Guruprasad Madhavan, MS, Ayana A. Goddard, MS, Kenneth J. McLeod, PhD

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Prevalence and Etiology of Delayed Orthostatic Hypotension in Adult Women Guruprasad Madhavan, MS, Ayana A. Goddard, MS, Kenneth J. McLeod, PhD Archives of Physical Medicine and Rehabilitation Volume 89, Issue 9, Pages 1788-1794 (September 2008) DOI: 10.1016/j.apmr.2008.02.021 Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 1 A representative SBP and DBP profile obtained by continuous blood pressure monitoring during 30 minutes of quiet sitting from a (A) normotensive subject and (B) delayed OH subject. Archives of Physical Medicine and Rehabilitation 2008 89, 1788-1794DOI: (10.1016/j.apmr.2008.02.021) Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 2 The mean resting DBP of the study population 2 minutes, 15 minutes, and 30 minutes after sitting. The normotensive group (n=21) exhibited a significant increase in DBP (P=.001) during 30 minutes of quiet upright sitting (71.1±1.0mmHg) in comparison to the 15-minute time point (64.2±0.9mmHg). The delayed OH group (n=9) experienced a significant decrease in resting DBP (53.1±0.9mmHg, P=.02) compared with the 15-minute time point (59.8±0.4mmHg). Archives of Physical Medicine and Rehabilitation 2008 89, 1788-1794DOI: (10.1016/j.apmr.2008.02.021) Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 3 The venous-filling index and calf venous volume for all study subjects. The venous-filling index was in the normative range (≤5mL/s) for all the subjects, as was calf venous volume (20–80mL). Legend: •, delayed OH group; ○, normotensive group. Archives of Physical Medicine and Rehabilitation 2008 89, 1788-1794DOI: (10.1016/j.apmr.2008.02.021) Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 4 Peripheral edema (index of microvascular filtration) and venous ejection fraction after 30 minutes of upright sitting. Six subjects (4 from the normotensive group; 2 delayed OH group) had an ejection fraction less than 30%. Four normotensive subjects showed higher peripheral edema rate than any of the delayed OH subjects. Legend: •, delayed OH group; ○, normotensive group. Archives of Physical Medicine and Rehabilitation 2008 89, 1788-1794DOI: (10.1016/j.apmr.2008.02.021) Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 5 Effect of 30 minutes of plantar micromechanical stimulation on both SBP and DBP of 9 subjects in the delayed OH group. Both SBP (P=.003) and DBP (P=.002) values were significantly increased because of stimulation in comparison to values observed after 30 minutes of quiet upright sitting. Legend: ☐, blood pressure after 30 minutes of upright sitting; ○, blood pressure values after 30 minutes of plantar-based stimulation. Archives of Physical Medicine and Rehabilitation 2008 89, 1788-1794DOI: (10.1016/j.apmr.2008.02.021) Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions