Orthostatic Hypotension
Open accessAbstract
Orthostatic hypotension (OH) is a common cardiovascular disorder, with or without signs of underlying neurodegenerative disease. OH is diagnosed on the basis of an orthostatic challenge and implies a persistent systolic/diastolic blood pressure decrease of at least 20/10 mm Hg upon standing. Its prevalence is age dependent, ranging from 5% in patients <50 years of age to 30% in those >70 years of age. OH may complicate treatment of hypertension, heart failure, and coronary heart disease; cause disabling symptoms, faints, and traumatic injuries; and substantially reduce quality of life. Despite being largely asymptomatic or with minimal symptoms, the presence of OH independently increases mortality and the incidence of myocardial infarction, stroke, heart failure, and atrial fibrillation. In this review, we outline the etiology and prevalence of OH in the general population, summarize its relationship with morbidity and mortality, propose a diagnostic and therapeutic algorithm, and delineate current challenges and future perspectives.
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In the absence of compensatory mechanisms, a fall in blood pressure may lead to syncope.
“In the absence of compensatory mechanisms, a fall in BP may lead to syncope. 20,103,104”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [104]
Changing from the supine to the upright position produces a displacement of blood from the thorax to the lower limbs and abdominal cavity that leads to a decrease in venous return and cardiac output.
“Changing from the supine to the upright position produces a displacement of blood from the thorax to the lower limbs and abdominal cavity that leads to a decrease in venous return and cardiac output.”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [104]
When more frequent readings are required, as for initial orthostatic hypotension, continuous beat-to-beat non-invasive blood pressure measurement is needed.
“When more frequent readings are required, as for initial OH, continuous beat-tobeat non-invasive BP measurement is needed. 20,103,104”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [104]
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Self-citationUngar, A., Mussi, C., Ceccofiglio, A., Bellelli, G., Nicosia, F., Bo, M., Riccio, D., Martone, A. M., Guadagno, L., Noro, G., et al. (2016) · Journal of the American Geriatrics Society · doi:10.1111/jgs.14225 · Cited by 80 · see citing works
Syndromes of orthostatic intolerance and syncope in young adults
Hamrefors, V., Spahic, J. M., Nilsson, D., Senneby, M., Sutton, R., Melander, O., & Fedorowski, A. (2017) · Open Heart · doi:10.1136/openhrt-2016-000585 · Cited by 23 · see citing works
Self-citation
- Authors
- Ricci, F., De Caterina, R., & Fedorowski, A.
- Affiliations
- University of Chieti-Pescara (IT)
- Lund University (SE)
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2015-08
- Volume
- 66
- Issue
- 7
- Pages
- 848-860
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W1866606464
- Cited by
- 472
- References
- 86
- Citations by year
- 2026: 37 · 2025: 49 · 2024: 54 · 2023: 39 · 2022: 39 · 2021: 44 · 2020: 51 · 2019: 46 · 2018: 46 · 2017: 30 · 2016: 32 · 2015: 5
- FWCI
- 7.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Funders
- Università degli Studi G. d'Annunzio Chieti - Pescara
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Keywords
- orthostatic hypotension, orthostatic challenge, blood pressure, neurodegenerative diseases, prevalence, hypertension, heart failure, coronary artery disease, syncope, mortality, diagnostic algorithm, treatment
- MeSH terms
- Blood Pressure, Humans, Hypotension, Orthostatic, Posture, Prognosis, Droxidopa, Treatment Outcome, Head-Down Tilt
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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