Association of blood pressure variability with orthostatic intolerance symptoms
Open accessAbstract
The short-term blood pressure variability (BPV) reflects autonomic regulatory mechanisms. However, the influence of BPV in orthostatic intolerance (OI) is unknown. Herein, we assessed BPV profiles in patients with OI and determined their association with orthostatic symptoms. In this cross-sectional study, we prospectively enrolled 126 patients presenting with OI at the Seoul National University Hospital from December 2014 to August 2016. Among them, those with other neurological diseases (n = 8) and insufficient BP measurements (n = 15) were excluded. The degree of OI symptoms were measured using the self-administered orthostatic intolerance questionnaire (OIQ). All patients underwent ambulatory BP monitoring and we calculated the standard deviation and coefficient of variation as a measure of BPV. The mean age was 48.6 years and the average of the total OIQ score was 11.6. The severe OI group had higher BPV values than the mild group, although mean BP profiles did not differ significantly. Correlation analysis demonstrated that the orthostatic symptoms were positively correlated with diastolic BPV for the total and awake periods. Multiple linear regression analysis revealed that diastolic BPV (B = 0.46, p = 0.031) and current smoking (B = 4.687, p = 0.018) were independent factors for higher OI symptom scores after adjusting for covariates. The results of the current study demonstrated that a positive correlation exists between BPV and OI symptoms. Further studies are required to confirm the present findings and understand the neural mechanisms contributing to the excessive BPV in patients with OI.
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Orthostatic intolerance symptoms in children with POTS have shown significant positive associations with diastolic blood pressure variability.
“orthostatic intolerance symptoms in children with POTS have shown significant positive associations with diastolic blood pressure variability (Sunwoo et al., 2017”
From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Sunwoo et al., 2017
The Results > Correlation analysis reports a significant positive association between orthostatic symptom scores and diastolic blood pressure variability in the study group overall. Results > Clinical features gives a mean age of 48.6 years and identifies only 27 of 103 patients as having POTS; the paper does not establish this association specifically in children with POTS. Page numbers are unavailable in our copy. (LLM, conf=0.91)
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Cites
Freeman, R., Wieling, W., Axelrod, F. B., Benditt, D. G., Benarroch, E., Biaggioni, I., Cheshire, W. P., Chelimsky, T., Cortelli, P., Gibbons, C. H., et al. (2011) · Clinical Autonomic Research · doi:10.1007/s10286-011-0119-5 · Cited by 1,697 · see citing works
Freeman, R., Wieling, W., Axelrod, F. B., Benditt, D. G., Benarroch, E., Biaggioni, I., Cheshire, W. P., Chelimsky, T., Cortelli, P., Gibbons, C. H., et al. (2011) · Autonomic Neuroscience · doi:10.1016/j.autneu.2011.02.004 · Cited by 1,243 · see citing works
Assessment and management of blood-pressure variability
Parati, G., Ochoa, J. E., Lombardi, C., & Bilo, G. (2013) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2013.1 · Cited by 853 · see citing works
Parati, G., Saul, J. P., Di Rienzo, M., & Mancia, G. (1995) · Hypertension · doi:10.1161/01.hyp.25.6.1276 · Cited by 849 · see citing works
Rothwell, P. M., Howard, S. C., Dolan, E., O'Brien, E., Dobson, J. E., Dahlöf, B., Poulter, N. R., & Sever, P. S. (2010) · The Lancet Neurology · doi:10.1016/s1474-4422(10)70066-1 · Cited by 690 · see citing works
Rutan, G. H., Hermanson, B., Bild, D. E., Kittner, S. J., LaBaw, F., & Tell, G. S. (1992) · Hypertension · doi:10.1161/01.hyp.19.6.508 · Cited by 607 · see citing works
Reid, I. A. (1992) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1992.262.6.e763 · Cited by 553 · see citing works
Sander, D., Kukla, C., Klingelhöfer, J., Winbeck, K., & Conrad, B. (2000) · Circulation · doi:10.1161/01.cir.102.13.1536 · Cited by 404 · see citing works
The neuropathic postural tachycardia syndrome
Jacob, G., Costa, F., Shannon, J. R., Robertson, R. M., Wathen, M., Stein, M., Biaggioni, I., Ertl, A., Black, B., & Robertson, D. (2000) · New England Journal of Medicine · doi:10.1056/nejm200010053431404 · Cited by 398 · see citing works
Mechanisms responsible for sympathetic activation by cigarette smoking in humans.
Grassi, G., Seravalle, G., Calhoun, D. A., Bolla, G. B., Giannattasio, C., Marabini, M., Del Bo, A., & Mancia, G. (1994) · Circulation · doi:10.1161/01.cir.90.1.248 · Cited by 394 · see citing works
The Sympathetic-Nervous-System Defect in Primary Orthostatic Hypotension
Ziegler, M. G., Lake, C. R., & Kopin, I. J. (1977) · New England Journal of Medicine · doi:10.1056/nejm197702102960601 · Cited by 354 · see citing works
Parati, G., Mancia, G., Rienzo, M. D., & Castiglioni, P. (2006) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00446.2006 · Cited by 325 · see citing works
Blood Pressure Variability and Organ Damage in a General Population
Sega, R., Corrao, G., Bombelli, M., Beltrame, L., Facchetti, R., Grassi, G. M., Ferrario, M., & Mancia, G. (2002) · Hypertension · doi:10.1161/hy0202.104376 · Cited by 276 · see citing works
Sympathetic overactivity in hypertension. A moving target
JULIUS, S., & NESBITT, S. (1996) · American Journal of Hypertension · doi:10.1016/0895-7061(96)00287-7 · Cited by 237 · see citing works
Chronic Orthostatic Intolerance: A Disorder With Discordant Cardiac and Vascular Sympathetic Control
Furlan, R., Jacob, G., Snell, M., Robertson, D., Porta, A., Harris, P., & Mosqueda-Garcia, R. (1998) · Circulation · doi:10.1161/01.cir.98.20.2154 · Cited by 229 · see citing works
Central sympathetic overactivity: Maladies and mechanisms
Fisher, J. P., Young, C. N., & Fadel, P. J. (2009) · Autonomic Neuroscience · doi:10.1016/j.autneu.2009.02.003 · Cited by 202 · see citing works
Relationship Between Muscle Sympathetic Nerve Activity and Diurnal Blood Pressure Profile
Narkiewicz, K., Winnicki, M., Schroeder, K. E., Phillips, B. G., Kato, M., Cwalina, E., & Somers, V. K. (2002) · Hypertension · doi:10.1161/hy1201.097302 · Cited by 176 · see citing works
Hypovolemia in syncope and orthostatic intolerance role of the renin-angiotensin system
Jacob, G., Robertson, D., Mosqueda-Garcia, R., Ertl, A. C., Robertson, R. M., & Biaggioni, I. (1997) · The American Journal of Medicine · doi:10.1016/s0002-9343(97)00133-2 · Cited by 164 · see citing works
Common Syndromes of Orthostatic Intolerance
Stewart, J. M. (2013) · PEDIATRICS · doi:10.1542/peds.2012-2610 · Cited by 159 · see citing works
Endurance Exercise Training in Orthostatic Intolerance
Winker, R., Barth, A., Bidmon, D., Ponocny, I., Weber, M., Mayr, O., Robertson, D., Diedrich, A., Maier, R., Pilger, A., et al. (2005) · Hypertension · doi:10.1161/01.hyp.0000156540.25707.af · Cited by 156 · see citing works
Syndromes of orthostatic intolerance: a hidden danger
Fedorowski, A., & Melander, O. (2013) · Journal of Internal Medicine · doi:10.1111/joim.12021 · Cited by 151 · see citing works
Wu, J., Yang, Y., Lu, F., Wu, C., & Chang, C. (2008) · Hypertension Research · doi:10.1291/hypres.31.897 · Cited by 130 · see citing works
Postural Hypotension and Postural Dizziness in Elderly Women
Ensrud, K. E. (1992) · Archives of Internal Medicine · doi:10.1001/archinte.1992.00400170130024 · Cited by 119 · see citing works
Mechanisms of sympathetic regulation in orthostatic intolerance
Stewart, J. M. (2012) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00266.2012 · Cited by 118 · see citing works
Diurnal blood pressure variation and sympathetic activity
Grassi, G. M., Bombelli, M., Seravalle, G., Dell’Oro, R., & Quarti‐Trevano, F. (2010) · Hypertension Research · doi:10.1038/hr.2010.26 · Cited by 108 · see citing works
Chowdhury, E., Owen, A. J., Krum, H., Wing, L. M. H., Nelson, M. R., & Reid, C. M. (2013) · Journal of Hypertension · doi:10.1097/hjh.0000000000000028 · Cited by 106 · see citing works
Autonomic control of vasovagal syncope
Jardine, D. L., Ikram, H., FRAMPTON, C. M. A., Frethey, R., Bennett, S. I., & Crozier, I. (1998) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.1998.274.6.h2110 · Cited by 85 · see citing works
Moon, J., Kim, D.-Y., Byun, J.-I., Sunwoo, J.-S., Lim, J.-A., Kim, T.-J., Shin, J.-W., Lee, W.-J., Lee, H. S., Jun, J.-S., et al. (2016) · Health and Quality of Life Outcomes · doi:10.1186/s12955-016-0548-x · Cited by 66 · see citing works
Self-citationEffects of Renal Sympathetic Denervation on 24-hour Blood Pressure Variability
Zuern, C. S., Rizas, K. D., Eick, C., Stoleriu, C., Bunk, L., Barthel, P., Balletshofer, B. M., Gawaz, M., & Bauer, A. (2012) · Frontiers in Physiology · doi:10.3389/fphys.2012.00134 · Cited by 58 · see citing works
Smoking is associated with chronic sympathetic activation in hypertension
Hering, D., Kucharska, W., Kára, T., Somers, V. K., & Narkiewicz, K. (2010) · Blood Pressure · doi:10.3109/08037051.2010.484150 · Cited by 58 · see citing works
Fedorowski, A., Stavenow, L., Hedblad, B., Berglund, G. L., Nilsson, P. M., & Melander, O. (2010) · Journal of Hypertension · doi:10.1097/hjh.0b013e3283350e8c · Cited by 57 · see citing works
Role of Heart Rate Variability in the Production of Blood Pressure Variability in Man
Parati, G., Pomidossi, G. A., Casadei, R., Groppelli, A., Trazzi, S., Rienzo, M. D., & Mancia, G. (1987) · Journal of Hypertension · doi:10.1097/00004872-198710000-00008 · Cited by 48 · see citing works
Diagnostic management of orthostatic intolerance in the workplace
Winker, R., Barth, A., Dorner, W., Mayr, O., Pilger, A., Ivancsits, S., Ponocny, I., Heider, A., Wolf, C., & Rüdiger, H. W. (2003) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-002-0395-4 · Cited by 43 · see citing works
Neural Cardiovascular Regulation and 24‐Hour Blood Pressure and Heart Rate Variability
Parati, G., Rienzo, M. D., & Mancia, G. (1996) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1996.tb26706.x · Cited by 32 · see citing works
Reulecke, S., Charleston-Villalobos, S., Voss, A., González-Camarena, R., González-Hermosillo, J. A., Gaitán-González, M. J., Hernández‐Pacheco, G., Schroeder, R., & Aljama-Corrales, T. (2015) · Computer Methods and Programs in Biomedicine · doi:10.1016/j.cmpb.2015.12.005 · Cited by 29 · see citing works
Orthostatic intolerance without postural tachycardia: how much dysautonomia?
Parsaik, A. K., Singer, W., Allison, T. G., Sletten, D. M., Joyner, M. J., Benarroch, E. E., Low, P. A., & Sandroni, P. (2013) · Clinical Autonomic Research · doi:10.1007/s10286-013-0199-5 · Cited by 23 · see citing works
Exacerbation of sleep-apnoea related nocturnal blood-pressure fluctuations in hypertensive subjects
Planès, C., Leroy, M., Fayet, G., Aegerter, P., Foucher, A., & Raffestin, B. (2002) · European Respiratory Journal · doi:10.1183/09031936.02.00272202 · Cited by 22 · see citing works
Onishi, Y., Minoura, Y., Chiba, Y., Onuki, T., Ito, H., Adachi, T., ASANO, T., & Kobayashi, Y. (2015) · Pacing and Clinical Electrophysiology · doi:10.1111/pace.12661 · Cited by 17 · see citing works
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Knoop, I., Picariello, F., Jenkinson, E., Gall, N., Chisari, C., & Moss-Morris, R. (2023) · Autonomic Neuroscience · doi:10.1016/j.autneu.2022.103052 · Cited by 21 · see citing works
“Whilst physical measurements such as orthostatic heart rate increases appear unrelated to symptom reports, orthostatic intolerance symptoms in children with POTS have shown significant positive associations with diastolic blood pressure variability (Sunwoo et al., 2017) and negative associations with 24-h sodium consu…”
- Authors
- Sunwoo, J.-S., Yang, T.-W., Kim, D.-Y., Lim, J.-A., Kim, T.-J., Byun, J.-I., Moon, J., Lee, S.-T., Jung, K.-H., Park, K.-I., Jung, K.-Y., Kim, M., Lee, S. K., & Chu, K.
- Affiliations
- Soonchunhyang University (KR)
- Gyeongsang National University Changwon Hospital (KR)
- Seoul National University (KR)
- Ministry of Health and Welfare (KR)
- Kyung Hee University Hospital at Gangdong (KR)
- Seoul National University Hospital (KR)
- Corresponding author
- Lee, Sang Kun
- Chu, Kon
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2017-06-07
- Volume
- 12
- Issue
- 6
- Pages
- e0179132
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5462414
- OpenAlex
- W2624052116
- Cited by
- 16
- References
- 38
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 2 · 2022: 2 · 2020: 2 · 2019: 3 · 2018: 2
- FWCI
- 1.96
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- Daiichi Sankyo Korea (06-2014-3970)
- SK Plasma (06-2016-4080)
- Topics
- Health Sciences › Medicine › Surgery › 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 intolerance, blood pressure variability, autonomic dysfunction, diastolic blood pressure, ambulatory blood pressure monitoring, smoking, autonomic regulation
- MeSH terms
- Adult, Aged, Blood Pressure, Cross-Sectional Studies, Female, Heart Rate, Humans, Male, Middle Aged, Surveys and Questionnaires, Blood Pressure Monitoring, Ambulatory, Orthostatic Intolerance, Seoul
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