Effects of body position on autonomic regulation of cardiovascular function in young, healthy adults

Abstract

Background: Analysis of rhythmic patterns embedded within beat-to-beat variations in heart rate (heart rate variability) is a tool used to assess the balance of cardiac autonomic nervous activity and may be predictive for prognosis of some medical conditions, such as myocardial infarction. It has also been used to evaluate the impact of manipulative therapeutics and body position on autonomic regulation of the cardiovascular system. However, few have compared cardiac autonomic activity in supine and prone positions, postures commonly assumed by patients in manual therapy. We intend to redress this deficiency.

Methods: Heart rate, heart rate variability, and beat-to-beat blood pressure were measured in young, healthy non-smokers, during prone, supine, and sitting postures and with breathing paced at 0.25 Hz. Data were recorded for 5 minutes in each posture: Day 1 - prone and supine; Day 2 - prone and sitting. Paired t-tests or Wilcoxon signed-rank tests were used to evaluate posture-related differences in blood pressure, heart rate, and heart rate variability.

Results: Prone versus supine: blood pressure and heart rate were significantly higher in the prone posture (p < 0.001). Prone versus sitting: blood pressure was higher and heart rate was lower in the prone posture (p < 0.05) and significant differences were found in some components of heart rate variability.

Conclusion: Cardiac autonomic activity was not measurably different in prone and supine postures, but heart rate and blood pressure were. Although heart rate variability parameters indicated sympathetic dominance during sitting (supporting work of others), blood pressure was higher in the prone posture. These differences should be considered when autonomic regulation of cardiovascular function is studied in different postures.

Figure 1

Comparison of blood pressure and heart rate between two horizontal postures (prone ▪ and supine ▫). Expressed as mean ± SD and compared using paired t-tests. Left scale applies to MAP, SYS, and DIA, right scale only to HR; DIA = diastolic blood pressure, HR = heart rate, MAP = mean arterial pressure, SYS = systolic blood pressure, BPM = beats per minute, and * = statistically significant difference from value in prone posture.

Figure 2

Comparison of BP and HR between the horizontal (prone ▪) and vertical (sitting ) postures. Expressed as mean ± SD and compared using the paired t-tests. Left scale applies to MAP, SYS, and DIA, right scale only to HR; DIA = diastolic blood pressure, HR = heart rate, MAP = mean arterial pressure, SYS = systolic blood pressure, BPM = beats per minute, and * = statistically significant difference from a value in the prone posture.