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Relation of blood volume and blood pressure in orthostatic intoleranceA complex but crucial relationship exists between blood volume and blood pressure in human subjects; it has been recognized that in essential hypertension, renovascular hypertension, and pheochromocytoma, the relationship between plasma volume and diastolic blood pressure is an inverse one. This phenomenon has not been studied in individuals with low normal and reduced blood pressures. Orthostatic intolerance is a commonly encountered abnormality in blood pressure regulation often associated with tachycardia in the standing position. Most of these patients have varying degrees of reduced blood volume. We tested the hypothesis that the relationship previously found between plasma volume and diastolic blood pressure in pressor states would also hold in orthostatic intolerance. We studied 16 patients with a history of symptomatic orthostatic intolerance associated with an elevation in plasma norepinephrine in the upright posture and hypovolemia in 9 patients and normovolemia in 7 patients. Our studies demonstrate an inverse relationship between plasma volume and diastolic blood pressure in patients with orthostatic intolerance. This finding also holds for the change in diastolic blood pressure in response to upright posture. In this relationship, patients with orthostatic intolerance with high plasma norepinephrine resemble those with essential hypertension, renovascular hypertension, and pheochromocytoma. We conclude that in a variety of conditions at both ends of the blood pressure spectrum, the seemingly paradoxical association of hypovolemia and diastolic blood pressure is preserved.
Document ID
20040172777
Acquisition Source
Legacy CDMS
Document Type
Reprint (Version printed in journal)
Authors
Jacob, G.
(Clinical Research Center, Vanderbilt University Department of Medicine, Nashville, Tennessee 37232-2195, United States)
Biaggioni, I.
Mosqueda-Garcia, R.
Robertson, R. M.
Robertson, D.
Date Acquired
August 22, 2013
Publication Date
February 1, 1998
Publication Information
Publication: The American journal of the medical sciences
Volume: 315
Issue: 2
ISSN: 0002-9629
Subject Category
Aerospace Medicine
Funding Number(s)
CONTRACT_GRANT: HL44589
CONTRACT_GRANT: RR00095
Distribution Limits
Public
Copyright
Other
Keywords
NASA Discipline Regulatory Physiology
Non-NASA Center

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