Effect of Raised Head of the Bed on Lying Blood Pressure in Autonomic Failure

Conditions studied

Supine Hypertension, Autonomic Failure

About this study

Many persons with autonomic failure often have high blood pressure when lying down (supine hypertension). This study is exploring the impact of decreased venous return to the heart (achieved by raising the head of the bed) to lessen supine blood pressure. If decreased venous return to the heart is effective at lowering supine blood pressure, these approaches may be utilized to treat supine hypertension non-pharmacologically. Raising the head of the bed decreases the amount of blood returning to the heart due to the effects of gravity. In this case, the decreased blood return to the heart may decrease blood pressure.

Interventions

• Other: Tilt — Tilt of the whole bed so that the head is elevated by 9 and/or 12 inches in an acute trial or overnight.
• Other: Elevated trunk — Elevation of the trunk through raising just the head of the bed until the head is elevated by 9 and/or 12 inches in an acute trial or overnight.
• Other: Tilt - In home — Tilt of the whole bed so that the head is elevated by 8 inches overnight.
• Other: Elevated Trunk - In home — Elevation of the trunk through raising the head 8 inches on a wedge pillow overnight.

Primary outcomes

• Systolic Blood Pressure (10 PM to 8 AM)
• Systolic Blood Pressure (10 PM to 8 AM or acute session (1 hour at each elevation of the head))

Eligibility information

Study locations

• Vanderbilt University Medical Center, Nashville, Tennessee 37232 United States