{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T20:15:43Z","timestamp":1774556143842,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T00:00:00Z","timestamp":1731283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Experimental Physiology"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Gravity, an invisible but constant force\n, challenges the regulation of blood pressure when transitioning between postures. As physiological reserve diminishes with age, individuals grow more susceptible to such stressors over time, risking inadequate haemodynamic control observed in orthostatic hypotension. This prevalent condition is characterized by drops in blood pressure upon standing; however, the contrary phenomenon of blood pressure rises has recently piqued interest. Expanding on the currently undefined orthostatic hypertension, our study uses continuous non\u2010invasive cardiovascular data to explore the full spectrum of blood pressure profiles and their associated frailty outcomes in community\u2010dwelling older adults. Given the richness of non\u2010invasive beat\u2010to\u2010beat data, artificial intelligence (AI) offers a solution to detect the subtle patterns within it. Applying machine learning to an existing dataset of community\u2010based adults undergoing postural assessment, we identified three distinct clusters (iOHYPO, OHYPO and OHYPER) akin to initial and classic orthostatic hypotension and orthostatic hypertension, respectively. Notably, individuals in our OHYPER cluster exhibited indicators of frailty and sarcopenia, including slower gait speed and impaired balance. In contrast, the iOHYPO cluster, despite transient drops in blood pressure, reported fewer fallers and superior cognitive performance. Surprisingly, those with sustained blood pressure deficits outperformed those with sustained rises, showing greater independence and higher Fried frailty scores. Working towards more refined definitions, our research indicates that AI approaches can yield meaningful blood pressure morphologies from beat\u2010to\u2010beat data. Furthermore, our findings support orthostatic hypertension as a distinct clinical entity, with frailty implications suggesting that it is worthy of further investigation.<\/jats:p>","DOI":"10.1113\/ep091876","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T15:39:55Z","timestamp":1731339595000},"page":"230-247","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Artificial intelligence driven clustering of blood pressure profiles reveals frailty in orthostatic hypertension"],"prefix":"10.1113","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0892-4190","authenticated-orcid":false,"given":"Claire M.","family":"Owen","sequence":"first","affiliation":[{"name":"Population Health Sciences Institute, Faculty of Medical Sciences Newcastle University  Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaume","family":"Bacardit","sequence":"additional","affiliation":[{"name":"Interdisciplinary Computing and Complex BioSystems (ICOS) research group, School of Computing Newcastle University  Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maw P.","family":"Tan","sequence":"additional","affiliation":[{"name":"Ageing and Age\u2010Associated Disorders Research Group, Department of Medicine, Faculty of Medicine Universiti Malaya  Kuala Lumpur Malaysia"},{"name":"Centre for Innovations in Medicine Engineering Universiti Malaya  Kuala Lumpur Malaysia"},{"name":"Department of Medical Sciences, School of Medical and Life Sciences Sunway University  Bandar Sunway Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nor I.","family":"Saedon","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine Universiti Malaya  Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Choon\u2010Hian","family":"Goh","sequence":"additional","affiliation":[{"name":"Department of Mechatronics and Biomedical Engineering, Lee Kong Chian Faculty of Engineering and Science Universiti Tunku Abdul Rahman  Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia L.","family":"Newton","sequence":"additional","affiliation":[{"name":"Health Innovation North East and North Cumbria, Gallowgate  Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Frith","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute, Faculty of Medical Sciences Newcastle University  Newcastle upon Tyne UK"},{"name":"Falls and Syncope Service Newcastle upon Tyne Hospitals NHS Trust  Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.1982.243.5.H676"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41371-018-0091-9"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(88)90976-9"},{"key":"e_1_2_10_5_1","first-page":"1383","article-title":"Association between orthostatic hypertension and frailty among older patients with hypertension","volume":"81","author":"Choi J.\u2010Y.","year":"2024","journal-title":"Hypertension"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/aft112"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.504159"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1291\/hypres.27.235"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-017-0409-7"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14563"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-016-0393-3"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-019-00606-y"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.compbiomed.2005.04.003"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-011-0119-5"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcv126"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-023-00966-w"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003614"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/hc4501.099308"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-022-01074-0"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.120.14340"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.18497"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2013.224"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-011-0146-2"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41371-019-0180-4"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-017-0468-7"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glt111"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/jch.13521"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2004.04.014"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2018.11.003"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaa174"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2022.110928"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-02844-8"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03352.x"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afr076"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-019-00647-3"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gly188"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-014-1686-8"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.exger.2021.111330"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1552-4604.1994.tb04977.x"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-097X.1996.tb00565.x"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.91650.2008"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/MBP.0000000000000251"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(97)89517-4"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13113696"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03324636"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1042\/CS20060091"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000003097"}],"container-title":["Experimental Physiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/pdf\/10.1113\/EP091876","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T03:21:37Z","timestamp":1741749697000},"score":1,"resource":{"primary":{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/10.1113\/EP091876"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,11]]},"references-count":46,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1113\/EP091876"],"URL":"https:\/\/doi.org\/10.1113\/ep091876","archive":["Portico"],"relation":{},"ISSN":["0958-0670","1469-445X"],"issn-type":[{"value":"0958-0670","type":"print"},{"value":"1469-445X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,11]]},"assertion":[{"value":"2024-03-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}