · Cited by 342
Self-citationReplacing sitting time with standing or stepping: associations with cardio-metabolic risk biomarkers
Healy, G. N., WINKLER, E. A. H., Owen, N. G., Anuradha, S., & Dunstan, D. W. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv308 · Cited by 306
Computational modeling of cardiovascular response to orthostatic stress
Heldt, T., Shim, E. B., Kamm, R. D., & Mark, R. G. (2002) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00241.2001 · Cited by 300
“Studies have shown that within minutes after the onset of gravitational stress, hormone levels in the circulation rise significantly (37).”
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“The subsequent increase in hydrostatic pressure in these vessels leads to a further 10% shift of plasma volume from the intravascular space to the interstitial space in dependent regions (34).”
Background
Metadata
- Authors
- Jacob, G., Ertl, A. C., Shannon, J. R., Furlan, R., Robertson, R. M., & Robertson, D.
- Affiliations
- Vanderbilt University (US)
- Venue
- Journal of Applied Physiology
- Publisher
- American Physiological Society
- Published
- 1998-03-01
- Volume
- 84
- Issue
- 3
- Pages
- 914-921
- ISSN
- 0161-7567 (ISSN-L)
- 8750-7587
- 1522-1601
- OpenAlex
- W2157236879
- Cited by
- 134
- References
- 37
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 4 · 2022: 4 · 2021: 9 · 2020: 6 · 2019: 4 · 2018: 4 · 2017: 5 · 2016: 4 · 2015: 6 · 2014: 7 · 2013: 3 · 2012: 5
- FWCI
- 4.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Applied Physiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5u01ns033460-03)
- National Heart, Lung, and Blood Institute (P01HL056693, P01 HL-56693)
- National Institute of Neurological Disorders and Stroke (NS 33460)
- National Center for Research Resources (RR00095)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- standing posture, upright posture, plasma volume, neurohumoral response, norepinephrine spillover, epinephrine, vasopressin, plasma renin activity, aldosterone, hemoconcentration, blood pressure, heart rate, sodium excretion, potassium excretion, urine osmolality, plasma osmolarity, renal response
- MeSH terms
- Adult, Aldosterone, Arginine Vasopressin, Blood Pressure, Blood Volume, Catecholamines, Diet, Female, Heart Rate, Humans, Kidney, Male, Middle Aged, Plasma Volume, Posture, Reference Values, Renin, Supine Position, Neurotransmitter Agents
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