Mechanisms of hypotensive effects of a posture change from seated to supine in humans

• Published in: Acta physiologica Scandinavica Vol. 171; no. 4; pp. 405 - 412
• Main Authors: Pump, B., Kamo, T., Gabrielsen, A., Norsk, P.
• Format: Journal Article
• Language: English
• Published: Oxford UK Blackwell Science Ltd 01.04.2001; Blackwell Science
• Subjects: Adult; Atrial Function, Left - physiology; atrium; baroreceptors; Biological and medical sciences; blood pressure; Blood Pressure - physiology; Cardiac Output - physiology; Carotid Sinus - physiology; Fundamental and applied biological sciences. Psychology; Heart Rate - physiology; Hemodynamics. Rheology; Humans; Hypotension, Orthostatic; immersion; Male; peripheral vascular resistance; posture; Pressoreceptors - physiology; Space life sciences; supine position; Supine Position - physiology; Vertebrates: cardiovascular system; Water; Human; Induced arterial hypotension; Stimulation; Immersion; Artery; Posture; Vascular resistance; Blood vessel; Carotid; Hydrostatic pressure; Blood pressure; Circulatory system; Hemodynamics; Baroreceptor
• ISSN: 0001-6772; 1365-201X
• DOI: 10.1046/j.1365-201X.2001.00804.x

The hypothesis tested was that the hydrostatic stimulation of carotid baroreceptors is pivotal to decrease mean arterial pressure at heart level during a posture change from seated to supine. In eight males, the cardiovascular responses to a 15‐min posture change from seated to supine were compared with those of water immersion to the xiphoid process and to the neck, respectively. Left atrial diameter and cardiac output (rebreathing) increased similarly during the posture change and water immersion to the xiphoid process and further so during neck immersion. Mean arterial pressure decreased by 12 ± 2 mmHg during the posture change, by 5 ± 1 mmHg during xiphoid immersion, and was unchanged during neck immersion. Arterial pulse pressure increased by 12 ± 3 mmHg during the posture change (P < 0.05) and less during xiphoid and neck immersion by 7 ± 3 mmHg (P < 0.05). Total peripheral vascular resistance decreased similarly during the posture change and neck immersion and slightly less during xiphoid immersion (P < 0.05). In conclusion, the hydrostatic stimulation of carotid baroreceptors combined with some additional increase in arterial pulse pressure, which also stimulates aortic baroreceptors, accounts for more than half of the hypotensive response at heart level to a posture change from seated to supine.