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Updated: Sep 27, 2026

Quantitative Autonomic Testing
Published on: July 19, 2011
Lower body negative pressure: a test of cardiovascular autonomic function
A R Patel1, J E Engstrom, L D Tusing
1Autonomic Laboratory, Department of Neurology, University Hospitals of Cleveland, and Case Western Reserve University, Cleveland, Ohio, USA.
Abstract:
Lower body negative pressure (LBNP) may provide an alternative test of cardiovascular autonomic function for patients unable to perform the Valsalva maneuver (VM). LBNP at -40 mmHg for 30 s was compared to the VM at 40 mmHg for 15 s with heart rate and blood pressure measured continuously in three age groups: 10-25 years; 26-40 years; and 41-55 years. Heart rate and blood pressure responses were comparable, with moderately diminished changes in blood pressure and heart rate in the LBNP test. When heart response to LBNP was converted to a ratio similar to that calculated for the VM, a high degree of correlation was found (R(2) = 0.5711). The LBNP test shows promise as an alternative test of cardiovascular autonomic function based on studies in normal subjects. The less marked changes may relate to the more passive nature of the applied stress. Future work should improve the device's accessibility and establish values for patients with autonomic disorders.
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