Generic placeholder image

Current Aging Science


ISSN (Print): 1874-6098
ISSN (Online): 1874-6128

Mini-Review Article

A Review of Heart Rate and Blood Pressure Responses to Active Standing in Healthy Adults

Author(s): Caitríona Quinn*, Ann Monaghan, Tim Foran, Rose Anne Kenny and John Gormley

Volume 15, Issue 3, 2022

Published on: 15 June, 2022

Page: [198 - 208] Pages: 11

DOI: 10.2174/1874609815666220419102648

Price: $65


Objectives: This review outlines the normal heart rate and blood pressure response to active standing, the physiological mechanisms governing these, and the effect of ageing on the responses.

Methods: A literature search was conducted to identify articles investigating the normal heart rate and/or blood pressure response to standing.

Results: Heart rate when standing increases and then decreases and recovers to baseline. Blood pressure responses are inverse. Skeletal muscle contraction and the baroreceptor reflex drive this. With ageing, heart rate response attenuates and the initial blood pressure response increases.

Discussion: Normal heart rate and blood pressure responses are attributed to the baroreceptor reflex and skeletal muscle contraction. Decreased muscle strength and baroreceptor sensitivity are associated with ageing, suggesting a possible benefit in improving skeletal muscle strength to maintain an efficient response. Understanding these responses and their variation with ageing is clinically relevant and may be beneficial in improving rehabilitation outcomes.

Keywords: Heart rate, blood pressure, standing, ageing, sensitivity, muscle.

Graphical Abstract
Bohannon RW. Daily sit-to-stands performed by adults: a systematic review. J Phys Ther Sci 2015; 27(3): 939-42.
[] [PMID: 25931764]
Lord S, Chastin SF, McInnes L, Little L, Briggs P, Rochester L. Exploring patterns of daily physical and sedentary behaviour in communi-ty-dwelling older adults. Age Ageing 2011; 40(2): 205-10.
[] [PMID: 21239410]
Finucane C, van Wijnen VK, Fan CW, et al. A practical guide to active stand testing and analysis using continuous beat-to-beat non-invasive blood pressure monitoring. Clin Auton Res 2019; 29(4): 427-41.
[] [PMID: 31076939]
Ewing DJ, Campbell IW, Murray A, Neilson JM, Clarke BF. Immediate heart-rate response to standing: simple test for autonomic neuropa-thy in diabetes. BMJ 1978; 1(6106): 145-7.
[] [PMID: 620228]
Rivasi G, Ungar A. Orthostatic hypotension in older adults: the role of medications. Monaldi Arch Chest Dis 2020; 90(4)
[] [PMID: 33238696]
Esler M, Julius S, Coghlan B, Sari CI, Guo L, Esler D. Consequences of the evolutionary cardiovascular challenge of human bipedalism: orthostatic intolerance syndromes, orthostatic hypertension. J Hypertens 2019; 37(12): 2333-40.
[] [PMID: 31335513]
Wieling W, Borst C, van Brederode JFM, van Dongen Torman MA, van Montfrans GA, Dunning AJ. Testing for autonomic neuropathy: heart rate changes after orthostatic manoeuvres and static muscle contractions. Clin Sci (Lond) 1983; 64(6): 581-6.
[] [PMID: 6839664]
McCrory C, Berkman LF, Nolan H, O’Leary N, Foley M, Kenny RA. Speed of heart rate recovery in response to orthostatic challenge. Circ Res 2016; 119(5): 666-75.
[] [PMID: 27330018]
Lagro J, Schoon Y, Heerts I, et al. Impaired systolic blood pressure recovery directly after standing predicts mortality in older falls clinic patients. J Gerontol A Biol Sci Med Sci 2014; 69(4): 471-8.
[] [PMID: 23873962]
Juraschek SP, Daya N, Appel LJ, et al. Orthostatic hypotension in middle-age and risk of falls. Am J Hypertens 2017; 30(2): 188-95.
[] [PMID: 27638848]
Finucane C, O’Connell MDL, Donoghue O, Richardson K, Savva GM, Kenny RA. Impaired Orthostatic blood pressure recovery is associ-ated with unexplained and injurious falls. J Am Geriatr Soc 2017; 65(3): 474-82.
[] [PMID: 28295143]
Frewen J, Finucane C, Savva GM, Boyle G, Kenny RA. Orthostatic hypotension is associated with lower cognitive performance in adults aged 50 plus with supine hypertension. Gerontology 2014; 69(7): 878-85.
[] [PMID: 24214492]
Zygmunt A, Stanczyk J. Methods of evaluation of autonomic nervous system function. Arch Med Sci 2010; 6(1): 11-8.
[] [PMID: 22371714]
Borst C, Wieling W, van Brederode JFM, Hond A, de Rijk LG, Dunning AJ. Mechanisms of initial heart rate response to postural change. Am J Physiol 1982; 243(5): H676-81.
[PMID: 7137360]
Dambrink JHA, Wieling W. Circulatory response to postural change in healthy male subjects in relation to age. Clin Sci (Lond) 1987; 72(3): 335-41.
[] [PMID: 3816087]
Romero-Ortuno R, O’Connell MDL, Finucane C, Fan CW, Kenny RA. Higher orthostatic heart rate predicts mortality: The Irish longitudi-nal study on ageing (TILDA). Aging Clin Exp Res 2014.
[PMID: 25034834]
Mol A, Bui Hoang PTS, Sharmin S, et al. Orthostatic hypotension and falls in older adults: a systematic review and meta-analysis. J Am Med Dir Assoc 2019; 20(5): 589-597.e5.
[] [PMID: 30583909]
Xin W, Lin Z, Mi S. Orthostatic hypotension and mortality risk: a meta-analysis of cohort studies. Heart 2014; 100(5): 406-13.
[] [PMID: 23878177]
Ewing DJ, Hume L, Campbell IW, Murray A, Neilson JM, Clarke BF. Autonomic mechanisms in the initial heart rate response to standing. J Appl Physiol 1980; 49(5): 809-14.
[] [PMID: 7429902]
Borst C, van Brederode JF, Wieling W, van Montfrans GA, Dunning AJ. Mechanisms of initial blood pressure response to postural change. Clin Sci (Lond) 1984; 67(3): 321-7.
[] [PMID: 6467836]
Ten Harkel AD, Van Lieshout JJ, Van Lieshout EJ, Wieling W. Assessment of cardiovascular reflexes: influence of posture and period of preceding rest. J Appl Physiol 1990; 68(1): 147-53.
[] [PMID: 2312453]
Imholz BPM, Dambrink JHA, Karemaker JM, Wieling W. Orthostatic circulatory control in the elderly evaluated by non-invasive continu-ous blood pressure measurement. Clin Sci (Lond) 1990; 79(1): 73-9.
[] [PMID: 2167794]
Wieling W, Veerman DP, Dambrink JHA, Imholz BPM. Disparities in circulatory adjustment to standing between young and elderly sub-jects explained by pulse contour analysis. Clin Sci (Lond) 1992; 83(2): 149-55.
[] [PMID: 1327629]
Cybulski G. Influence of age on the immediate cardiovascular response to orthostatic manoeuvre. Eur J Appl Physiol Occup Physiol 1996; 73(6): 563-72.
Akselrod S, Oz O, Greenberg M, Keselbrener L. Autonomic response to change of posture among normal and mild-hypertensive adults: investigation by time-dependent spectral analysis. J Auton Nerv Syst 1997; 64(1): 33-43.
[] [PMID: 9188083]
Mehagnoul-Schipper DJ, Vloet LCM, Colier WNJM, Hoefnagels WHL, Jansen RWMM. Cerebral oxygenation declines in healthy elderly subjects in response to assuming the upright position. Stroke 2000; 31(7): 1615-20.
[] [PMID: 10884462]
Davrath LR, Goren Y, Pinhas I, Toledo E, Akselrod S. Early autonomic malfunction in normotensive individuals with a genetic predispo-sition to essential hypertension. Am J Physiol Heart Circ Physiol 2003; 285(4): H167.704..
Yamanaka Y, Honma K. Cardiovascular autonomic nervous response to postural change in 610 healthy Japanese subjects in relation to age. Auton Neurosci 2006; 124(1-2): 125-31.
[] [PMID: 16469546]
Pauls JP, Roberts LA, Burgess T, Fraser JF, Gregory SD, Tansley G. Time course response of the heart and circulatory system to active postural changes. J Biomech Eng 2018; 140(3)
[] [PMID: 29131882]
O’Connor JD, O’Connell MDL, Nolan H, Newman L, Knight SP, Kenny RA. Impact of standing speed on the peripheral and central He-modynamic response to Orthostasis: Evidence from the irish longitudinal study on ageing. Hypertension 2020; 75(2): 524-31.
[] [PMID: 31838912]
Hartley P, Costello P, Fenner R, et al. Change in skeletal muscle associated with unplanned hospital admissions in adult patients: A sys-tematic review and meta-analysis. PLoS One 2019; 14(1): e0210186.
[] [PMID: 30608987]
Volpi E, Nazemi R, Fujita S. Muscle tissue changes with aging. Curr Opin Clin Nutr Metab Care 2004; 7(4): 405-10.
[] [PMID: 15192443]
O’Connell MDL, Savva GM, Fan CW, Kenny RA. Orthostatic hypotension, orthostatic intolerance and frailty: The Irish Longitudinal Study on Aging-TILDA. Arch Gerontol Geriatr 2015; 60(3): 507-13.
[] [PMID: 25687529]

Rights & Permissions Print Export Cite as
© 2023 Bentham Science Publishers | Privacy Policy