Contribution of the leg vasculature to hypotensive effects of an antiorthostatic posture change in humans

1Previous results from our laboratory have shown that vasodilatation in the legs prevents mean arterial pressure (MAP) from increasing during water immersion. Therefore, we tested the hypothesis that vasodilatation in the legs is necessary for the hypotensive effects to occur during a moderate antiorthostatic posture change. 2Ten healthy males underwent a 5 min posture change from upright seated to horizontal supine (SUP) and back to seated again with (OCCL-SUP) and without simultaneous total arterial (154 ± 1 mmHg) thigh occlusion, and a control seated period, also with and without arterial occlusion. Cardiac output (CO) was measured by a non-invasive foreign (N2O) gas rebreathing technique. 3MAP (brachial auscultation) decreased during SUP from 94 ± 3 to 84 ± 2 mmHg (P < 0.0001) and total peripheral vascular resistance (TPR = MAP/CO, n= 8) decreased by 15 ± 4 % (P < 0.001). During OCCL-SUP, MAP decreased from 98 ± 2 to 90 ± 2 mmHg (P < 0.005) and TPR decreased by 14 ± 3 % (P < 0.01). 4In conclusion, vasodilatation in the legs is not necessary for the decrease in MAP to occur during a moderate antiorthostatic manoeuvre. Therefore, vasodilatation in more central vascular beds (e.g. abdomen) can alone account for the hypotensive effects.