Evidence map›Paper›PMID 40360851›Full record

ArticleClinical autonomic research : official journal of the Clinical Autonomic Research Society2025

Peripheral autonomic failure is associated with more severe postprandial hypotension compared to central autonomic failure.

Pouya E Mehr, Pedro J Ortiz, Kaitlyn R O'Rourke, Tan Ding, Amber J Hackstadt, Surat Kulapatana, André Diedrich, Daniel O Claassen, Italo Biaggioni, Amanda C Peltier and 1 more

Abstract readComparative Study
In one paragraph

Article in Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Postprandial Hypotension-Methods for the Evaluation and Management.Geriatrics & gerontology international · 2026
    Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Pouya E MehrDepartment of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Center, Vanderbilt University Medical Center, 2220 Pierce Avenue 506 RRB, Nashville, TN, 37027, USA.
Pedro J OrtizDepartment of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Center, Vanderbilt University Medical Center, 2220 Pierce Avenue 506 RRB, Nashville, TN, 37027, USA.
Kaitlyn R O'RourkeDepartment of Neurology, Vanderbilt Center for Cognitive Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Tan DingDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
Amber J HackstadtDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
Surat KulapatanaDepartment of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Center, Vanderbilt University Medical Center, 2220 Pierce Avenue 506 RRB, Nashville, TN, 37027, USA.
André DiedrichDepartment of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Center, Vanderbilt University Medical Center, 2220 Pierce Avenue 506 RRB, Nashville, TN, 37027, USA.
Daniel O ClaassenDepartment of Neurology, Vanderbilt Center for Cognitive Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Italo BiaggioniDepartment of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Center, Vanderbilt University Medical Center, 2220 Pierce Avenue 506 RRB, Nashville, TN, 37027, USA.
Amanda C PeltierDepartment of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Center, Vanderbilt University Medical Center, 2220 Pierce Avenue 506 RRB, Nashville, TN, 37027, USA.
Cyndya A ShibaoDepartment of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Center, Vanderbilt University Medical Center, 2220 Pierce Avenue 506 RRB, Nashville, TN, 37027, USA. cyndya.shibao@vumc.org.ORCID http://orcid.org/0000-0002-4518-6801

Funding

The Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR000445 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BERNARD, GORDON RAPHAEL · 2012 to 2016
$41.4M
Clinical Trial Readiness for Multiple System Atrophy - Resubmission - 1U01NS122419 · NINDS · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI HORACIO KAUFMANN · 2022 to 2026
$4.8M
Mechanism of Glucose-dependent insulinotropic polypeptide (GIP) on Splanchnic Venous Capacitance in Postural Tachycardia SyndromeR01HL159203 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Cyndya Adriana Shibao · 2022 to 2026
$4.1M
Hemodynamic Effects of Positive Airway Pressure to Treat Supine Hypertension and Improve Neurogenic Orthostatic HypotensionR01HL161095 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Italo Biaggioni, Luis Enrique Okamoto · 2022 to 2026
$3.2M
Automated Abdominal Binder for Orthostatic HypotensionR01HL144568 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI OKAMOTO, LUIS ENRIQUE · 2020 to 2024
$2.7M
Mentoring in cholinergic regulation of vascular oxidationK24HL165163 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Cyndya Adriana Shibao · 2023 to 2026
$464k
NCATS NIH HHS UL1 TR000445NHLBI NIH HHS K24 HL165163NHLBI NIH HHS R01 HL144568NHLBI NIH HHS R01 HL159203NHLBI NIH HHS R01 HL161095NIH HHS K24HL165163NIH HHS R01HL144568NIH HHS R01HL159203NIH HHS R01HL161095NIH HHS U01NS122419NIH HHS UL1TR000445NINDS NIH HHS U01 NS122419
6 · The paper itself

Abstract

purposePostprandial hypotension (PPH) defined as a decrease in systolic blood pressure of more than 20 mmHg within 2 h post meal is prevalent in patients with autonomic failure and is associated with negative cardiovascular outcomes. Previous studies reported peripheral autonomic failure with less residual sympathetic tone in Parkinson disease (PD). Therefore, we hypothesized that PPH is more severe in PD than in multiple system atrophy (MSA) with central autonomic failure.

methodsThirteen patients with PD and 13 patients with MSA were enrolled. Autonomic function testing and neurohormonal measurements were performed to assess autonomic failure and residual sympathetic activity. Subjects were fed a standard breakfast. Systolic and diastolic blood pressure and heart rate were monitored every 5 min from 30 min before to 120 min post meal. Postprandial hemodynamic changes were summarized using area under the curve (AUC). Differences between the groups were assessed with two-sample independent t test and linear regression.

resultsPatients with PD (69% male, 72 ± 9 years) had a significantly lower post-meal diastolic blood pressure (P = 0.003) and heart rate AUC (P = 0.007) than patients with MSA (62% male, 62 ± 8 years). After adjusting for age and supine systolic blood pressure, PD as diagnosis still had significant estimate effect for diastolic blood pressure AUC (P = 0.019). No significant difference was found in the mean systolic blood pressure AUC, but at 30 min post meal, systolic blood pressure decrease was significantly lower in PD (P = 0.016).

conclusionThe PD group with peripheral autonomic failure exhibits more severe PPH than the MSA group. This highlights the need for tailored management for PPH in PD.

Indexed as

Autonomic Nervous System DiseasesHypotensionMultiple System AtrophyParkinson DiseasePostprandial PeriodAgedBlood PressureFemaleHeart RateHumansMaleMiddle AgedAutonomic failureMultiple system atrophyParkinson diseasePostprandial hypotension

Identifiers

PMID40360851
PMCPMC12325557

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.