Orthostatic hypotension

References

Key articles

Juraschek SP, Cortez MM, Flack JM, et al. Orthostatic hypotension in adults with hypertension: a scientific statement from the American Heart Association. Hypertension. 2024 Mar;81(3):e16-30.Full text  Abstract

Gibbons CH, Schmidt P, Biaggioni I, et al. The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension. J Neurol. 2017 Aug;264(8):1567-82.Full text  Abstract

Lahrmann H, Cortelli P, Hilz M, et al. EFNS guidelines on orthostatic hypotension. In: Gilhus NE, Barnes MP, Brainin M (eds). European Handbook of Neurological Management. Vol 1, 2nd ed. Oxford: Wiley-Blackwell; 2011.

Shibao C, Lipsitz LA, Biaggioni I; American Society of Hypertension Writing Group. Evaluation and treatment of orthostatic hypotension. J Am Soc Hypertens. 2013 Jul-Aug;7(4):317-24.Full text  Abstract

Reference articles

1. Freeman R, Wieling W, Axelrod FB, et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res. 2011 Apr;21(2):69-72. Abstract

2. Norcliffe-Kaufmann L, Kaufmann H, Palma JA, et al. Orthostatic heart rate changes in patients with autonomic failure caused by neurodegenerative synucleinopathies. Ann Neurol. 2018 Mar;83(3):522-31.Full text  Abstract

3. Mol A, Bui Hoang PTS, Sharmin S, et al. Orthostatic hypotension and falls in older adults: a systematic review and meta-analysis. J Am Med Dir Assoc. 2019 May;20(5):589-97.e5. Abstract

4. Rawlings AM, Juraschek SP, Heiss G, et al. Association of orthostatic hypotension with incident dementia, stroke, and cognitive decline. Neurology. 2018 Aug 21;91(8):e759-68.Full text  Abstract

5. Fagard RH, De Cort P. Orthostatic hypotension is a more robust predictor of cardiovascular events than nighttime reverse dipping in elderly. Hypertension. 2010 Jul;56(1):56-61.Full text  Abstract

6. Fedorowski A, Stavenow L, Hedblad B, et al. Orthostatic hypotension predicts all-cause mortality and coronary events in middle-aged individuals (The Malmo Preventive Project). Eur Heart J. 2010 Jan;31(1):85-91.Full text  Abstract

7. McDonagh STJ, Mejzner N, Clark CE. Prevalence of postural hypotension in primary, community and institutional care: a systematic review and meta-analysis. BMC Fam Pract. 2021 Jan 2;22(1):1.Full text  Abstract

8. Saedon NI, Pin Tan M, Frith J. The prevalence of orthostatic hypotension: a systematic review and meta-analysis. J Gerontol A Biol Sci Med Sci. 2020 Jan 1;75(1):117-22.Full text  Abstract

9. Rutan GH, Hermanson B, Bild DE, et al. Orthostatic hypotension in older adults. The Cardiovascular Health Study. CHS Collaborative Research Group. Hypertension. 1992 Jun;19(6 pt 1):508-19.Full text  Abstract

10. Rose KM, Tyroler HA, Nardo CJ, et al. Orthostatic hypotension and the incidence of coronary heart disease: the Atherosclerosis Risk in Communities study. Am J Hypertens. 2000 Jun;13(6 pt 1):571-8.Full text  Abstract

11. Benvenuto LJ, Krakoff LR. Morbidity and mortality of orthostatic hypotension: implications for management of cardiovascular disease. Am J Hypertens. 2011 Feb;24(2):135-44.Full text  Abstract

12. Hartog LC, Cizmar-Sweelssen M, Knipscheer A, et al. The association between orthostatic hypotension, falling and successful rehabilitation in a nursing home population. Arch Gerontol Geriatr. 2015 Sep-Oct;61(2):190-6. Abstract

13. Hartog LC, Cimzar-Sweelssen M, Knipscheer A, et al. Orthostatic hypotension does not predict recurrent falling in a nursing home population. Arch Gerontol Geriatr. 2017 Jan - Feb;68:39-43. Abstract

14. Weiss A, Grossman E, Beloosesky Y, et al. Orthostatic hypotension in acute geriatric ward: is it a consistent finding? Arch Intern Med. 2002 Nov 11;162(20):2369-74.Full text  Abstract

15. Juraschek SP, Cortez MM, Flack JM, et al. Orthostatic hypotension in adults with hypertension: a scientific statement from the American Heart Association. Hypertension. 2024 Mar;81(3):e16-30.Full text  Abstract

16. Vagaonescu TD, Saadia D, Tuhrim S, et al. Hypertensive cardiovascular damage in patients with primary autonomic failure. Lancet. 2000 Feb 26;355(9205):725-6. Abstract

17. Palma JA, Redel-Traub G, Porciuncula A, et al. The impact of supine hypertension on target organ damage and survival in patients with synucleinopathies and neurogenic orthostatic hypotension. Parkinsonism Relat Disord. 2020 Jun;75:97-104. Abstract

18. Bhanu C, Nimmons D, Petersen I, et al. Drug-induced orthostatic hypotension: A systematic review and meta-analysis of randomised controlled trials. PLoS Med. 2021 Nov;18(11):e1003821.Full text  Abstract

19. Zhou Y, Ke SJ, Qiu XP, et al. Prevalence, risk factors, and prognosis of orthostatic hypotension in diabetic patients: A systematic review and meta-analysis. Medicine (Baltimore). 2017 Sep;96(36):e8004.Full text  Abstract

20. Olshansky B, Muldowney J. Cardiovascular safety considerations in the treatment of neurogenic orthostatic hypotension. Am J Cardiol. 2020 May 15;125(10):1582-93.Full text  Abstract

21. Kaufmann H, Biaggioni I. Autonomic failure in neurodegenerative disorders. Semin Neurol. 2003 Dec;23(4):351-63. Abstract

22. Vernino S, Low PA, Fealey RD, et al. Autoantibodies to ganglionic acetylcholine receptors in autoimmune autonomic neuropathies. N Engl J Med. 2000 Sep 21;343(12):847-55.Full text  Abstract

23. Dani M, Dirksen A, Taraborrelli P, et al. Orthostatic hypotension in older people: considerations, diagnosis and management. Clin Med (Lond). 2021 May;21(3):e275-82.Full text  Abstract

24. Noack C, Schroeder C, Heusser K, et al. Cardiovascular effects of levodopa in Parkinson's disease. Parkinsonism Relat Disord. 2014 Aug;20(8):815-8.Full text  Abstract

25. Nimmons D, Bhanu C, Orlu M, et al. Orthostatic hypotension and antiparkinsonian drugs: a systematic review and meta-analysis. J Geriatr Psychiatry Neurol. 2021 Dec 29;:8919887211060017.Full text  Abstract

26. Jost WH, Altmann C, Fiesel T, et al. Influence of levodopa on orthostatic hypotension in Parkinson's Disease. Neurol Neurochir Pol. 2020;54(2):200-3.Full text  Abstract

27. Shaw BH, Garland EM, Black BK, et al. Optimal diagnostic thresholds for diagnosis of orthostatic hypotension with a 'sit-to-stand test'. J Hypertens. 2017 May;35(5):1019-25.Full text  Abstract

28. Gibbons CH, Schmidt P, Biaggioni I, et al. The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension. J Neurol. 2017 Aug;264(8):1567-82.Full text  Abstract

29. Lahrmann H, Cortelli P, Hilz M, et al. EFNS guidelines on orthostatic hypotension. In: Gilhus NE, Barnes MP, Brainin M (eds). European Handbook of Neurological Management. Vol 1, 2nd ed. Oxford: Wiley-Blackwell; 2011.

30. Gilani A, Juraschek SP, Belanger MJ, et al. Postural hypotension. BMJ. 2021 Apr 23;373:n922. Abstract

31. Cremer A, Rousseau AL, Boulestreau R, et al. Screening for orthostatic hypotension using home blood pressure measurements. J Hypertens. 2019 May;37(5):923-27. Abstract

32. Norcliffe-Kaufmann L, Kaufmann H. Is ambulatory blood pressure monitoring useful in patients with chronic autonomic failure? Clin Auton Res. 2014 Aug;24(4):189-92. Abstract

33. Kaufmann H, Norcliffe-Kaufmann L, Palma JA, et al. Natural history of pure autonomic failure: a United States prospective cohort. Ann Neurol. 2017 Feb;81(2):287-97. Abstract

34. Millar Vernetti P, Norcliffe-Kaufmann L, Palma JA, et al. Phenoconversion in pure autonomic failure: a multicentre prospective longitudinal cohort study. Brain. 2024 Jul 5;147(7):2440-8. Abstract

35. Thijs RD, Brignole M, Falup-Pecurariu C, et al. Recommendations for tilt table testing and other provocative cardiovascular autonomic tests in conditions that may cause transient loss of consciousness : Consensus statement of the European Federation of Autonomic Societies (EFAS) endorsed by the American Autonomic Society (AAS) and the European Academy of Neurology (EAN). Auton Neurosci. 2021 Jul;233:102792.Full text  Abstract

36. Cheshire WP, Freeman R, Gibbons CH, et al. Electrodiagnostic assessment of the autonomic nervous system: A consensus statement endorsed by the American Autonomic Society, American Academy of Neurology, and the International Federation of Clinical Neurophysiology. Clin Neurophysiol. 2021 Feb;132(2):666-82.Full text  Abstract

37. Mathias CJ. Autonomic diseases: clinical features and laboratory evaluation. J Neurol Neurosurg Psychiatry. 2003 Sep;74 Suppl 3:iii31-41.Full text  Abstract

38. Shen WK, Sheldon RS, Benditt DG, et al. 2017 ACC/AHA/HRS Guideline for the evaluation and management of patients with syncope: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2017 Aug 1;136(5):e60-e122.Full text  Abstract

39. Shibao C, Lipsitz LA, Biaggioni I; American Society of Hypertension Writing Group. Evaluation and treatment of orthostatic hypotension. J Am Soc Hypertens. 2013 Jul-Aug;7(4):317-24.Full text  Abstract

40. Fanciulli A, Jordan J, Biaggioni I, et al. Consensus statement on the definition of neurogenic supine hypertension in cardiovascular autonomic failure by the American Autonomic Society (AAS) and the European Federation of Autonomic Societies (EFAS) : Endorsed by the European Academy of Neurology (EAN) and the European Society of Hypertension (ESH). Clin Auton Res. 2018 Aug;28(4):355-62.Full text  Abstract

41. Brignole M, Moya A, de Lange FJ, et al. 2018 ESC Guidelines for the diagnosis and management of syncope. Eur Heart J. 2018 Jun 1;39(21):1883-948.Full text  Abstract

42. Wahba A, Shibao CA, Muldowney JAS, et al. Management of orthostatic hypotension in the hospitalized patient: a narrative review. Am J Med. 2022 Jan;135(1):24-31.Full text  Abstract

43. Park JW, Okamoto LE, Shibao CA, et al. Pharmacologic treatment of orthostatic hypotension. Auton Neurosci. 2020 Dec;229:102721.Full text  Abstract

44. Bird ST, Delaney JA, Brophy JM, et al. Tamsulosin treatment for benign prostatic hyperplasia and risk of severe hypotension in men aged 40-85 years in the United States: risk window analyses using between and within patient methodology. BMJ. 2013 Nov 5;347:f6320.Full text  Abstract

45. Seo GH, Lee YK, Ha YC. Risk of hip fractures in men with alpha-blockers: a nationwide study base on claim registry. J Bone Metab. 2015 Feb;22(1):29-32.Full text  Abstract

46. Juraschek SP, Hu JR, Cluett JL, et al. Effects of intensive blood pressure treatment on orthostatic hypotension: a systematic review and individual participant-based meta-analysis. Ann Intern Med. 2021 Jan;174(1):58-68.Full text  Abstract

47. Fanciulli A, Goebel G, Metzler B, et al. Elastic abdominal binders attenuate orthostatic hypotension in Parkinson's disease. Mov Disord Clin Pract. 2015 Nov 27;3(2):156-60.Full text

48. Okamoto LE, Diedrich A, Baudenbacher FJ, et al. Efficacy of servo-controlled splanchnic venous compression in the treatment of orthostatic hypotension: a randomized comparison with midodrine. Hypertension. 2016 Aug;68(2):418-26.Full text  Abstract

49. Logan A, Freeman J, Pooler J, et al. Effectiveness of non-pharmacological interventions to treat orthostatic hypotension in elderly people and people with a neurological condition: a systematic review. JBI Evid Synth. 2020 Dec;18(12):2556-2617.Full text  Abstract

50. Magkas N, Tsioufis C, Thomopoulos C, et al. Orthostatic hypotension: from pathophysiology to clinical applications and therapeutic considerations. J Clin Hypertens (Greenwich). 2019 May;21(5):546-54.Full text  Abstract

51. Chen JJ, Han Y, Tang J, et al. Standing and supine blood pressure outcomes associated with droxidopa and midodrine in patients with neurogenic orthostatic hypotension: a Bayesian meta-analysis and mixed treatment comparison of randomized trials. Ann Pharmacother. 2018 Dec;52(12):1182-94. Abstract

52. Gales BJ, Gales MA. Pyridostigmine in the treatment of orthostatic intolerance. Ann Pharmacother. 2007 Feb;41(2):314-8. Abstract

53. Shibao C, Raj SR, Gamboa A, et al. Norepinephrine transporter blockade with atomoxetine induces hypertension in patients with impaired autonomic function. Hypertension. 2007 Jul;50(1):47-53.Full text  Abstract

54. Ramirez CE, Okamoto LE, Arnold AC, et al. Efficacy of atomoxetine versus midodrine for the treatment of orthostatic hypotension in autonomic failure. Hypertension. 2014 Dec;64(6):1235-40. Abstract

55. Kaufmann H, Saadia D, Voustianiouk A, et al. Norepinephrine precursor therapy in neurogenic orthostatic hypotension. Circulation. 2003 Aug 12;108(6):724-8.Full text  Abstract

56. Kaufmann H, Freeman R, Biaggioni I, et al; NOH301 Investigators. Droxidopa for neurogenic orthostatic hypotension: a randomized, placebo-controlled, phase 3 trial. Neurology. 2014 Jul 22;83(4):328-35.Full text  Abstract

57. Hauser RA, Isaacson S, Lisk JP, et al. Droxidopa for the short-term treatment of symptomatic neurogenic orthostatic hypotension in Parkinson's disease (nOH306B). Mov Disord. 2015 Apr 15;30(5):646-54.Full text  Abstract

58. US National Library of Medicine. ClinicalTrials.gov. Sustained effect of droxidopa in symptomatic neurogenic orthostatic hypotension (RESTORE). Dec 2021 [internet publication].Full text

59. Hickler RB, Thompson GR, Fox LM, et al. Successful treatment of orthostatic hypotension with 9-alpha-fluorohydrocortisone. N Engl J Med. 1959 Oct 15;261:788-91. Abstract

60. Veazie S, Peterson K, Ansari Y, et al. Fludrocortisone for orthostatic hypotension. Cochrane Database Syst Rev. 2021 May 17;(5):CD012868.Full text  Abstract

61. Young MJ, Rickard AJ. Mineralocorticoid receptors in the heart: lessons from cell-selective transgenic animals. J Endocrinol. 2015 Jan;224(1):R1-13.Full text  Abstract

62. Okamoto LE, Shibao CA, Gamboa A, et al. Synergistic pressor effect of atomoxetine and pyridostigmine in patients with neurogenic orthostatic hypotension. Hypertension. 2019 Jan;73(1):235-41.Full text  Abstract

63. National Institute for Health and Care Excellence. Orthostatic hypotension due to autonomic dysfunction: midodrine. NICE advice [ESNM61]. October 2015 [internet publication].Full text

64. Figueroa JJ, Basford JR, Low PA. Preventing and treating orthostatic hypotension: As easy as A, B, C. Cleve Clin J Med. 2010 May;77(5):298-306.Full text  Abstract

Use of this content is subject to our disclaimer