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Clinical Autonomic Research

, Volume 3, Issue 1, pp 57–65 | Cite as

Physical manoeuvres that reduce postural hypotension in autonomic failure

  • W. Wieling
  • J. J. van Lieshout
  • A. M. van Leeuwen
Clinical Autonomic Research Society Proceedings

Guest Lecture

A Young female with autonomic failure is described. She successfully reduced the symptoms of orthostatic hypotension by application of physical manoeuvres like leg-crossing, bending forward and placing a foot on a chair. The beneficial effects of these manoeuvres can be explained by a small (10–15 mmHg) increase in mean arterial pressure to a level just sufficient to maintain adequate cerebral blood flow. The underlying common mechanism appears to be an increase of thoracic blood volume by translocation of blood from the vascular beds below the diaphragm to the chest. Instruction in these physical manoeuvres should be part of the management programme to reduce the disabilities arising from postural hypotension in patients with autonomic failure.

Key words

Orthostatic tolerance Blood pressure Heart rate Venous pooling Central blood volume Autonomic circulatory function Standing up 

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Copyright information

© Rapid Communications of Oxford Ltd. 1993

Authors and Affiliations

  • W. Wieling
    • 1
  • J. J. van Lieshout
    • 1
  • A. M. van Leeuwen
    • 1
  1. 1.Department of MedicineAcademic Medical CentreAmsterdamThe Netherlands

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