Is it time to move beyond blood pressure and heart rate during head-up tilt testing?

Excerpt

Perhaps the first description of head-up tilt table testing (HUTT) in its current form was published in 1957 by Weissler et al. [1], however its origins date back to detailed human and animal experiments by Hill at London College in the late nineteenth century [2]. In 1986, Kenny and Sutton published their seminal study on the use of HUTT in the evaluation of unexplained syncope [3], an indication that remained the primary focus of the test until nearly a decade later, when it was expanded for the diagnosis of other disorders of orthostatic intolerance (OI), including orthostatic hypotension (OH) and postural tachycardia syndrome (POTS). The current practice in most clinical autonomic centers is to perform a 5–40-min HUTT with noninvasive, continuous beat-to-beat blood pressure (BP) and heart rate (HR) measurements using finger peripheral arterial plethysmography, confirmed with automated brachial artery sphygmomanometer BP measurements at 1–5-min intervals. …