Feeling dizzy when you stand up? Simple muscle techniques can
effectively manage symptoms of initial orthostatic hypotension
Two cost-free, non-drug treatments can improve a patient's quality of
life

Date:
February 9, 2022
Source:
Elsevier
Summary:
Feeling lightheaded upon standing up due to initial orthostatic
hypotension (IOH), or a transient decrease in blood pressure
and increase in heart rate, is a common but poorly understood
condition. A new study offers two simple cost- and drug-free
techniques to effectively manage symptoms of IOH and improve quality
of life by activating lower body muscle before or after standing.



FULL STORY ========================================================================== Feeling lightheaded upon standing up due to initial orthostatic
hypotension (IOH), or a transient decrease in blood pressure and increase
in heart rate, is a common but poorly understood condition. A new
study offers two simple cost- and drug-free techniques to effectively
manage symptoms of IOH and improve quality of life by activating
lower body muscle before or after standing. The research appears
in Heart Rhythm, the official journal of the Heart Rhythm Society,
the Cardiac Electrophysiology Society, and the Pediatric & Congenital Electrophysiology Society, published by Elsevier.


========================================================================== Syncope, lightheadedness, dizziness, or loss of consciousness from IOH,
affects up to 40% of the general population (all ages), while presyncope
is probably even more common. Despite this, the condition is relatively understudied and there is minimal information available about the
underlying mechanisms or symptom management and treatment. Currently,
there are very few options available to patients with IOH and no pharmacological treatments. The most common recommendations have been
to stand up slowly or sit up first before standing.

"Almost everyone has probably experienced some lightheadedness at some
time after standing up," explained lead investigator Satish R. Raj,
MD, MSCI, FHRS, Professor of Cardiac Sciences, Libin Cardiovascular
Institute, Cumming School of Medicine, University of Calgary, Calgary,
AB, Canada. "For some people this is a frequent occurrence and may happen several times a day, which can be very frightening and negatively impact
their quality of life. We wanted to explore this further and provide novel
and effective symptom management techniques with the goal of improving
the IOH patient's quality of life." This study investigated physical
maneuvers before or after standing and their efficacy in reducing the
drop in blood pressure as well as the symptoms typically seen in IOH
patients upon standing. Study participants included 24 young women (mean
age 32 +/- 8 years) with a high burden history of fainting immediately
after standing and more than four episodes of presyncope or syncope per
month. The study participants were required to have a significant drop
in systolic blood pressure of at least 40 mmHg upon standing to fulfill
the diagnostic criteria of IOH on the study day. Two participants had inadequate heart rate recordings and were excluded from the analysis.

The 22 study participants completed three sit-to-stand maneuvers including
a stand with no intervention (control), and two interventions. Researchers found that both lower body muscle preactivation (thighs) through repeated
knee raises prior to standing (PREACT) and lower body muscle tensing
(thighs and buttocks) through leg crossing and tensing immediately after standing (TENSE) effectively improve the blood pressure drop. This led
to a reduction in symptoms upon standing. They found that the PREACT
maneuver accomplished this by increasing cardiac output, while the TENSE maneuver did so by increasing stroke volume.

"Our study provides a novel and cost-free symptom management technique
that patients with IOH can use to manage their symptoms," noted first
author Nasia A. Sheikh, MSc, Libin Cardiovascular Institute, Cumming
School of Medicine, University of Calgary, Calgary, AB, Canada. "Since
it is a physical maneuver, it simply requires the lower body limbs,
which patients can utilize at any time and from anywhere to combat their symptoms." "Our study demonstrates the physiology of IOH and assesses the utility of physical maneuvers that can help the IOH patient manage their symptoms. A diagnosis of IOH is identified by patients as the critical
first step to empowering them to understand and master their symptoms and
thus minimize the disruptions to daily living caused by this common, but
not commonly understood, condition," added co-investigator Mary Runte',
PhD, University of Lethbridge, Lethbridge, AB, Canada.

In an accompanying editorial, 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, commented that "PREACT and TENSE provide an elegant and
simple effective symptom relief option for patients with IOH." However,
they noted, "The study needs to be validated in men, as well as
being explored in the elderly where multiple confounders should be
addressed. Understanding the role of cardiopulmonary mechanoreceptors
should also provide further mechanistic insights into the effects of these simple yet very effective physiologic maneuvers." special promotion Get
a free digital "Metabolism Myths" issue of New Scientist and discover the
7 things we always get wrong about diet and exercise. Claim_yours_now_>>> ========================================================================== Story Source: Materials provided by Elsevier. Note: Content may be edited
for style and length.


========================================================================== Journal Reference:
1. Nasia A. Sheikh, Shaun Ranada, Matthew Lloyd, Dallan McCarthy,
Karolina
Kogut, Kate M. Bourne, Juliana G. Jorge, Lucy Y. Lei, Robert
S. Sheldon, Derek V. Exner, Aaron A. Phillips, Mary Runte',
Satish R. Raj. Lower body muscle preactivation and tensing mitigate
symptoms of initial orthostatic hypotension in young females. Heart
Rhythm, 2022; DOI: 10.1016/ j.hrthm.2021.12.030 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/02/220209093301.htm

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