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David Robertson, MD; Rose Marie Robertson, MD

Arch Intern Med. 1994;154(14):1620-1624.

Abstract
Objective
To determine the frequency of various causes of orthostatic hypotension.

Design
Survey.

Setting
Tertiary referral center.

Patients
One hundred patients with moderate to severe orthostatic hypotension.

Results
Twenty-seven percent of the patients had primary autonomic failure, 35% had secondary autonomic failure, and 38% had hypotension without evidence of generalized autonomic degeneration.

Conclusions
In a tertiary referral center, only a minority of patients with severe orthostatic hypotension will have Shy-Drager syndrome or Bradbury-Eggleston syndrome as their primary disease. Occasional patients who initially appear to have Bradbury-Eggleston syndrome ultimately prove to have Shy-Drager syndrome or paraneoplastic autonomic failure. Antidepressant drugs, even in low doses, remain a major overlooked cause of orthostatic hypotension.

(Arch Intern Med. 1994;154:1620-1624)

Author Affiliations
From the Departments of Medicine (Drs D. and R. M. Robertson), Pharmacology (Dr D. Robertson), and Neurology (Dr D. Robertson), Vanderbilt University, Nashville, Tenn.

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