The DOI matches its Crossref record; 54 of the 56 references it cites were found in a registry or an index.
EFNS guidelines on the diagnosis and management of orthostatic hypotension
Open accessAbstract
Orthostatic (postural) hypotension (OH) is a common, yet under diagnosed disorder. It may contribute to disability and even death. It can be the initial sign, and lead to incapacitating symptoms in primary and secondary autonomic disorders. These range from visual disturbances and dizziness to loss of consciousness (syncope) after postural change. Evidence based guidelines for the diagnostic workup and the therapeutic management (non‐pharmacological and pharmacological) are provided based on the EFNS guidance regulations. The final literature research was performed in March 2005. For diagnosis of OH, a structured history taking and measurement of blood pressure (BP) and heart rate in supine and upright position are necessary. OH is defined as fall in systolic BP below 20 mmHg and diastolic BP below 10 mmHg of baseline within 3 min in upright position. Passive head‐up tilt testing is recommended if the active standing test is negative, especially if the history is suggestive of OH, or in patients with motor impairment. The management initially consists of education, advice and training on various factors that influence blood pressure. Increased water and salt ingestion effectively improves OH. Physical measures include leg crossing, squatting, elastic abdominal binders and stockings, and careful exercise. Fludrocortisone is a valuable starter drug. Second line drugs include sympathomimetics, such as midodrine, ephedrine, or dihydroxyphenylserine. Supine hypertension has to be considered.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Funnekotter, B. (2005) · Amsterdam University Press eBooks · doi:10.1017/9789048505418.012 · Cited by 1,672
The Consensus Committee of the American Autonomic Society and the American Academy of Neurology (1996) · Neurology · doi:10.1212/wnl.46.5.1470 · Cited by 1,247
Guidelines on management (diagnosis and treatment) of syncope
Brignole, M. (2001) · European Heart Journal · doi:10.1053/euhj.2001.2739 · Cited by 951
Low, P. A. (1997) · JAMA · doi:10.1001/jama.1997.03540370036033 · Cited by 425
Neurogenic orthostatic hypotension: a double-blind, placebo-controlled study with midodrine
Jankovic, J., Gilden, J. L., Hiner, B. C., Kaufmann, H., Brown, D. C., Coghlan, C. H., Rubin, M., & Fouad-Tarazi, F. M. (1993) · The American Journal of Medicine · doi:10.1016/0002-9343(93)90230-m · Cited by 396
Brainin, M., Barnes, M., Baron, J., Ne, G., Hughes, R. A., Selmaj, K. W., & Waldemar, G. (2004) · European Journal of Neurology · doi:10.1111/j.1468-1331.2004.00867.x · Cited by 373
A double-blind, dose-response study of midodrine in neurogenic orthostatic hypotension
Wright, R. A., Kaufmann, H. C., Perera, R., Opfer-Gehrking, T. L., McElligott, M. A., Sheng, K. N., & Low, P. A. (1998) · Neurology · doi:10.1212/wnl.51.1.120 · Cited by 331
Leone, M. A., Brainin, M., Boon, P., Pugliatti, M., Keindl, M., & Bassetti, C. L. (2013) · European Journal of Neurology · doi:10.1111/ene.12043 · Cited by 277
Treatment of Orthostatic Hypotension with Erythropoietin
Hoeldtke, R. D., & Streeten, D. H. P. (1993) · New England Journal of Medicine · doi:10.1056/nejm199308263290904 · Cited by 226
Investigation of autonomic disorders
Mathias, C. J., Low, D. A., Iodice, V., & Bannister, R. (2013) · Oxford University Press eBooks · doi:10.1093/med/9780198566342.003.0024 · Cited by 208
Self-citationMathias, C. J., Fosbraey, P., Costa, D., Thornley, A., & Bannister, R. (1986) · BMJ · doi:10.1136/bmj.293.6543.353 · Cited by 190
Self-citationThe Anemia of Primary Autonomic Failure and its Reversal with Recombinant Erythropoietin
Biaggioni, I., Robertson, D., Krantz, S., Jones, M., & Haile, V. (1994) · Annals of Internal Medicine · doi:10.7326/0003-4819-121-3-199408010-00004 · Cited by 182
Norepinephrine Precursor Therapy in Neurogenic Orthostatic Hypotension
Kaufmann, H., Saadia, D., Voustianiouk, A., Goldstein, D. S., Holmes, C. S., Yahr, M. D., Nardin, R. A., & Freeman, R. L. (2003) · Circulation · doi:10.1161/01.cir.0000083721.49847.d7 · Cited by 177
Autonomic Failure: A Textbook of Clinical Disorders of the Autonomic Nervous System
Goldstein, D. S. (1985) · Archives of Internal Medicine · doi:10.1001/archinte.1985.00360030041006 · Cited by 163
Autonomic diseases: clinical features and laboratory evaluation
Mathias, C. J. (2003) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.74.suppl_3.iii31 · Cited by 154
Self-citationvan Lieshout, J. J., ten Harkel, A. D. J., & Wieling, W. (2000) · Clinical Autonomic Research · doi:10.1007/bf02291388 · Cited by 144
Contrasting actions of pressor agents in severe autonomic failure
Jordan, J., Shannon, J. R., Biaggioni, I., Norman, R., Black, B. K., & Robertson, D. (1998) · The American Journal of Medicine · doi:10.1016/s0002-9343(98)00193-4 · Cited by 143
Physical manoeuvres that reduce postural hypotension in autonomic failure
Wieling, W., van Lieshout, J. J., & van Leeuwen, A. M. (1993) · Clinical Autonomic Research · doi:10.1007/bf01819146 · Cited by 140
Efficacy of compression of different capacitance beds in the amelioration of orthostatic hypotension
Denq, J.-C., Opfer-Gehrking, T. L., Giuliani, M., Felten, J., Convertino, V. A., & Low, P. A. (1997) · Clinical Autonomic Research · doi:10.1007/bf02267725 · Cited by 138
Kaufmann, H., Brannan, T. S., Krakoff, L. R., Yahr, M. D., & Mandeli, J. (1988) · Neurology · doi:10.1212/wnl.38.6.951 · Cited by 136
Ten Harkel, A. D. J., Van Lieshout, J. J., & Wieling, W. (1994) · Clinical Science · doi:10.1042/cs0870553 · Cited by 128
Orthostatic Hypotension in Patients with Parkinson??s Disease
Sénard, J., Brefel‐Courbon, C., Rascol, O., & Montastruc, J. (2001) · Drugs & Aging · doi:10.2165/00002512-200118070-00003 · Cited by 125
Mathias, C. J., Sénard, J., Braune, S., Watson, L. P. E., Aragishi, A., Keeling, J. E., & Taylor, M. D. (2001) · Clinical Autonomic Research · doi:10.1007/bf02298955 · Cited by 115
Self-citationTREATMENT OF IDIOPATHIC ORTHOSTATIC HYPOTENSION (SHY-DRAGER SYNDROME) WITH INDOMETHACIN
Ms, K., & Hd, I. (1978) · The Lancet · doi:10.1016/s0140-6736(78)90737-7 · Cited by 115
Alpha sympathomimetic treatment of autonomic insufficiency with orthostatic hypotension
Fouad-Tarazi, F. M., Okabe, M., & Goren, H. (1995) · The American Journal of Medicine · doi:10.1016/s0002-9343(99)80246-0 · Cited by 108
van Dijk, N., de Bruin, I. G. J., Berecki‐Gisolf, J., Bruin-Bon, H. A. C. M. D., Linzer, M., LIESHOUT, J. J. V., & Wieling, W. (2004) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00738.2004 · Cited by 101
Perera, R., Isola, L. M., & Kaufmann, H. (1995) · Clinical Autonomic Research · doi:10.1007/bf01824009 · Cited by 99
The treatment of neurogenic orthostatic hypotension with 3,4-DL-threo-dihydroxyphenylserine
Freeman, R. L., Landsberg, L., & Young, J. (1999) · Neurology · doi:10.1212/wnl.53.9.2151 · Cited by 98
Bouvette, C. M., McPhee, B. R., Opfer‐Gehrking, T. L., & Low, P. A. (1996) · Mayo Clinic Proceedings · doi:10.4065/71.9.847 · Cited by 89
Treatment of Orthostatic Hypotension with Midodrine and Octreotide
Hoeldtke, R. D. (1998) · Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.83.2.339 · Cited by 86
Treatment of Orthostatic Hypotension with Midodrine and Octreotide
Hoeldtke, R. D., Horvath, G. G., Bryner, K. D., & Hobbs, G. R. (1998) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.83.2.4534 · Cited by 86
Mathias, C. J., & Young, T. (2004) · European Journal of Neurology · doi:10.1111/j.1468-1331.2004.00840.x · Cited by 84
Self-citationCampbell, I. W., Ewing, D. J., & Clarke, B. F. (1975) · Diabetes · doi:10.2337/diab.24.4.381 · Cited by 70
McClellan, K. J., Wiseman, L. R., & Wilde, M. I. (1998) · Drugs & Aging · doi:10.2165/00002512-199812010-00007 · Cited by 62
Pavitt, D. V., Mathias, C. J., Alam, M., Smith, G. D. P., & Bleasdale-Barr, K. (1995) · Journal of Hypertension · doi:10.1097/00004872-199512010-00028 · Cited by 62
Self-citationTreatment of orthostatic intolerance with inflatable abdominal band
Tanaka, H., Yamaguchi, H., & Tamai, H. (1997) · The Lancet · doi:10.1016/s0140-6736(97)24003-1 · Cited by 61
Levodopa-Induced Postural Hypotension
Hoehn, M. M. M. (1975) · Archives of Neurology · doi:10.1001/archneur.1975.00490430072013 · Cited by 60
Octreotide Effects on Orthostatic Hypotension in Patients with Multiple System Atrophy
Bordet, R., Benhadjali, J., Destée, A., Belabbas, A., & Libersa, C. (1995) · Clinical Neuropharmacology · doi:10.1097/00002826-199502000-00012 · Cited by 48
Chandler, M. P., & Mathias, C. J. (2002) · Journal of Neurology · doi:10.1007/s004150200062 · Cited by 46
Self-citationAre portable folding chairs useful to combat orthostatic hypotension?
Smit, A. A. J., Hardjowijono, M. A., & Wieling, W. (1997) · Annals of Neurology · doi:10.1002/ana.410420620 · Cited by 32
Victor, R. G., & Talman, W. T. (2002) · The American Journal of Medicine · doi:10.1016/s0002-9343(02)01023-9 · Cited by 29
Octreotide in the Management of Orthostatic Hypotension in Multiple System Atrophy
Bordet, R., Benhadjali, J., Libersa, C., & Destée, A. (1994) · Clinical Neuropharmacology · doi:10.1097/00002826-199408000-00010 · Cited by 26
Schrage, W. G., Eisenach, J. H., Dinenno, F. A., Roberts, S. K., Johnson, C. P., Sandroni, P., Low, P. A., & Joyner, M. J. (2004) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00547.2004 · Cited by 25
Autonomic nervous system laboratories: a European survey
Lahrmann, H., Magnifico, F., Haensch, C., & Cortelli, P. (2005) · European Journal of Neurology · doi:10.1111/j.1468-1331.2004.01114.x · Cited by 23
Self-citationde Carvalho, M. L., van den Meiracker, A. H., Boomsma, F., Veld, A. J. M. I. '., Freitas, J. P., Costa, O., & de Freitas, A. F. (1997) · Journal of the Autonomic Nervous System · doi:10.1016/s0165-1838(96)00110-5 · Cited by 23
Corticosteroids in the Management of Orthostatic Hypotension
Schatz, I. J., Miller, M., & Frame, B. (2008) · Cardiology · doi:10.1159/000169821 · Cited by 20
Akizawa, T., Koshikawa, S., Iida, N., Marumo, F., Akiba, T., Kawaguchi, Y., Imada, A., Yamazaki, C., Suzuki, M., & Tubakihara, Y. (2002) · The Nephron journals/Nephron journals · doi:10.1159/000054725 · Cited by 19
Pacing does not improve hypotension in patients with severe orthostatic hypotension
Sahul, Z. H., Trusty, J. M., Erickson, M., Low, P. A., & Shen, W.-K. (2004) · Clinical Autonomic Research · doi:10.1007/s10286-004-0202-2 · Cited by 17
Effects of L-Threo-3,4-Dihydroxyphenylserine on Orthostatic Hypotension in Hemodialysis Patients
Iida, N., Koshikawa, S., Akizawa, T., Tsubakihara, Y., Marumo, F., Akiba, T., Kawaguchi, Y., Imada, A., Yamazaki, C., & Suzuki, M. (2002) · American Journal of Nephrology · doi:10.1159/000065224 · Cited by 16
Patients' choice of portable folding chairs to reduce symptoms of orthostatic hypotension
Smit, A. A. J., Wieling, W., Opfer‐Gehrking, T. L., van Emmerik-Levelt, H. M., & Low, P. A. (1999) · Clinical Autonomic Research · doi:10.1007/bf02318381 · Cited by 14
Time and frequency domain analysis of acoustic signals from a human muscle
Chen, D.-M., Durand, L., & Bellemare, F. (1997) · Muscle and Nerve · doi:10.1002/(sici)1097-4598(199708)20:8 · Cited by 12
A Controlled Study with Dihydergot® on Patients with Orthostatic Dysregulation
Lübke, K. O. (2008) · Cardiology · doi:10.1159/000169827 · Cited by 11
Conté, J. J., Fournié, G. J., & Maurette, M. H. (2008) · Cardiology · doi:10.1159/000169828 · Cited by 8
Treating neurogenic orthostatic hypotension
Wieling, W., Cortelli, P., & Mathias, C. (2000) · UCL Discovery (University College London) · Cited by 4
Self-citation
Cited by
Sorted by citations
Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association
Muntner, P., Shimbo, D., Carey, R. M., Charleston, J. B., Gaillard, T., Misra, S., Myers, M. G., Ogedegbe, G., Schwartz, J. E., Townsend, R. R., et al. (2019) · Hypertension · doi:10.1161/hyp.0000000000000087 · Cited by 1,512
The clinical symptoms of Parkinson's disease.
Sveinbjornsdottir, S. (2016) · Journal of Neurochemistry · doi:10.1111/jnc.13691 · Cited by 1,410
“This is defined as a fall in systolic blood pressure of > 20 mm Hg or in diastolic blood pressure > 10 mm Hg on either standing or head-up tilt to at least 60 degrees within 3 min (Lahrmann et al. 2006).”
BackgroundSpallone, V., Ziegler, D., Freeman, R., Bernardi, L., Frontoni, S., Pop‐Busui, R., Stevens, M., Kempler, P., Hilsted, J., Tesfaye, S., et al. (2011) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.1239 · Cited by 957
“Other possible treatments include (1) desmopressin acetate, a vasopressin analogue useful to correct nocturnal polyuria and morning orthostatic hypotension; (2) somatostatin analogues aimed at inhibiting the release of vasoactive gastrointestinal peptides, enhancing cardiac output, and increasing forearm and splanchni…”
BackgroundAutonomic dysfunction in ‘long COVID’: rationale, physiology and management strategies
Dani, M., Dirksen, A., Taraborrelli, P., Torocastro, M., Panagopoulos, D., Sutton, R., & Lim, P. B. (2020) · Clinical Medicine · doi:10.7861/clinmed.2020-0896 · Cited by 769
Seppi, K., Weintraub, D., Coelho, M., Perez‐Lloret, S., Fox, S. H., Katzenschlager, R., Hametner, E., Poewe, W., Rascol, O., Goetz, C. G., et al. (2011) · Movement Disorders · doi:10.1002/mds.23884 · Cited by 1,141
“5 L/day] and salt intake [>8 g or 150 mmol/day], and wearing support stockings) before initiating adjunct treatment with antihypotensive agents.(68)”
Method
Metadata
- Authors
- Lahrmann, H., Cortelli, P., Hilz, M., Mathias, C. J., Struhal, W., & Tassinari, M.
- Affiliations
- Kaiser-Franz-Josef-Spital (AT)
- University of Bologna (IT)
- Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
- St Mary's Hospital (GB)
- Corresponding author
- Lahrmann, H.
- Venue
- European Journal of Neurology
- Publisher
- Wiley
- Published
- 2006-08-23
- Volume
- 13
- Issue
- 9
- Pages
- 930-936
- ISSN
- 1351-5101 (ISSN-L)
- 1468-1331
- OpenAlex
- W1983067632
- Cited by
- 334
- References
- 56
- Citations by year
- 2026: 9 · 2025: 9 · 2024: 13 · 2023: 19 · 2022: 22 · 2021: 19 · 2020: 13 · 2019: 26 · 2018: 18 · 2017: 23 · 2016: 23 · 2015: 11 · 2014: 23 · 2013: 19 · 2012: 21
- FWCI
- 9.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › 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, autonomic dysfunction, syncope, head-up tilt, blood pressure measurement, fludrocortisone, midodrine, sympathomimetic drugs, non-pharmacological treatment, supine hypertension
- MeSH terms
- Diagnosis, Differential, Humans, Hypotension, Orthostatic, Practice Guidelines as Topic
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.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
