Related Experiment Video

Updated: Jan 10, 2026

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
14:09

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance

Published on: March 21, 2013

21.6K

Association of orthostatic hypertension identified according to different definitions with cardiovascular disease.

Paolo Palatini1, Lucile Admant2, Sylvie Gautier3

  • 1Department of Medicine - University of Padova, Padua, Italy.

Journal of Hypertension
|November 27, 2025
PubMed

Insights

An exaggerated blood pressure increase upon standing (ERTS) of systolic blood pressure (SBP) ≥15-20 mmHg, or combined with diastolic blood pressure (DBP) ≥15 mmHg, is linked to cardiovascular events and mortality in older adults.

Area of Science:

  • Cardiology
  • Gerontology
  • Clinical Physiology

Background:

  • Diagnostic criteria for exaggerated blood pressure increase in response to standing (ERTS) are debated, complicating the assessment of its cardiovascular risk.
  • Previous studies have yielded inconsistent results regarding the association between ERTS and adverse cardiovascular outcomes.

Purpose of the Study:

  • To identify the most accurate definition of ERTS associated with cardiovascular disease.
  • To evaluate the prognostic value of different ERTS definitions in an elderly population.

Main Methods:

  • The study analyzed data from 920 individuals aged 80 years and older within the PARTAGE study.
  • Blood pressure was measured at 1 and 3 minutes after standing, with 16 different ERTS definitions applied.
  • Multivariable survival Cox analyses were used to explore the risk of adverse cardiovascular outcomes.

Main Results:

  • An increase in systolic blood pressure (SBP) of ≥20 mmHg or ≥15 mmHg upon standing was significantly associated with cardiovascular events and mortality.
  • Combining SBP increase (≥20 mmHg) with diastolic blood pressure (DBP) increase (≥15 mmHg) showed the best model fit for predicting adverse outcomes.
  • Other ERTS definitions did not show an independent association with cardiovascular events and mortality.

Conclusions:

  • An SBP increase of >15-20 mmHg upon standing is a significant prognostic indicator for cardiovascular risk in older adults.
  • Incorporating a DBP increase of ≥15 mmHg alongside SBP increase enhances the predictive value of ERTS for cardiovascular outcomes.
Abstract

Keywords:
blood pressurecardiovascularorthostaticresponseriskstanding

More Related Videos

Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis07:51

Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis

Published on: September 26, 2018

8.0K
Evaluation of Hydration Status by Bioelectrical Impedance Vector Analysis in Patients with Ischemic Heart Disease Undergoing Exercise Stress Test10:21

Evaluation of Hydration Status by Bioelectrical Impedance Vector Analysis in Patients with Ischemic Heart Disease Undergoing Exercise Stress Test

Published on: September 22, 2023

941

Related Concept Videos

Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
443
Alterations in Blood Pressure01:30

Alterations in Blood Pressure

Alterations in blood pressure, such as hypertension (high blood pressure) and hypotension (low blood pressure), significantly affect human health. Understanding these conditions' classifications, causes, and symptoms is essential for effective management and treatment.
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...
1.9K
Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
708
Hypertension I: Introduction01:28

Hypertension I: Introduction

Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
676
Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
3.6K
Disorders of the Autonomic Nervous System01:18

Disorders of the Autonomic Nervous System

The autonomic nervous system (ANS) is an intricate network of nerves that controls functions such as the regulation of heart rate, digestion, and blood pressure regulation. When this system malfunctions, it can lead to various disorders that affect multiple bodily functions. One common feature of many autonomic disorders is the involvement of smooth blood vessels, which play a crucial role in regulating blood flow throughout the body.
Raynaud's disease, also known as Raynaud's...
1.4K