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Initial orthostatic hypotension (IOH) is a large transient (<1 minute) abrupt drop in blood pressure (BP) and cardiac output that occurs within 15 seconds of standing and is associated with postural symptoms in otherwise healthy people. Isometric handgrip evokes an exercise pressor reflex that increases BP by increasing cardiac output. Investigators examined the hemodynamic effects of isometric handgrip before and during standing in 14 patients with IOH (age range, 15–22 years). The average decrease in mean arterial pressure was 35 mm Hg and in cardiac output was 2.0 L/mm while standing.
Researchers used a dynamometer to obtain measurements at baseline, when patients stood from the supine position, and while patients performed an isometric h…