Causes of Chronic Orthostatic Hypotension

David Robertson, MD; Rose Marie Robertson, MD
Arch Intern Med. 1994;154(14):1620-1624. doi:10.1001/archinte.1994.00420140086011.
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Objective:  To determine the frequency of various causes of orthostatic hypotension.

Design:  Survey.

Setting:  Tertiary referral center.

Patients:  One hundred patients with moderate to severe orthostatic hypotension.

Results:  Twenty-seven percent of the patients had primary autonomic failure, 35% had secondary autonomic failure, and 38% had hypotension without evidence of generalized autonomic degeneration.

Conclusions:  In a tertiary referral center, only a minority of patients with severe orthostatic hypotension will have Shy-Drager syndrome or Bradbury-Eggleston syndrome as their primary disease. Occasional patients who initially appear to have Bradbury-Eggleston syndrome ultimately prove to have Shy-Drager syndrome or paraneoplastic autonomic failure. Antidepressant drugs, even in low doses, remain a major overlooked cause of orthostatic hypotension.(Arch Intern Med. 1994;154:1620-1624)


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