Instantaneous Orthostatic Hypotension in Children and Adolescents: A New Entity of Orthostatic Intolerance

Tanaka, Hidetaka; Yamaguchi, Hitoshi; Matushima, Reiko; Tamai, Hiroshi

doi:10.1203/00006450-199912000-00022

Cited by 60 publications

(48 citation statements)

References 20 publications

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“…Symptomatic initial orthostatic hypotension is also reported to occur frequently in young subjects with a tendency to faint, but the site of the lesion in the baroreflex arc in these subjects remains to be determined [3,5].…”

Section: -9851 9 2001 Lippincott Williams and Wilkins 269mentioning

confidence: 99%

“…Wzelznget aL ness are caused by a transient decrease in systemic BP, which occurs on active standing, but not on passive head-up tilt [1][2][3]. This initial transient decrease in BP is ascribed to vasodilatation in the active muscles during standing and characterized by its time of onset and short duration.…”

Section: -9851 9 2001 Lippincott Williams and Wilkins 269mentioning

confidence: 99%

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Initial orthostatic hypotension as a cause of recurrent syncope: A case report

Wieling

Harms

Kortz

et al. 2001

Clinical Autonomic Research

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Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Download date: 11 May 2018Case Report Clinical Autonomic Research 2001, 11:269-270 A 60-year-old male patient with recurrent unexplained syncope on standing was studied. During continuous, noninvasive blood pressure (BP) recording with a Finapres device, an abnormally large and symptomatic initial decrease in systemic BP was documented. After 2 minutes of standing, BP had recovered. The transient decrease in BP was attributed to the use of a combination of antidepressants known to interfere with sympathetic function. This case shows the importance of continuous, noninvasive BP measurement on standing: routine intermittent BP recording would have missed the abnormality. In patients using medications such as antidepressants, initial transient hypotension should be considered as the cause of faUs and syncope.

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Section: -9851 9 2001 Lippincott Williams and Wilkins 269mentioning

confidence: 99%

Section: -9851 9 2001 Lippincott Williams and Wilkins 269mentioning

confidence: 99%

Initial orthostatic hypotension as a cause of recurrent syncope: A case report

Wieling

Harms

Kortz

et al. 2001

Clinical Autonomic Research

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show abstract

“…20) In a broad sense, OH belongs to orthostatic dysregulation (OD) along with NMS (neurally mediated syncope) and others. [21][22][23][24] Kaufmann 25) states that severe OH induces NMS. Kenny 26) mentioned OH as the most common cause of NMS.…”

Section: Discussionmentioning

confidence: 99%

Effects of Some .BETA.-Adrenoceptor Antagonists on Orthostatic Hypotension in Repeatedly Cold- (SART-) Stressed Rats

Funakami

Hata

Itoh

et al. 2007

Biological & Pharmaceutical Bulletin

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Hypotension has not been recognized as a disease and has been neglected till now, because the symptoms are quiet and rarely life-threatening unlike those of hypertension. However, many people suffer from hypotension, and these people also suffer from orthostatic hypotension (OH). While the role played by stress in hypertension is often talked about, there are nearly no reports on the relationship between hypotension and stress and that between OH and stress just like there are nearly no reports on hypotension itself. We have been studying the relationship.1,2) We receive various kinds of stress in our everyday life. Among many stressors, those we talk about daily seem to be psychological stresses arising from jobs or personal relationships. The majority of these stressors are anger and hostility, as well as suppression and anxiety. Hypotensive patients often manifest symptoms when they have these psychological factors.3) Hypotension also occurs when patients are under excessive environmental stress, such as cold and heat. Many cases are thought to be induced not by organic injury but by the breakdown of circulatory regulation due to the dysfunction of the hypothalamo-autonomic nervous system. 4)Various tests often find no abnormalities, when the breakdown of circulatory regulation due to autonomic dysfunction occurs in patients with normal circulatory functions. Headup tilt test (HUT) 5) is one method often used to induce OH in humans for the purpose of testing OH of undetermined origin and neurally mediated syncope (NMS). However, details of HUT vary by researchers, such as degree of HUT or the positive criteria of OH and NMS. The dose of isoproterenol, which is often used in HUT in order to increase the induction rate of NMS, also varies by researchers. [6][7][8][9][10][11] In the present study, the role played by the autonomic nervous system, especially b-adrenoceptors in OH was investigated by performing HUT to SART (specific alternation of rhythm in temperature) 12) -stressed rats with various symptoms of autonomic imbalance 13) and hypotension. 1) There are many people who complain of poor physical condition at a season with severe temperature changes or at a change of seasons, such as early spring or the beginning of autumn. SART-stressed animals are created in simulation of such a state by rearing in an environment where temperature changes rapidly, intermittently and repeatedly between room temperature and low temperature. 12,14) The animals are used widely in research as an autonomic imbalance model animal of systemic parasympathetic hypertonia and sympathetic hypotonia 13) based on results of, the Aschner's test, Mecholyl test and GSR (galvanic skin response) test.SART-stressed rats have been reported to have increased heart rate, 12) abnormal electrocardiogram (ECG), 15) continuous hypotension 1) and other circulatory changes. 16,17) SARTstressed rats develop OH easily when subjected to HUT.2) It has also been reported that these symptoms are improved by muscarinic M 2 -receptor antagonists. 18,19) E...

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“…Many Japanese adolescents suffer from orthostatic dysregulation (OD) (1)(2)(3)(4), characterized by dizziness on standing, malaise, palpitation, headaches, abdominal pain, and syncope. Students with this disease sometimes cannot attend school, and this becomes a social problem.…”

Section: Introductionmentioning

confidence: 99%