THE EFFECT OF ELASTIC BANDAGE OF THE LOWER LIMBS, ON BLOOD PRESSURE AND BAROREFLEX

Objective: to examine the effect of Elastic Bandage (EB) of the lower limbs, on blood pressure (BP), heart rate (HR) and cardiac baroreflex sensitivity (BRS in ms/mmHg, and BRSf in Hz/mmHg) derived from spectral analysis of BP fluctuations and HR. Methods: We studied 10 healthy normotensive volunteers of age 30 ± 5 years (mean ±SD). We recorded beat-to-beat arterial blood pressure: systolic (SBP), dyastolic (DBP), mean (MBP); and inter-beat-interval (IBI in ms) with breathing controlled by metronome. Measurments were repeated 4 times (Finapres Ohmeda): 1.: in supine position (SP) without bandage. 2.: suddenly after 20 seconds of the standing (S) from the SP. 3.: in SP with the bandage and 4.: in S with the bandage (each measurment lasted 5 min. the rest before measurment in SP 25 min., intervals between SP and S positions were 20 sec). We used spectral analysis  to determine BRS and BRSf. The values from the first measurment were taken as base line values. Results: When compared with the base line values we found that the increase in HR  during S with EB (P=0.009) is less than the increase during S without EB (P=0.001). Less decrease in SBP, DBP, and MBPs (P=0.011, P=0.0004, and P=0.001 consequently), during S with EB than the decrease during S without EB: SBP, DBP and MBP  (P=0.014, P=0.001 and P=0.002). The BRS (ms/mmHg) was less impaired during S with EB (P=0.21) than during S without EB  (P=0.01). No significant changes were found in the BRSf (Hz /mmHg). Conclusions: We found that in orthostatism, decrease in baroreflex sensitivity during elastic bandage of the lower limbs is less; increase in heart rate  is less and decrease in the blood pressure is less than during standing without EB. Those results indicate the use of the elastic bandage to avoid the neural sympathetic response to gravitional stimulus in persons with orthostatic intolerance.