[Ambulatory measurement of blood pressure and plasma catecholamines in the study of orthostatic hypotension].
The purpose of the study was to investigate the interest of ambulatory blood pressure (BP) monitoring (ABPM) and plasma catecholamines in the management of orthostatic hypotension (OH). Fifteen patients, 4 men, 11 females, 53.3 +/- 21.1 years old, with OH were included in the study: 7 with dysautonomia (G1) = multiple systemic atrophy, pure autonomic failure, OH in elderly people; 8 with OH from other origin (G2) = hypovolemia, neurodystonia, vaso-vagal syncope. ABPM and plasma catecholamines assays (HPLC) in lying then in standing position were carried out in all patients. BP was 131.2 +/- 31.9/78.1 +/- 12.0 mmHg in lying and 112.1 +/- 25.3/75.4 +/- 15.8 in standing position (n = 15). The systolic (S) standing-induced (delta) decrease in BP after 1 min and 10 min (delta SBP) correlated with standard-deviation and variation coefficient of mean SBP (r = 0.78, p < 0.01; r = 0.82, p < 0.01 for delta sBP 1 min and r = 0.80, p < 0.01; r = 0.81, p < 0.01 for delta sBP 10 min), but not with norepinephrine (NorE) or epinephrine levels. There was a significant correlation between diastolic nycthemeral BP variability expressed by mean night-time DBP/mean day-time DBP ratio/diastolic N/D) and standing-induced decrease in DBP after 1 min (r = 0.59, p < 0.05). delta SBP 1 min and 10 min, delta DBP 1 min (p = 0.02, p = 0.05, p = 0.01) and systolic and diastolic N/D (p = 0.02; p < 0.01) were significantly different in G1 and G2.(ABSTRACT TRUNCATED AT 250 WORDS)
Chamontin
B
B
Service de médecine interne et d'hypertension artérielle, CHU Purpan, Toulouse.
Amar
J
J
Bégasse
F
F
Tran
M A
MA
Senard
J M
JM
Montastruc
J L
JL
Salvador
M
M
D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000150:complications; D018660:Blood Pressure Monitoring, Ambulatory; D002395:Catecholamines / Q000097:blood*; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011187:Posture
D002395:Catecholamines
Mesure ambulatoire de la pression artérielle et catécholamines plasmatiques dans l'investigation d'une hypotension orthostatique.