▶ Valsalva technique, heart rate and blood pressure measurement while breathing with abdominals
Diagnosing orthostatic hypotension with the Valsalva maneuver. [고려대 안암병원 제공]
A study has found that the diagnosis rate of orthostatic hypotension can be increased with the ‘Valsalva maneuver’, which measures changes in heart rate and blood pressure while breathing through the stomach. Orthostatic hypotension is a disease that causes dizziness, visual disturbances, and fainting due to a sudden drop in blood pressure when a person wakes up due to an abnormality in the autonomic nervous system. Early and accurate diagnosis is important as it can be caused by severe diseases such as diabetes and Parkinson’s disease.
The standing tilt test is a test that measures blood pressure while changing the angle the patient is lying down. This is because patients with delayed orthostatic hypotension, which account for 20 to 45% of patients with orthostatic hypotension, develop symptoms 10 minutes after changing the angle.
In response, a research team led by Kim Byeong-jo and Park Jin-woo, professors of neurology at Korea University Anam Hospital, jointly researched with the Center for Autonomic Nervous Disorders at Vanderbilt University in the U.S., and presented a study result showing that ‘Valsalva Sugi’ can increase the efficiency and diagnosis rate of orthostatic hypotension tests.
The research team analyzed the relationship with orthostatic hypotension by comparing heart rate change and blood pressure recovery time when performing the Valsalva maneuver on 2,498 patients who underwent an autonomic nerve test between March 2016 and May 2022.
The Valsalva technique is an autonomic nerve test that evaluates cardiovascular function. It is a test method that measures changes in heart rate and blood pressure by exhaling by applying force to the stomach as if blowing up a balloon while covering the nose and mouth. Through this, the medical staff can determine whether the patient’s blood pressure drop is due to an abnormality of the autonomic nervous system.
As a result of the study, it was found that when the Valsalva maneuver was performed for 15 seconds, the change in heart rate was small and the longer it took to recover to normal blood pressure, the more the standing tilt test should be performed for more than 30 minutes.
This provides an implication in that the medical staff can predict the standing tilt test time required for the patient.
In the meantime, it was difficult to select the optimal test time for each patient because there was no objective guideline on how long a standing tilt test was needed for which patient.
The Valsalva technique predicts the symptom onset time during the standing tilt test to reduce the patient’s burden of examination, and improves examination efficiency by allowing medical staff to set the optimal examination time for each patient.
Professor Kim Byeong-jo said, “This study is aimed at increasing the diagnosis rate of orthostatic hypotension and sensitively finding patients with abnormal findings. It can help in the diagnosis and treatment of
The results of the study were published in the American Heart Association’s ‘Hypertension’, an international journal published by the American Heart Association. He was selected as one of the ‘people who make Korea shine (Hanbitsa)’ selected by the Biological Research Information Center (BRIC).
Daeik Kwon Medical Specialist Reporter>
