ReviewAutonomic neuroscience : basic & clinical2020
Pharmacologic treatment of orthostatic hypotension.
Review in Autonomic neuroscience : basic & clinical, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Postural orthostatic tachycardia syndrome after COVID-19 vaccination: A systematic review.BMC cardiovascular disorders · 2024Pooled it
- Mechanism-Based Therapy With Ampreloxetine for Neurogenic Orthostatic Hypotension in Multiple System Atrophy: A Randomized Withdrawal Trial.Neurology · 2026Trial
- Use of Valsalva Maneuver to Detect Late-Onset Delayed Orthostatic Hypotension.Hypertension (Dallas, Tex. : 1979) · 2023Trial
- Orthostatic Hypotension in Hypertensive Patients Hospitalized in Italian Internal Medicine Departments: FADOI-HYP-OP Study.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026Article
- Somatostatin and Its Analogues as Second-Line Treatments in Non-Neoplastic Conditions.International journal of molecular sciences · 2026Review
- Postprandial Hypotension-Methods for the Evaluation and Management.Geriatrics & gerontology international · 2026Review
- Immunological mechanisms and therapeutic advances in diabetic neuropathy.Journal of neurology · 2026Review
- Supine hypertension and cardiovascular disease: controversies and advances.Future cardiology · 2025Review
- Review
- Orthostatic hypotension in Parkinson's disease: therapeutic considerations.Therapeutic advances in neurological disorders · 2025Review
- Cardiovascular Autonomic Dysfunction Before and After Chemotherapy in Cancer Patients.Journal of clinical neurology (Seoul, Korea) · 2024Review
- Norepinephrine Reuptake Inhibition, an Emergent Treatment for Neurogenic Orthostatic Hypotension.Hypertension (Dallas, Tex. : 1979) · 2024Review
- Effect of Electronic Moxibustion in Patients with IDH: A Randomized Crossover Pilot Study.International journal of general medicine · 2024Article
- Synchronous Bilateral Brachial Blood Pressure Measurements Increased Orthostatic Hypotension Detection in the Elderly.Current hypertension reviews · 2024Article
- The diagnostic value of neutrophil to lymphocyte ratio, albumin to fibrinogen ratio, and lymphocyte to monocyte ratio in Parkinson's disease: a retrospective study.Frontiers in neurology · 2024Article
- Updates on the Diagnosis and Treatment of Peripheral Autonomic Neuropathies.Current neurology and neuroscience reports · 2022Review
- Orthostatic Hypotension in Parkinson Disease: What Is New?Neurology. Clinical practice · 2022Article
- Fludrocortisone Induces Aortic Pathologies in Mice.Biomolecules · 2022Article
- Assessment of Abdominal Constrictor's Forces for Informing Computational Models of Orthostatic Hypotension.Materials (Basel, Switzerland) · 2022Article
- Advances in the Pathophysiology and Management of Supine Hypertension in Patients with Neurogenic Orthostatic Hypotension.Current hypertension reports · 2022Review
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
Neurogenic orthostatic hypotension (OH) is a disabling disorder caused by impairment of the normal autonomic compensatory mechanisms that maintain upright blood pressure. Nonpharmacologic treatment is always the first step in the management of this condition, but a considerable number of patients will require pharmacologic therapies. Denervation hypersensitivity and impairment of baroreflex buffering makes these patients sensitive to small doses of pressor agents. Understanding the underlying pathophysiology can help in selecting between treatment options. In general, patients with low "sympathetic reserve", i.e., those with peripheral noradrenergic degeneration (pure autonomic failure, Parkinson's disease) and low plasma norepinephrine, tend to respond better to "norepinephrine replacers" (midodrine and droxidopa). On the other hand, patients with relatively preserved "sympathetic reserve", i.e., those with impaired central autonomic pathways but spared peripheral noradrenergic fibers (multiple system atrophy) and normal or slightly reduced plasma norepinephrine, tend to respond better to "norepinephrine enhancers" (pyridostigmine, atomoxetine, and yohimbine). There is, however, a spectrum of responses within these extremes, and treatment should be individualized. Other nonspecific treatments include fludrocortisone and octreotide. The presence of associated clinical conditions, such as supine hypertension, heart failure, postprandial hypotension, PD, MSA, and diabetes need to be considered in the pharmacologic management of these patients.
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Registered trials
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