Cardiac and peripheral vascular responses to head-up tilt during whole body thermal stress

During acute orthostatic stress, neurally mediated control of cardiac output (CO) and total peripheral vascular resistance (TPR) play an important role in the maintenance of systemic blood pressure. To examine the influence of thermal stress on the CO and TPR responses to orthostatic stress, 10 healthy male volunteers were exposed to normothermic control conditions followed by whole-body thermal stress produced by a cold or hot water-perfused suit during 5 min-70 degrees head-up tilt (HUT). HUT increased mean arterial pressure (MAP) by 3% of the pre-tilt value during normothermic control and cooling, whereas it decreased MAP by 4% of the pre-tilt value during heating. HUT decreased CO by 16-17% of the pre-tilt value under each thermal condition. The increase of TPR during HUT was exaggerated during cooling and inhibited during heating compared to normothermic control. Tilt-induced decrease of skin blood flow was greater during heating than cooling. These results suggest that the smaller increase of TPR rather than the CO change is responsible for the decreased MAP during acute orthostatic stress in hyperthermic humans. The contribution of skin vascular constriction to TPR changes during HUT is increased during heating and decreased during cooling.