OBJECTIVE: To observe the effect of heat-sensitive moxibustion combined with medication on orthostatic hypotension (OH) of yang -qi deficiency in the elderly. METHODS: Sixty elderly patients with OH of yang -qi deficiency were randomly divided into an observation group (30 cases, 1 case dropped out) and a control group (30 cases). The patients in the control group were treated with oral midodrine hydrochloride tablets, 2.5 mg each time and twice daily, while the patients in the observation group were treated with heat-sensitive moxibustion in addition to the treatment in the control group. Acupoints selected included Dazhui (GV 14), Fengfu (GV 16), and Baihui (GV 20), with each session lasting 30-40 min, once daily. Both groups were treated for 4 weeks. Blood pressure in the supine and standing positions, as well as the decrease of blood pressure when the position changing from supine to standing, were measured before treatment and after 2 and 4 weeks of treatment. Clinical efficacy was also evaluated. RESULTS: After 4 weeks of treatment, both groups showed an increase in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in both the supine and standing positions (P<0.05), and the decrease in SBP and DBP when the position changing from supine to standing was reduced (P<0.05). Compared with the control group, the observation group had higher SBP and DBP in both positions and a smaller decrease in SBP and DBP when the position changing from supine to standing (P<0.05). The total effective rate was 96.6% (28/29) in the observation group, which was higher than 70.0% (21/30) in the control group (P<0.05). CONCLUSION Heat-sensitive moxibustion combined with medication could increase the blood pressure in both supine and standing position, and decrease the reducing of blood pressure when the position changing from supine to standing in elderly patients with OH of yang-qi deficiency.
Humans ; Moxibustion ; Hypotension, Orthostatic/etiology* ; Male ; Aged ; Female ; Combined Modality Therapy ; Acupuncture Points ; Yang Deficiency/therapy* ; Blood Pressure/drug effects* ; Aged, 80 and over ; Middle Aged ; Midodrine

A 50-year-old man had undergone lumbar vertebral surgery and was confined to bed in the supine position for three months. When he sat up from the prolonged supine position, he showed clinical signs of orthostatic hypotension and reported decreased vision in both eyes. He also had underlying anemia. Ophthalmologic findings suggested bilateral anterior ischemic optic neuropathy (ION) as the cause of the visual loss. Although there are numerous reports of ION in the setting of hemodynamic compromise, such as systemic hypotension, cases of ION-associated orthostatic hypotension are very rare.
Acute Disease ; Blindness/diagnosis/*etiology/physiopathology ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Hypotension, Orthostatic/*complications/physiopathology ; Male ; Middle Aged ; Visual Acuity

OBJECTIVETo study the clinical characteristics of orthostatic hypertension (OHT) in children.

METHODA total of 96 children with OHT who met the diagnostic criteria and clinical manifestations were recruited in the Department of Pediatrics, Peking University First Hospital. Age and sex distributions were observed. The duration of disease, the frequencies of symptoms and the predisposing factors were recorded. The hemodynamic changes from supine to up-right positions were also analyzed.

RESULTThere were 50 boys and 46 girls in the study group. The mean age was (11.8 ± 2.7) years. Thirty-two children were from 6 to 10 years old, accounting for 33.3% of all subjects, while 64 patients were from 11 to 17 years old, accounting for 66.7%. Durations of symptoms of OHT were less than 1 month in 22.9% children, from 1 month to 1 year in 51.1% children and longer than 1 year in 26.0% children. The most common clinical manifestations were syncope and dizziness. The incidence of them was 70.8% and 46.9%, respectively. Other clinical manifestations included transitional amaurosis, nausea and/or vomiting, pallor and so on. These clinical manifestations often occurred on position change (24.0%) and long-time standing (57.3%) in children. Other predisposing factors included exercise, emotion changes and fuggy environment. The baseline systolic and diastolic blood pressures were (103 ± 8) mm Hg (1 mm Hg = 0.133 kPa) and (59 ± 6) mm Hg, respectively, the up-right systolic and diastolic blood pressure at 3 min were (113 ± 8) mm Hg and (73 ± 6) mm Hg and the differences were significant (t = 27.674, P < 0.01; t = 17.936, P < 0.01). The baseline heart rate in supine position was (81 ± 11) bpm and the maximum heart rate in up-right position was (113 ± 12) bpm (t = 33.092, P < 0.01).

CONCLUSIONOHT is commonly seen in puberty of children. The chief complaints are syncope and dizziness. They were mostly induced by position change and long-time standing. Blood pressure was significantly increased from supine to up-right position.

Adolescent ; Blood Pressure ; physiology ; Child ; Dizziness ; epidemiology ; physiopathology ; Female ; Heart Rate ; Humans ; Hypotension, Orthostatic ; epidemiology ; etiology ; physiopathology ; Male ; Multivariate Analysis ; Posture ; Risk Factors ; Syncope ; epidemiology ; physiopathology

We introduced the method of computer simulation in the studies of gravitational physiology. Based on work of Melchior (1994), we developed a mathematical model that can be used to stimulate cardiovascular responses to orthostatic stress (lower body negative pressure, LBNP). The model includes 7 sub-models: the redistribution of blood, the filling of left ventricle, left ventricle working, peripheral circulation, control of heart rate (HR), control of peripheral resistance and control of venous tone. Then we simulated the changes of blood pressure (BP) and heart rate during lower body negative pressure, and the results agreed well with the results of our human experiment. By using the developed model, we also simulated the effects of hypovolemia on the BP, HR and shock index during orthostatic stress. The simulation results indicate that the cardiovascular responses to orthostatic stress change significantly when the decrease of blood volume is more than 15% of the total blood volume. However, if the amount of the decrease of blood volume is less than 5% of the total blood volume, HR and BP could be maintained in normal range by the regulation of baroreflex during LBNP. Our simulation results suggest that hypovolemia may be the main cause of orthostatic intolerance induced by weightlessness.
Adult ; Blood Pressure ; physiology ; Cardiovascular Deconditioning ; physiology ; Computer Simulation ; Heart Rate ; physiology ; Humans ; Hypotension, Orthostatic ; etiology ; physiopathology ; Hypovolemia ; etiology ; physiopathology ; Lower Body Negative Pressure ; adverse effects ; Male ; Models, Cardiovascular ; Ventricular Function, Left ; physiology ; Weightlessness Simulation ; adverse effects