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Neurogenic Orthostatic Hypotension: Expert Perspectives on Diagnosis and Treatment Strategies

Neurogenic orthostatic hypotension is a disorder of noradrenergic neurotransmission. It’s most familiar presentation is lightheadedness or even syncope on standing. We know that the basic mechanism is impaired norepinephrine release from postganglionic sympathetic nerve terminals, resulting in a decrease in blood pressure (BP) and reduced blood flow to vital organs, especially the brain, when one stands. Orthostatic hypotension (OH) is defined as a fall in systolic BP of at least 20 mm Hg or in diastolic BP of at least 10 mm Hg within 3 minutes of standing. Symptoms may include lightheadedness, dizziness, weakness, fatigue, vision changes, poor concentration, head and neck pain, and difficulty standing.[1] It could be due to an underlying neurologic condition or other factors. To get the conversation going, Billy, what are the non-neurologic causes of OH?Continue reading: