title: Orthostatic Blood Pressure Changes and Subclinical Markers of Atherosclerosis.
abstract: BACKGROUND
  Using a simple standing-up test in normotensive subjects, we evaluated orthostatic upright postural blood pressure (BP) changes and autonomic nervous function, as well as the relationship between orthostatic BP changes and subclinical markers of atherosclerosis.
  
  
  METHODS
  A total of 515 normotensive subjects aged 35-75 years (58.4±10.0 years) were enrolled. We measured body mass index (BMI), systolic BP (SBP) and diastolic BP (DBP), serum lipids, hemoglobin A1c (HbA1c), high-sensitivity C-reactive protein (hs-CRP), and urinary albumin-to-creatinine ratio. Brachial to ankle pulse wave velocity (baPWV) and carotid mean intima-media thickness (IMT) were measured. Participants underwent a simple standing-up test involving sitting then standing for 2 minutes each, followed again by sitting. To evaluate autonomic fluctuations, we calculated the coefficient of variation of the R-R interval, the ratio of low to high frequency heart rate variability (LF/HF), and the coefficient of component variance of high frequency.
  
  
  RESULTS
  SBP and DBP decreased when standing, with a reduction of SBP when changing position of -8.0±10.2mm Hg. Orthostatic hypotension (OH) produced a significantly higher SBP than without OH. The baPWV was significantly higher in OH than in without OH. Stepwise regression analysis adjusted for age, sex, BMI, baseline SBP, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting glucose, HbA1c, hs-CRP, IMT, late systolic peak of the pressure wave form (SBP2), and baPWV confirmed that baPWV, SBP2, and triglycerides were independently related to orthostatic BP changes. Multiple regression analyses showed that a decrease in SBP as well as baseline SBP, age, BMI, and fasting glucose were independent determinants of PWV.
  
  
  CONCLUSIONS
  We have shown that increased arterial stiffness was associated with OH during a standing-up test. Arterial stiffness may contribute to greater BP responses to postural changes from standing.
authors: School of Health and Nursing Sciences, Wakayama Medical University, Wakayama City, Wakayama, Japan;
authors: Maasa
authors: M
authors: Takahashi
authors: School of Health and Nursing Sciences, Wakayama Medical University, Wakayama City, Wakayama, Japan;
authors: Nobuyuki
authors: N
authors: Miyai
authors: School of Health and Nursing Sciences, Wakayama Medical University, Wakayama City, Wakayama, Japan;
authors: Shiori
authors: S
authors: Nagano
authors: School of Health and Nursing Sciences, Wakayama Medical University, Wakayama City, Wakayama, Japan;
authors: Miyoko
authors: M
authors: Utsumi
authors: School of Health and Nursing Sciences, Wakayama Medical University, Wakayama City, Wakayama, Japan;
authors: Mayumi
authors: M
authors: Oka
authors: School of Health and Nursing Sciences, Wakayama Medical University, Wakayama City, Wakayama, Japan;
authors: Mio
authors: M
authors: Yamamoto
authors: School of Health and Nursing Sciences, Wakayama Medical University, Wakayama City, Wakayama, Japan;
authors: Mitsuru
authors: M
authors: Shiba
authors: School of Health and Nursing Sciences, Wakayama Medical University, Wakayama City, Wakayama, Japan;
authors: Yuji
authors: Y
authors: Uematsu
authors: School of Health and Nursing Sciences, Wakayama Medical University, Wakayama City, Wakayama, Japan;
authors: Yoshiko
authors: Y
authors: Nishimura
authors: Department of Public Health, Wakayama Medical University, Wakayama City, Wakayama, Japan.
authors: Tatsuya
authors: T
authors: Takeshita
authors: School of Health and Nursing Sciences, Wakayama Medical University, Wakayama City, Wakayama, Japan; t.hori@wakayama-med.ac.jp.
authors: Mikio
authors: M
authors: Arita
mesh_terms: D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D001341:Autonomic Nervous System / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D002319:Cardiovascular System / Q000294:innervation*; D059168:Carotid Intima-Media Thickness; D005260:Female; D006339:Heart Rate; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis / Q000503:physiopathology*; D007564:Japan; D008297:Male; D008875:Middle Aged; D011187:Posture; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness
chemical_list: D015415:Biomarkers
keywords: arterial stiffness; arterial wave reflection; blood pressure; hypertension; orthostatic hypotension.