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Cited by 387Cardiovascular Syncope and Autonomic DisordersHeart Rate Variability and Autonomic ControlBalance, Gait, and Falls Prevention

Pathophysiological basis of orthostatic hypotension in autonomic failure

Open access
Smit, Adrianus A. J., Halliwill, John R., Low, Phillip A., Wieling, Wouter·1999·The Journal of Physiology
DOI 10.1111/j.1469-7793.1999.0001o.xPMC PMC2269496
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Abstract

In patients with autonomic failure orthostatic hypotension results from an impaired capacity to increase vascular resistance during standing. This fundamental defect leads to increased downward pooling of venous blood and a consequent reduction in stroke volume and cardiac output that exaggerates the orthostatic fall in blood pressure. The location of excessive venous blood pooling has not been established so far, but present data suggest that the abdominal compartment and perhaps leg skin vasculature are the most likely candidates. To improve the orthostatic tolerance in patients with autonomic failure, protective measures that reduce excessive orthostatic blood pooling have been developed and evaluated. These measures include physical counter-manoeuvres and abdominal compression.

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Crossref · 10.1111/j.1469-7793.1999.0001o.x

Cites

131 of 131 references verified0 citation errors · 0 not checkable

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Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • 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 [103]

  • 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 [103]

  • 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 [103]

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Authors
Smit, A. A. J., Halliwill, J. R., Low, P. A., & Wieling, W.
Affiliations
  • Amsterdam UMC Location University of Amsterdam (NL)
  • University of Rochester (US)
  • Mayo Clinic (US)
Corresponding author
Wieling, Wouter
ORCID
Venue
The Journal of Physiology
Publisher
Wiley
Published
1999-08
Volume
519
Issue
1
Pages
1-10
ISSN
  • 0022-3751 (ISSN-L)
  • 1469-7793
DOI
10.1111/j.1469-7793.1999.0001o.x
PMC
PMC2269496
OpenAlex
W2044135793
Cited by
387
References
131
Citations by year
2026: 6 · 2025: 15 · 2024: 10 · 2023: 11 · 2022: 13 · 2021: 23 · 2020: 17 · 2019: 14 · 2018: 15 · 2017: 17 · 2016: 16 · 2015: 19 · 2014: 19 · 2013: 20 · 2012: 12
FWCI
1.27
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 1864 d)
Locations
  • The Journal of Physiology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion)
Funders
National Aeronautics and Space Administration
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, autonomic failure, orthostatic tolerance, venous pooling, vascular resistance, stroke volume, cardiac output, abdominal compression, blood pressure regulation
MeSH terms
Autonomic Nervous System Diseases, Humans, Hypotension, Orthostatic, Posture, Vascular Resistance

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