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Posted by on Feb 23, 2019 in Hypertension | 0 comments

In a nutshell

This study investigated if spinal curvature (SC) is linked to orthostatic hypertension (OSH; high blood pressure when you stand up) in the elderly. They found that SC was linked to increased orthostatic blood pressure (BP).

Some background

Orthostatic hypertension (OSH) is high blood pressure (BP) caused by changes in posture. When patients with OSH stand up, their BP increases. A BP increase of greater than 20 mmHg due to posture is defined as OSH. OSH can increase the risk of serious events such as thrombosis (clots) and stroke. The cause and mechanism of OSH are unknown. One study suggests that sitting in a bending position increases the risk of OSH. A stooped posture may also contribute to OSH. 

A stooped posture is caused by a curvature in the spine. Curves occur at 3 main areas on the spine. A curve in the upper spine is called thoracic kyphosis (TK). A curve in the middle spine is called lumbar lordosis (LL). A curve in the lower spine is called sacral inclination (SI). It is unclear if spinal curvature (SC) is linked to OSH in older patients.

Methods & findings

This study included 1,992 patients over the age of 60. Seated BP was measured twice. After this, patients were asked to stand and BP was measured. This was the orthostatic BP measurement. The alignment of the spine was assessed in the seated and standing position. This was done using a computer-aided device. It measured the angle of the spine at 3 intervals to determine if there was a curve. Muscle mass and strength were also assessed. 

LL was significantly lower in patients with OSH. LL and TK was a significant predictor of OSH in these patients. OSH episodes were more frequent in patients that were obese and had LL. The number of OSH episodes increased with increasing weight and LL. Patients with sustained OSH (longer than 3 mins) had the least degree of LL. 

The bottom line

The authors concluded that SC (LL) was linked to increased orthostatic BP. 

The fine print

This study was conducted in healthy patients. It is unclear if LL and OSH are linked in frail patients or those with other illnesses. 

What’s next?

If you have any concerns regarding hypertension, please consult with your physician. 

Published By :

American journal of hypertension

Date :

Sep 28, 2018

Original Title :

Small Degree of Lumbar Lordosis as an Overlooked Determinant for Orthostatic Increases in Blood Pressure in the Elderly: The Nagahama Study.

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