The pathophysiology and diagnosis of orthostatic hypotension
- 1.1k Downloads
Orthostatic Hypotension (OH) is a common manifestation of blood pressure dysregulation. OH takes a heavy toll on quality of life. It has many potential etiologies, and many effects of aging can increase susceptibility to OH. Neurological disorders are especially likely to cause severe OH. In this brief review, the pathogenesis of OH is considered, particularly in terms of autonomic neuropathy, multiple system atrophy (MSA), pure autonomic failure, baroreflex failure, and dopamine beta hydroxylase deficiency. While OH is difficult to treat, its control greatly enhances the quality of life.
Key wordsorthostatic hypotension orthostatic hypertension autonomic syncope fainting
The help of my colleagues in Vanderbilt’s Autonomic Dysfunction Center is acknowledged. I thank Ms Ella Henderson for help in the preparation of this manuscript. Supported in part by the U.S. Public Health Service: P01-HL56693, R01 HL71784, and RR 00095. Disclosure Dr. Robertson has served as a consultant for Chelsea Therapeutics.
- 12.Krediet CT, Go-Schon IK, Kim YS, Linzer M, van Lieshout JJ, Wieling W (2007) Management of initial orthostatic hypotension: Lower body muscle tensing attenuates the transient arterial blood pressure decrease upon standing from squatting. Clin Sci (Lond) Google Scholar
- 20.Schatz IJ, Bannister R, Freeman RL, Goetz CG, Jankovic J, Kaufmann HC, Koller WC, Low PA, Mathias CJ, Polinsky RJ, Quinn NP, Robertson D, Streeten DHP (1996) Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. Neurology 46:1470Google Scholar
- 21.Shannon JR, Jordan J, Diedrich A, Biaggioni I, Robertson RM, Robertson D (2000) Water drinking: an effective treatment for orthostatic and post-prandial hypotension in autonomic failure. Circulation 102:700Google Scholar