Orthostatic hypotension in amputees and subjects with spinal cord injuries

Orthostatic examinations were performed with a tilt table on 64 male volunteers, of whom 21 had sustained amputation of one or both lower limbs and 23 were paraplegic due to spinal cord injuries (SCI), with 20 healthy subjects as controls. Following tilting, signs and symptoms of fainting appeared in 5 of the SCI subjects, 4 of whom had spinal injuries above the level of D ₅. These phenomena appeared in only 2 of the controls and in none of the amputees. The mean systolic and diastolic blood pressures of the amputees at rest and standing were higher than those recorded in the other 2 groups. The mean pulse pressures were lower in the amputees than in the other 2 groups. The changes in the systolic, diastolic, and pulse pressures were more profound in those subjects with high spinal cord injuries than in subjects with lower cord injuries. ECG changes and fainting were more frequent among the SCI subjects than in the other 2 groups.