Tilt test

hypotension, which in people with CAN may result in dizziness, blurry vision and upon standing up. The BP response to

brachial

recorded up to 10 minutes because some individuals have been found to have a delayed hypotensive response to head

to three

BP fall of more than 10 mm Hg after or hypotensive response.

signs or symptoms

Figure 3.5. Participant from

mage used with permissi

3.3.7.2. Tilt test

The purpose of the head

hypotension, which in people with CAN may result in dizziness, blurry vision and upon standing up. The BP response to

brachial BPs minus the lowest BP during the first

recorded up to 10 minutes because some individuals have been found to have a delayed hypotensive response to head

three minutes

BP fall of more than 10 mm Hg after or hypotensive response. However, n

symptoms of CAN testing

Participant from

mage used with permissi

3.3.7.2. Tilt test

The purpose of the head

hypotension, which in people with CAN may result in dizziness, blurry vision and upon standing up. The BP response to

BPs minus the lowest BP during the first

recorded up to 10 minutes because some individuals have been found to have a delayed hypotensive response to head

minutes (Weimer, 2010 BP fall of more than 10 mm Hg after

However, n of CAN testing.

Participant from the T2DM Group study

mage used with permission of participant)

The purpose of the head-up tilt test is to assess the effects of postural hypotension, which in people with CAN may result in dizziness, blurry vision and upon standing up. The BP response to

BPs minus the lowest BP during the first

recorded up to 10 minutes because some individuals have been found to have a delayed hypotensive response to head-up tilt which can be missed if data

Weimer, 2010). A s

BP fall of more than 10 mm Hg after two to three However, no test was

the T2DM Group study

of participant)

up tilt test is to assess the effects of postural hypotension, which in people with CAN may result in dizziness, blurry vision and

upon standing up. The BP response to tilting was calculated as the average of two resting BPs minus the lowest BP during the first

recorded up to 10 minutes because some individuals have been found to have a delayed tilt which can be missed if data

systolic BP two to three

o test was interrupted or

the T2DM Group study performing the Valsalva test

up tilt test is to assess the effects of postural hypotension, which in people with CAN may result in dizziness, blurry vision and

tilting was calculated as the average of two resting BPs minus the lowest BP during the first three minutes of tilting. BPs were recorded up to 10 minutes because some individuals have been found to have a delayed

tilt which can be missed if data ystolic BP fall of more than two to three minutes head

interrupted or terminated due to adverse

performing the Valsalva test

up tilt test is to assess the effects of postural hypotension, which in people with CAN may result in dizziness, blurry vision and

tilting was calculated as the average of two resting minutes of tilting. BPs were recorded up to 10 minutes because some individuals have been found to have a delayed

tilt which can be missed if data are recorded for only of more than 20 mm Hg and/o

minutes head-up tilt is indicative of CAN terminated due to adverse

performing the Valsalva test

up tilt test is to assess the effects of postural, or orthostatic hypotension, which in people with CAN may result in dizziness, blurry vision and

tilting was calculated as the average of two resting minutes of tilting. BPs were recorded up to 10 minutes because some individuals have been found to have a delayed

recorded for only 0 mm Hg and/o

up tilt is indicative of CAN terminated due to adverse

performing the Valsalva test

or orthostatic hypotension, which in people with CAN may result in dizziness, blurry vision and syncope

tilting was calculated as the average of two resting minutes of tilting. BPs were recorded up to 10 minutes because some individuals have been found to have a delayed

recorded for only two 0 mm Hg and/or diastolic up tilt is indicative of CAN terminated due to adverse

or orthostatic

two r diastolic

Chapter 3 – General Methods

(Vinik et al., 2003). The heart rate response to tilting in people with T2DM is typically less than in healthy individuals, with a gradual increase in heart rate (Vinik et al., 2003). To assess autonomic control of heart rate during the tilt, the 30:15 tilt Ratio was calculated by dividing the longest R-R interval (in ms) during beats 20-40 by the shortest R-R interval during beats 5-25, all post-tilt (Ziegler et al., 1992).

For the tilt test, all participants rested their feet directly on the foot-board of the table and were strapped securely with a large Velcro straps. Straps were placed over the chest (over the pectorals in men, but either above or below the breasts in women, depending on their height), and there were individual straps for each lower leg, below the knee joint (Figure 3.6). Participants were inclined to 60° measured by an inbuilt slope gauge on the table. BP was usually measured on the right arm unless medically contraindicated for that participant, and was taken immediately upon reaching 60° for a 30-second post-tilt measure, then again every minute for 10 minutes. ECG was recorded continuously throughout testing, and time points for “upright” and “end tilt” were marked on the LabChart ECG recording. Participants were kept under observation and asked regularly throughout the test if they were experiencing any adverse signs or symptoms of head-up tilt, for instance any dizziness, blurry vision, or nausea. Participants were brought back to horizontal immediately after the deflation of the BP cuff after the final 10 minute measure. No participant asked to terminate a test early due to adverse symptoms from tilting.

Figure 3.6. Participant from the T2DM Group study performing the tilt test. A) supine and B) head-up tilt to 60°.

(Image used with permission of participant)