Influence of postural misalignment on blood pressure fall in hypertensive individuals: an exploratory cross sectional study

Abstract

INTRODUCTION: blood pressure System (SNS) has been considered as the ultimate integrator of the systems’ physiology on Blood Pressure (BP) control. Posture is also regulated by SNS. Systems which regulate BP also act on postural control. OBJECTIVE: To test the hypothesis of an association between postural misalignments (PM) and BP fall in hypertensive individuals. METHODS: Exploratory study using a sample of 40 hypertensive individuals, who regularly use antihypertensive drugs. All of them underwent Ambulatory Blood Pressure Monitoring (ABPM) and posture assessment, through Postural Assessment Software (PAS). To test association between posture angles and BP variables, the student’s t-test and Mann-Whitney tests were used, at a 5% level of significance. This study is registered at clinical trials, under the number NCT02401516. RESULTS: For Systolic Blood Pressure (SBP), anterior trunk shift presented smaller awake/asleep variation (14.7%vs25.3%, p=0.01), and flexing ankle for higher BP loads: 21.9%vs7.8% for total load (p=0.02), 21.8%vs9% for load during the period awake (p=0.04) and 21.9%vs7.9% for load during the period asleep (p=0.02). For Diastolic Blood Pressure (DBP), posterior trunk shift presented higher pressure load (24.0%vs16.2%, p=0.04), and anterior trunk shift presented smaller awake/asleep variation (14.4%vs25.5%, p=0.01) and flexing hip presented higher BP load (29.4%vs18.3%, p=0.02). From posture scores, the PM presented smaller awake/asleep variation for SBP (13.7%vs22.8%, p=0.03) and DBP (11.5%vs23.5%, p=0.01). CONCLUSION: PM can be associated with pressure fall. Three or more alterations in posture angles are associated with smaller awake/asleep BP variation.