Orthostatic intolerance occurs in some astronauts following space flight. Although orthostatic blood pressure responses should normalize in the weeks following the return to Earth, there may be situations where an immediate short-term solution is necessary (e.g., emergency evacuation).
The purpose of this study was to examine different levels of blood flow restriction on changes in blood pressure and heart rate when transitioning from supine to a head-up tilt and determine whether this change differs based on sex.
Eighty-nine participants (45 men, 44 women) completed the three visits with different pressures (Sham, Moderate, and High) in a randomized order. Cuffs were placed on the most proximal area of the thighs. Brachial blood pressure was measured at baseline, upon inflation of the cuffs in a supine position, immediately after tilt (70°), and eight more times separated by 45 seconds.
Data are presented as mean (SD). The change in systolic (High > Moderate > Sham) [High vs Sham: 5.5 (7.4) mmHg, High vs Moderate: 3 (7.4) mmHg, and Moderate vs Sham: 2.4 (8.4) mmHg] and diastolic pressure (High > Moderate = Sham) [High vs Sham: 2.4 (5.3) mmHg, High vs Moderate: 1.9 (6.3) mmHg] differed across applied pressures. The change in heart rate was initially greatest in the sham-pressure but increased the greatest in the high-pressure condition by the end of the head-up tilt period. Additionally, there was no influence of sex.
Blood flow restriction applied in this study increased blood pressure in a pressure-dependent manner upon head-up tilt.
Lanier JB , Mote MB , Clay EC . Evaluation and management of orthostatic hypotension. Am Fam Physician 2011; 84: 527–536.
Stewart JM . Common syndromes of orthostatic intolerance. Pediatrics 2013; 131: 968–980.
Cheng Y-C , Vyas A , Perlmuter LC , Hymen E . Gender differences in orthostatic hypotension. Am J Med Sci 2011; 342: 221–225.
Convertino VA . Gender differences in autonomic functions associated with blood pressure regulation. Am J Physiol-regul Integr Comp Physiol Am Physiol Soc 1998; 275: R1909–R1920.
Buckey JC , Lane LD , Levine BD , Watenpaugh DE , Wright SJ , Moore WE , et al. Orthostatic intolerance after spaceflight. J Appl Physiol [Internet] 1996 [cited 2021 Mar 7]; Available from: https://journals.physiology.org/doi/abs/10.1152/jappl.1996.81.1.7.
Meck JV , Reyes CJ , Perez SA , Goldberger AL , Ziegler MG . Marked exacerbation of orthostatic intolerance after long- vs. Short-duration spaceflight in veteran astronauts. Psychosom Med 2001; 63: 865–873.
Kimmerly DS , O’Leary DD , Menon RS , Gati JS , Shoemaker JK . Cortical regions associated with autonomic cardiovascular regulation during lower body negative pressure in humans. J Physiol 2005; 569: 331–345.
Iida H , Kurano M , Takano H , Kubota N , Morita T , Meguro K , et al. Hemodynamic and neurohumoral responses to the restriction of femoral blood flow by KAATSU in healthy subjects. Eur J Appl Physiol 2007; 100: 275–285.
Nakajima T , Iida H , Kurano M , Takano H , Morita T , Meguro K , et al. Hemodynamic responses to simulated weightlessness of 24-h head-down bed rest and KAATSU blood flow restriction. Eur J Appl Physiol 2008; 104: 727.
Tanaka H , Yamaguchi H , Tamai H . Treatment of orthostatic intolerance with inflatable abdominal band. Lancet Lond Engl 1997; 349: 175.
Mouser JG , Dankel SJ , Mattocks KT , Jessee MB , Buckner SL , Abe T , et al. Blood flow restriction and cuff width: effect on blood flow in the legs. Clin Physiol Funct Imaging 2018; 38: 944–948.
Sieljacks P , Knudsen L , Wernbom M , Vissing K . Body position influences arterial occlusion pressure: implications for the standardization of pressure during blood flow restricted exercise. Eur J Appl Physiol 2018; 118: 303–312.
Motykie GD , Zebala LP , Caprini JA , Lee CE , Arcelus JI , Reyna JJ , et al. A guide to venous thromboembolism risk factor Assessment. J Thromb Thrombolysis 2000; 9: 253–262.
Wagenmakers E-J , Love J , Marsman M , Jamil T , Ly A , Verhagen J , et al. Bayesian inference for psychology. Part II: example applications with JASP. Psychon Bull Rev 2018; 25: 58–76.
Wagenmakers E-J , Marsman M , Jamil T , Ly A , Verhagen J , Love J , et al. Bayesian inference for psychology. Part I: theoretical advantages and practical ramifications. Psychon Bull Rev 2018; 25: 35–57.
Podoleanu C , Maggi R , Brignole M , Croci F , Incze A , Solano A , et al. Lower limb and abdominal compression bandages prevent progressive orthostatic hypotension in elderly persons. J Am Coll Cardiol. American College of Cardiology Foundation 2006; 48: 1425–1432.
Arnold AC , Shibao C . Current concepts in orthostatic hypotension management. Curr Hypertens Rep 2013; 15: 304–312.
Fu Q , Arbab-Zadeh A , Perhonen MA , Zhang R , Zuckerman JH , Levine BD . Hemodynamics of orthostatic intolerance: implications for gender differences. Am J Physiol-heart Circ Physiol Am Physiol Soc 2004; 286: H449–H457.
Montgomery LD , Kirk PJ , Payne PA , Gerber RL , Newton SD , Williams BA . Cardiovascular responses of men and women to lower body negative pressure. Aviat Space Environ Med 1977; 48: 138–145.
Barón-Esquivias G , Pedrote A , Cayuela A , Valle JI , Fernández JM , Estepa MJ , et al. Age and gender differences in basal and isoprenaline protocols for head-up tilt table testing. EP Eur 2001; 3: 136–140.
Wieling W , van Brederode JFM , de Rijk LG , Borst C , Dunning AJ . Reflex control of heart rate in normal subjects in relation to age: a data base for cardiac vagal neuropathy. Diabetologia 1982; 22: 163–166.
Claydon VE , Younis NR , Hainsworth R . Phase of the menstrual cycle does not affect orthostatic tolerance in healthy women. Clin Auton Res 2006; 16: 98–104.