Many patients with cardiac disease develop orthostatic blood pressure lpar;OBPrpar; changes as a result of their disease or treatment. Although these changes are assessed by physical therapists and nurses, there is no standard as to optimal assessment of OBP. Frequently, patients with OBP changes are advised to sit before standing. However, this approach has not been validated. This study was conducted to determine 1rpar; optimal time to measure OBPsemi; 2rpar; effect of position on OBPsemi; and 3rpar; effect of cardiac drugs on OBP.The sample consisted of 24 subjects with complicated posthyphen;myocardial infarction and postcoronary artery bypass graft with a mean age of 74 years. Systolic and diastolic blood pressures lpar;SBPrpar; lpar;DBPrpar;, heart rate lpar;HRrpar;, cardiac rhythm, and symptoms were measured four times over 2 consecutive days, during rest lpar;supinerpar;, sitting, and standing at specific time intervals, resulting in four groupscolon; P1, at peak drug level lpar;supine to sit to standrpar;semi; P2, peak drug level lpar;supine to standrpar;semi; T1, trough drug level lpar;supine to sit to standrpar;, and T2, lpar;supine to standrpar;.Data were analyzed by repeated analysis of variance measures. Only the time effects on SBP were statistically significant for all groups at 15, 30, and 60 seconds after change in position. The greatest SBP decreases were at 30 seconds for all groups. P2and T2elicited more orthostasis than P1or T1but was not significant. There were no significant differences between groups for ectopy, HR, lightheadedness, DBP, and medication effect. Patients with higher ejection fractions showed less OBP differences than those with lower ejection fractions.
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