Blood pressure recovery from Valsalva maneuver in patients with autonomic failure

Elizabeth R. Vogel, Paola Sandroni, Phillip Anson Low

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

Background: Blood pressure (BP) changes in response to the Valsalva maneuver (VM) reflect the integrity of the baroreflex that regulates BP, and the phases of VM are widely used indices of adrenergic evaluation. Objective: To study the BP recovery time (PRT) following termination of VM back to baseline to determine if it could be an additional and better indicator of adrenergic function. Methods: The authors evaluated three groups of patients with increasing degrees of adrenergic failure and an age-matched control group. Adrenergic failure was graded on the basis of systolic blood pressure (SBP) reduction to tilt: Group 1, orthostatic hypotension (OH; SBP ≥ 30 mm Hg); Group 2, borderline OH (BOH; 30 > SBP > 10 mm Hg); and Group 3, sympathetic sudomotor failure. Results: PRT was found to vary directly with severity of adrenergic impairment. PRT significantly correlated with previously utilized phases of the VM and baroreflex gain, with highest correlations with phases II_L (reflex vasoconstriction following initial fall in BP) and IV (BP overshoot following the VM). PRT extends the indices for the quantitation of adrenergic failure, since it will continue to parallel increasing adrenergic failure after phase II_L is lost and is a reliable index when II_L cannot be recorded. Conclusions: Pressure recovery time is a valuable index of adrenergic failure. It extends the value of the Valsalva maneuver by providing a quantitative index that is measurable in patients with severe adrenergic failure.

Original languageEnglish (US)
Pages (from-to)1533-1537
Number of pages5
JournalNeurology
Volume65
Issue number10
DOIs
StatePublished - Nov 2005

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Valsalva Maneuver
Adrenergic Agents
Blood Pressure
Baroreflex
Orthostatic Hypotension
Vasoconstriction
Reflex
Research Design

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Blood pressure recovery from Valsalva maneuver in patients with autonomic failure. / Vogel, Elizabeth R.; Sandroni, Paola; Low, Phillip Anson.

In: Neurology, Vol. 65, No. 10, 11.2005, p. 1533-1537.

Research output: Contribution to journalArticle

Vogel, Elizabeth R. ; Sandroni, Paola ; Low, Phillip Anson. / Blood pressure recovery from Valsalva maneuver in patients with autonomic failure. In: Neurology. 2005 ; Vol. 65, No. 10. pp. 1533-1537.
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