Science Gazette

When you stand up, do you become dizzy? Symptoms of first orthostatic hypotension may be readily managed with simple muscle exercises

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Two non-drug therapies that are both free may improve a patient’s quality of life.

Initial orthostatic hypotension (IOH), or a temporary reduction in blood pressure and rise in heart rate, causes lightheadedness when you stand up. It’s a frequent but poorly understood disorder. By engaging lower body muscle before or after standing, a new research proposes two easy, drug-free approaches for efficiently managing IOH symptoms and improving quality of life. The findings were published by Elsevier in Heart Rhythm, the official publication of the Heart Rhythm Society, the Cardiac Electrophysiology Society, and the Pediatric & Congenital Electrophysiology Society.

Syncope, also known as lightheadedness, dizziness, or loss of consciousness caused by IOH, affects up to 40% of the general population (of all ages), with presyncope being even more frequent. Despite this, the disorder is understudied, and little is known about the underlying causes, as well as symptom management and therapy. Patients with IOH currently have limited therapy choices and no pharmaceutical medications. The most prevalent advice has been to carefully get up or to sit up first before standing.

Satish R. Raj, MD, MSCI, FHRS, Professor of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada, said, “Almost everyone has certainly experienced some lightheadedness at some point after getting up.” “This is a common occurrence for some individuals, and it may happen many times a day, which may be terrifying and have a bad influence on their quality of life. We sought to dig further into this and propose unique and effective symptom treatment approaches in order to improve the quality of life of IOH patients.”

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The effectiveness of physical movements before or after standing in lowering the decline in blood pressure as well as the symptoms often found in IOH patients upon standing was studied in this research. 24 young women (mean age 32 years) with a high burden history of fainting soon after standing and more than four occurrences of presyncope or syncope per month were included in the study. To meet the diagnostic criteria for IOH on the study day, subjects had to have a substantial decrease in systolic blood pressure of at least 40 mmHg while standing. Two subjects were removed from the study due to insufficient heart rate measurements.

The 22 individuals in the research did three sit-to-stand maneuvers: one with no intervention (control) and two with intervention. Lower body muscle preactivation (thighs) by repeated knee lifts before to standing (PREACT) and lower body muscle tensing (thighs and buttocks) via leg crossing and tensing immediately after standing (TENSE) were shown to be beneficial in lowering blood pressure. This resulted in a decrease in symptoms upon standing. They discovered that the PREACT technique increased cardiac output, but the TENSE maneuver increased stroke volume.

Nasia A. Sheikh, MSc, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada, said, “Our research presents a unique and cost-free symptom management strategy that patients with IOH may adopt to control their symptoms.” “Because it is a physical motion, it only involves the lower body limbs, which patients may use to treat their symptoms at any time and from anyplace.”

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“Our research examines the physiology of IOH and the effectiveness of physical techniques that might aid IOH patients in managing their symptoms. Patients recognize an IOH diagnosis as a critical first step toward empowering them to understand and master their symptoms, minimizing the disruptions to daily life caused by this common, but poorly understood condition “Mary Runté, PhD, University of Lethbridge, Lethbridge, AB, Canada, is a co-investigator.

Bert Vandenberk, MD, PhD, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; and Carlos A. Morillo, MD, FHRS, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; and Department of Cardiovascular Sciences, They did, however, point out that “The research has to be replicated in males, as well as looked at in the elderly, who have various confounders to contend with. Understanding the function of cardiopulmonary mechanoreceptors should give further mechanistic insight into the impact of these basic yet very efficient physiologic interventions.”

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