Physical manoeuvres for combating orthostatic dizziness in autonomic failure

Abstract

Some patients with orthostatic hypotension combat orthostatic dizziness by leg-crossing and squatting. Changes in blood pressure with these manoeuvres were studied in 7 patients with hypoadrenergic orthostatic hypotension and in 6 healthy subjects. Without leg-crossing, 5 of the patients reported dizziness within 10 min of standing up. Crossing of the legs allowed all to stand for 10 min or more, and there was an associated increase in mean blood pressure of 13 (SD 6) mm Hg compared with 1 (4) in healthy controls; the corresponding figures for squatting were 44 (18) and 8 (6) mm Hg. Patients with orthostatic intolerance should be told about these blood-pressure-raising manoeuvres.