{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:22:06Z","timestamp":1790630526198,"version":"4.1.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2018,9,27]],"date-time":"2018-09-27T00:00:00Z","timestamp":1538006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"The Center of Innovation Program"},{"name":"The Global University Project"},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science & Technology in Japan","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Practical Research Project for Rare\/Intractable Diseases"},{"name":"Comprehensive Research on Aging and Health Science Research Grants for Dementia R&D"},{"name":"Program for an Integrated Database of Clinical and Genomic Information","award":["kk0205008"],"award-info":[{"award-number":["kk0205008"]}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Orthostatic hypertension was associated with worse cardiovascular outcomes, although the factors responsible for an orthostatic rise in blood pressure (BP) are uncertain. We investigated a possible relationship between a stooping posture and orthostatic BP change.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Study participants consisted of 1,992 older individuals. Orthostatic BP change was calculated by systolic BP measured at sitting position, and again 1 and 3 minutes after standing up. Spinal alignment and curvature was assessed by guiding the SpinalMouse device on the surface of the skin along the spine.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Mean lumbar lordosis at standing position was 13.4\u00b0 \u00b1 12.4\u00b0. The degree of lumbar lordosis was significantly smaller in orthostatic hypertensive individuals (systolic BP change, \u2265+20 mm Hg: 3.3\u00b0 \u00b1 15.6\u00b0, \u2265+10 mm Hg: 10.4\u00b0 \u00b1 14.3\u00b0) than in individuals who were orthostatic normotensive (14.2\u00b0 \u00b1 11.9\u00b0). Multiple linear regression analysis identified lumbar lordosis (\u03b2 = \u22120.171, P &amp;lt; 0.001) and thoracic kyphosis (\u03b2 = 0.062, P = 0.007), but not sacral inclination (\u03b2 = 0.033, P = 0.303), as independent determinants for orthostatic BP change. As waist circumference was another independent determinant, the frequency of orthostatic hypertensive individuals was linearly increased with the combination of abdominal obesity and small degree of lumbar lordosis (control: 9.9%, abdominal obesity: 17.4%, small degree of lordosis: 19.4%, both: 24.1%, P &amp;lt; 0.001). Participants who sustained orthostatic hypertension for 3 minutes after standing up had the smallest degree of lumbar lordosis (5.2\u00b0 \u00b1 16.4\u00b0).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSION<\/jats:title>\n                  <jats:p>Stooped posture was an overlooked determinant for orthostatic increases in BP.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajh\/hpy137","type":"journal-article","created":{"date-parts":[[2018,9,20]],"date-time":"2018-09-20T16:36:18Z","timestamp":1537461378000},"page":"61-69","source":"Crossref","is-referenced-by-count":11,"title":["Small Degree of Lumbar Lordosis as an Overlooked Determinant for Orthostatic Increases in Blood Pressure in the Elderly: The Nagahama Study"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4505-7951","authenticated-orcid":false,"given":"Yasuharu","family":"Tabara","sequence":"first","affiliation":[{"name":"Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhiro","family":"Masaki","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tome","family":"Ikezoe","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Setoh","sequence":"additional","affiliation":[{"name":"Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiro","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahisa","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Kosugi","sequence":"additional","affiliation":[{"name":"Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeo","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriaki","family":"Ichihashi","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadao","family":"Tsuboyama","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumihiko","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Nagahama Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,9,27]]},"reference":[{"key":"2022101313564167200_CIT0001","doi-asserted-by":"crossref","first-page":"2307","DOI":"10.1161\/01.STR.31.10.2307","article-title":"Orthostatic hypotension as a risk factor for stroke: the Atherosclerosis Risk in Communities (ARIC) study, 1987\u20131996","volume":"31","author":"Eigenbrodt","year":"2000","journal-title":"Stroke"},{"key":"2022101313564167200_CIT0002","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1161\/HYPERTENSIONAHA.110.151654","article-title":"Orthostatic hypotension is a more robust predictor of cardiovascular events than nighttime reverse dipping in elderly","volume":"56","author":"Fagard","year":"2010","journal-title":"Hypertension"},{"key":"2022101313564167200_CIT0003","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/S0895-7061(99)00257-5","article-title":"Orthostatic hypotension and the incidence of coronary heart disease: the Atherosclerosis Risk in Communities study","volume":"13","author":"Rose","year":"2000","journal-title":"Am J Hypertens"},{"key":"2022101313564167200_CIT0004","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1111\/j.1532-5415.2008.01946.x","article-title":"Orthostatic hypotension and risk of cardiovascular disease in elderly people: the Rotterdam study","volume":"56","author":"Verwoert","year":"2008","journal-title":"J Am Geriatr Soc"},{"key":"2022101313564167200_CIT0005","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1093\/eurheartj\/ehp329","article-title":"Orthostatic hypotension predicts all-cause mortality and coronary events in middle-aged individuals (The Malmo Preventive Project)","volume":"31","author":"Fedorowski","year":"2010","journal-title":"Eur Heart J"},{"key":"2022101313564167200_CIT0006","doi-asserted-by":"crossref","first-page":"2290","DOI":"10.1161\/01.CIR.98.21.2290","article-title":"Orthostatic hypotension predicts mortality in elderly men: the Honolulu Heart Program","volume":"98","author":"Masaki","year":"1998","journal-title":"Circulation"},{"key":"2022101313564167200_CIT0007","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1161\/HYPERTENSIONAHA.117.10481","article-title":"Atherosclerosis and blood pressure variability","volume":"71","author":"Ziegler","year":"2018","journal-title":"Hypertension"},{"key":"2022101313564167200_CIT0008","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1097\/01.hjh.0000202816.25706.64","article-title":"Arterial stiffness as the candidate underlying mechanism for postural blood pressure changes and orthostatic hypotension in older adults: the Rotterdam Study","volume":"24","author":"Mattace-Raso","year":"2006","journal-title":"J Hypertens"},{"key":"2022101313564167200_CIT0009","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1097\/HJH.0b013e32834fa860","article-title":"Orthostatic blood pressure response, carotid intima-media thickness, and plasma fibrinogen in older nondiabetic adults","volume":"30","author":"Fedorowski","year":"2012","journal-title":"J Hypertens"},{"key":"2022101313564167200_CIT0010","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1161\/HYPERTENSIONAHA.116.07334","article-title":"Orthostatic changes in blood pressure and cognitive status in the elderly: the Progetto Veneto Anziani study","volume":"68","author":"Curreri","year":"2016","journal-title":"Hypertension"},{"key":"2022101313564167200_CIT0011","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/S0735-1097(02)01923-X","article-title":"U-curve relationship between orthostatic blood pressure change and silent cerebrovascular disease in elderly hypertensives: orthostatic hypertension as a new cardiovascular risk factor","volume":"40","author":"Kario","year":"2002","journal-title":"J Am Coll Cardiol"},{"key":"2022101313564167200_CIT0012","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1161\/HYPERTENSIONAHA.115.06386","article-title":"Evidence for a prognostic role of orthostatic hypertension on survival in a very old institutionalized population","volume":"67","author":"Agnoletti","year":"2016","journal-title":"Hypertension"},{"key":"2022101313564167200_CIT0013","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1097\/HJH.0000000000000910","article-title":"Orthostatic changes in blood pressure and mortality in a nursing home population","volume":"34","author":"Hartog","year":"2016","journal-title":"J Hypertens"},{"key":"2022101313564167200_CIT0014","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1097\/HJH.0000000000001044","article-title":"Prevalence of orthostatic hypertension in the very elderly and its relationship to all-cause mortality","volume":"34","author":"Bursztyn","year":"2016","journal-title":"J Hypertens"},{"key":"2022101313564167200_CIT0015","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1111\/jgs.2000.48.11.1538","article-title":"Orthostatic hypertension: another orthostatic disorder to be aware of","volume":"48","author":"Kohara","year":"2000","journal-title":"J Am Geriatr Soc"},{"key":"2022101313564167200_CIT0016","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/j.jash.2016.08.005","article-title":"Orthostatic changes in systolic blood pressure among SPRINT participants at baseline","volume":"10","author":"Townsend","year":"2016","journal-title":"J Am Soc Hypertens"},{"key":"2022101313564167200_CIT0017","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1378\/chest.104.1.65","article-title":"Pronus angina (angina pectoris induced by stooping or crouching). A proposed mechanism","volume":"104","author":"Klein","year":"1993","journal-title":"Chest"},{"key":"2022101313564167200_CIT0018","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1056\/NEJMcp074189","article-title":"Clinical practice. Neurogenic orthostatic hypotension","volume":"358","author":"Freeman","year":"2008","journal-title":"N Engl J Med"},{"key":"2022101313564167200_CIT0019","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1053\/j.ajkd.2008.12.034","article-title":"Revised equations for estimated GFR from serum creatinine in Japan","volume":"53","author":"Matsuo","year":"2009","journal-title":"Am J Kidney Dis"},{"key":"2022101313564167200_CIT0020","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s00402-004-0641-1","article-title":"Spinal mobility: sagittal range of motion measured with the SpinalMouse, a new non-invasive device","volume":"124","author":"Post","year":"2004","journal-title":"Arch Orthop Trauma Surg"},{"key":"2022101313564167200_CIT0021","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1007\/s00586-013-2721-9","article-title":"Influence of spinal sagittal alignment, body balance, muscle strength, and physical ability on falling of middle-aged and elderly males","volume":"22","author":"Imagama","year":"2013","journal-title":"Eur Spine J"},{"key":"2022101313564167200_CIT0022","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.jamda.2013.11.025","article-title":"Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia","volume":"15","author":"Chen","year":"2014","journal-title":"J Am Med Dir Assoc"},{"key":"2022101313564167200_CIT0023","doi-asserted-by":"crossref","first-page":"93","DOI":"10.2114\/jpa.23.93","article-title":"Percentage of total body fat as estimated by three automatic bioelectrical impedance analyzers","volume":"23","author":"Demura","year":"2004","journal-title":"J Physiol Anthropol Appl Human Sci"},{"key":"2022101313564167200_CIT0024","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1002\/oby.20583","article-title":"Body composition in 18- to 88-year-old adults\u2014comparison of multifrequency bioimpedance and dual-energy X-ray absorptiometry","volume":"22","author":"Sillanp\u00e4\u00e4","year":"2014","journal-title":"Obesity (Silver Spring)"},{"key":"2022101313564167200_CIT0025","doi-asserted-by":"crossref","first-page":"e0131975","DOI":"10.1371\/journal.pone.0131975","article-title":"Reference values and age differences in body composition of community-dwelling older Japanese men and women: a pooled analysis of four cohort studies","volume":"10","author":"Seino","year":"2015","journal-title":"PLoS One"},{"key":"2022101313564167200_CIT0026","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.clnu.2011.04.001","article-title":"Accuracy of direct segmental multi-frequency bioimpedance analysis in the assessment of total body and segmental body composition in middle-aged adult population","volume":"30","author":"Ling","year":"2011","journal-title":"Clin Nutr"},{"key":"2022101313564167200_CIT0027","doi-asserted-by":"crossref","first-page":"2187","DOI":"10.1097\/CCM.0b013e3181a021fa","article-title":"The impact of body position on intra-abdominal pressure measurement: a multicenter analysis","volume":"37","author":"Cheatham","year":"2009","journal-title":"Crit Care Med"},{"key":"2022101313564167200_CIT0028","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.jss.2006.10.023","article-title":"Influence of semi-recumbent position on intra-abdominal pressure as measured by bladder pressure","volume":"139","author":"Vasquez","year":"2007","journal-title":"J Surg Res"},{"key":"2022101313564167200_CIT0029","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/BF02765589","article-title":"The relationship of body mass index to intra-abdominal pressure as measured by multichannel cystometry","volume":"8","author":"Noblett","year":"1997","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"2022101313564167200_CIT0030","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1007\/s00134-009-1445-0","article-title":"What is normal intra-abdominal pressure and how is it affected by positioning, body mass and positive end-expiratory pressure","volume":"35","author":"De Keulenaer","year":"2009","journal-title":"Intensive Care Med"},{"key":"2022101313564167200_CIT0031","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/j.soard.2009.04.003","article-title":"Correlations between intra-abdominal pressure and obesity-related co-morbidities","volume":"5","author":"Varela","year":"2009","journal-title":"Surg Obes Relat Dis"},{"key":"2022101313564167200_CIT0032","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1161\/HYPERTENSIONAHA.110.161844","article-title":"Postural changes in blood pressure and incidence of ischemic stroke subtypes: the ARIC study","volume":"57","author":"Yatsuya","year":"2011","journal-title":"Hypertension"},{"key":"2022101313564167200_CIT0033","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1002\/jbmr.3089","article-title":"Relationship between low bone mineral density and fractures with incident cardiovascular disease: a systematic review and meta-analysis","volume":"32","author":"Veronese","year":"2017","journal-title":"J Bone Miner Res"}],"container-title":["American Journal of Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/32\/1\/61\/46497874\/ajh_32_1_61.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/32\/1\/61\/46497874\/ajh_32_1_61.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T15:44:25Z","timestamp":1665675865000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajh\/article\/32\/1\/61\/5108463"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,27]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,9,27]]},"published-print":{"date-parts":[[2019,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ajh\/hpy137","relation":{},"ISSN":["0895-7061","1941-7225"],"issn-type":[{"value":"0895-7061","type":"print"},{"value":"1941-7225","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,1]]},"published":{"date-parts":[[2018,9,27]]}}}