Cardiopulmonary deconditioning and plasma volume loss are not sufficient to provoke orthostatic hypertension

Hypertens Res. 2024 Aug;47(8):2211-2216. doi: 10.1038/s41440-024-01710-x. Epub 2024 May 23.

Abstract

Orthostatic hypertension, defined by an increase of systolic blood pressure (SBP) of ≥20 mmHg upon standing, harbors an increased cardiovascular risk. We pooled data from two rigorously conducted head-down tilt bedrest studies to test the hypothesis that cardiopulmonary deconditioning and hypovolemia predispose to orthostatic hypertension. With bedrest, peak VO2 decreased by 6 ± 4 mlO2/min/kg (p < 0.0001) and plasma volume by 367 ± 348 ml (p < 0.0001). Supine SBP increased from 127 ± 9 mmHg before to 133 ± 10 mmHg after bedrest (p < 0.0001). In participants with stable hemodynamics following head-up tilt, the incidence of orthostatic hypertension was 2 out of 67 participants before bedrest and 2 out of 57 after bedrest. We conclude that in most healthy persons, cardiovascular deconditioning and volume loss associated with long-term bedrest are not sufficient to cause orthostatic hypertension.

Keywords: Bedrest; Deconditioning; Orthostatic hypertension; Sympathetic nervous systems; Weightlessness.

MeSH terms

  • Adult
  • Bed Rest* / adverse effects
  • Blood Pressure* / physiology
  • Cardiovascular Deconditioning / physiology
  • Female
  • Head-Down Tilt*
  • Hemodynamics / physiology
  • Humans
  • Hypertension* / physiopathology
  • Hypovolemia / complications
  • Hypovolemia / physiopathology
  • Male
  • Middle Aged
  • Oxygen Consumption / physiology
  • Plasma Volume*