Blood flow restriction maintains blood pressure upon head-up tilt

Physiol Int. 2022 Mar 3. doi: 10.1556/2060.2022.00051. Online ahead of print.

Abstract

Background: Orthostatic intolerance occurs in some astronauts following space flight. Although orthostatic blood pressure responses should normalize in the weeks following the return to Earth, there may be situations where an immediate short-term solution is necessary (e.g., emergency evacuation).

Purpose: The purpose of this study was to examine different levels of blood flow restriction on changes in blood pressure and heart rate when transitioning from supine to a head-up tilt and determine whether this change differs based on sex.

Methods: Eighty-nine participants (45 men, 44 women) completed the three visits with different pressures (Sham, Moderate, and High) in a randomized order. Cuffs were placed on the most proximal area of the thighs. Brachial blood pressure was measured at baseline, upon inflation of the cuffs in a supine position, immediately after tilt (70°), and eight more times separated by 45 seconds.

Results: Data are presented as mean (SD). The change in systolic (High > Moderate > Sham) [High vs Sham: 5.5 (7.4) mmHg, High vs Moderate: 3 (7.4) mmHg, and Moderate vs Sham: 2.4 (8.4) mmHg] and diastolic pressure (High > Moderate = Sham) [High vs Sham: 2.4 (5.3) mmHg, High vs Moderate: 1.9 (6.3) mmHg] differed across applied pressures. The change in heart rate was initially greatest in the sham-pressure but increased the greatest in the high-pressure condition by the end of the head-up tilt period. Additionally, there was no influence of sex.

Conclusion: Blood flow restriction applied in this study increased blood pressure in a pressure-dependent manner upon head-up tilt.

Keywords: diastolic blood pressure; external compression; gender influence; no sex differences; orthostatic hypotension; orthostatic intolerance; systolic blood pressure.