Orthostatic Circulatory Disorders: From Nosology to Nuts and Bolts
- PMID: 27037712
- PMCID: PMC4978226
- DOI: 10.1093/ajh/hpw023
Orthostatic Circulatory Disorders: From Nosology to Nuts and Bolts
Abstract
When patients complain of altered consciousness or discomfort in the upright posture, either relieved by recumbency or culminating in syncope, physicians may find themselves baffled. There is a wide variety of disorders that cause abnormal regulation of blood pressure and pulse rate in the upright posture. The aim of this focused review is 3-fold. First, to offer a classification (nosology) of these disorders; second, to illuminate the mechanisms that underlie them; and third, to assist the physician in the practical aspects of diagnosis of adult orthostatic hypotension, by extending clinical skills with readily available office technology.
Keywords: baroreceptor testing; blood pressure measurement; hypertension; immune autonomic insufficiency; neurogenic orthostatic hypotension; orthostatic..
© American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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References
-
- Rowell LB. Human Cardiovascular Control. Oxford University Press: New York, 1993.
-
- van Dijk N, de Bruin IG, Gisolf J, de Bruin-Bon HA, Linzer M, van Lieshout JJ, Wieling W. Hemodynamic effects of leg crossing and skeletal muscle tensing during free standing in patients with vasovagal syncope. J Appl Physiol (1985) 2005; 98:584–590. - PubMed
-
- Von Euler US. Identification of the sympathomimetic ergone in adrenergic nerves of cattle (sympathin N) with levo-noradrenaline. Acta Physiol Scandinav 1948; 16:63–74.
-
- Raczak G, La Rovere MT, Mortara A, Assandri J, Prpa A, Pinna GD, Maestri R, D’Armini AM, Viganó M, Cobelli F. Arterial baroreflex modulation of heart rate in patients early after heart transplantation: lack of parasympathetic reinnervation. J Heart Lung Transplant 1999; 18:399–406. - PubMed
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