Orthostatic hypertension: An underestimated cause of orthostatic intolerance

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology
Hyung Lee, Hyun-Ah Kim

Abstract

To investigate the frequency and mechanism of orthostatic hypertension (OHT) in patients with orthostatic intolerance. We retrospectively reviewed 1033 consecutive case series of orthostatic intolerance that underwent autonomic function tests including a head-up tilt test. OHT was defined as a paradoxical orthostatic increase in systolic blood pressure (BP) of at least 20 mmHg during the tilt. We collected autonomic parameters during the standardized autonomic function tests, which included the beat-to-beat derived hemodynamic parameters during the tilt table test and compared them with age and sex-matched normal controls and the orthostatic hypotension (OH) group with orthostatic symptoms. We identified 38 (3.7%) patients who showed OHT during the tilt. The increase in mean systolic BP during the tilt was 26.5 mmHg. Approximately 87% (33/38) of the OHT patients showed an increase in total peripheral resistance during the tilt. The mean increase in total peripheral resistance from a supine baseline was significantly higher in OHT patients compared to normal controls, but the OH group showed a decrease in mean total peripheral resistance during the tilt. A select few patients with orthostatic dizziness can show OHT during the ti...Continue Reading

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Citations

Apr 30, 2016·International Journal of Cardiology·Donglei LiaoCheng Wang
Jan 31, 2017·The Journal of Emergency Medicine·Nissa J Ali, Shamai A Grossman
Feb 7, 2019·The Journal of Clinical Hypertension·Nikolaos MagkasDimitrios Tousoulis
Apr 1, 2020·Hypertension·Jens JordanArtur Fedorowski
Nov 27, 2020·Journal of Clinical Medicine·Sooyeoun YouHyung Lee
Feb 9, 2021·European Heart Journal. Case Reports·Martin B von BartheldM Louis Handoko
Feb 7, 2020·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Álvaro PetersenJ Antonio González-Hermosillo

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