Brignole M, Moya A, De Lange FJ, Deharo JC, Elliott PM, Fanciulli A, et al. 2018 ESC guidelines for the diagnosis and management of syncope. Eur Heart J. 2018;39(21):1883–948. https://doi.org/10.1093/EURHEARTJ/EHY037.

Article  PubMed  Google Scholar 

Thijs RD, Wieling W, Kaufmann H, Claydon VE, Van Wijnen VK, Harms MPM, et al. Diagnosis and treatment of orthostatic hypotension. Lancet Neurol. 2022;21(8):735–46. https://doi.org/10.1016/S1474-4422(22)00169-7.

Article  PubMed  PubMed Central  Google Scholar 

Saedon NIZ, Tan MP, Frith J. The prevalence of orthostatic hypotension: a systematic review and meta-analysis. J Gerontol A Biol Sci Med Sci. 2020;75(1):117–22. https://doi.org/10.1093/gerona/gly188.

Article  PubMed  PubMed Central  Google Scholar 

Fedorowski A, Ricci F, Hamrefors V, Sandau KE, Hwan Chung T, Muldowney JAS, et al. Orthostatic hypotension: management of a complex, but common, medical problem. Circ Arrhythm Electrophysiol. 2022;15(3):e010573. https://doi.org/10.1161/CIRCEP.121.010573.

Article  PubMed  PubMed Central  Google Scholar 

Christopoulos EM, Tran J, Hillebrand SL, Lange PW, Iseli RK, Meskers CGM, et al. Initial orthostatic hypotension and orthostatic intolerance symptom prevalence in older adults: a systematic review. Int J Cardiol Hypertens. 2020;8:100071. https://doi.org/10.1016/j.ijchy.2020.100071.

Article  PubMed  PubMed Central  Google Scholar 

Romero-Ortuno R, Cogan L, Foran T, Kenny RA, Fan CW. Continuous noninvasive orthostatic blood pressure measurements and their relationship with orthostatic intolerance, falls, and frailty in older people. J Am Geriatr Soc. 2011;59(4):655–65. https://doi.org/10.1111/j.1532-5415.2011.03352.x.

Article  PubMed  Google Scholar 

Freeman R, Illigens BMW, Lapusca R, Campagnolo M, Abuzinadah AR, Bonyhay I, et al. Symptom recognition is impaired in patients with orthostatic hypotension. Hypertension. 2020;75(5):1325–32. https://doi.org/10.1161/HYPERTENSIONAHA.119.13619.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Feeney J, O’Leary N, Kenny RA. Impaired orthostatic blood pressure recovery and cognitive performance at two-year follow up in older adults: the Irish Longitudinal Study on Ageing. Clin Auton Res. 2016;26(2):127–33. https://doi.org/10.1007/s10286-016-0340-3.

Article  PubMed  PubMed Central  Google Scholar 

Frewen J, Savva GM, Boyle G, Finucane C, Kenny RA. Cognitive performance in orthostatic hypotension: findings from a nationally representative sample. J Am Geriatr Soc. 2014;62(1):117–22. https://doi.org/10.1111/jgs.12592.

Article  PubMed  Google Scholar 

Elmståhl SWE. Orthostatic intolerance predicts mild cognitive impairment: incidence of mild cognitive impairment and dementia from the Swedish general population cohort Good Aging in Skåne. Clin Interv Aging. 2014;9:1993–2002. https://doi.org/10.2147/CIA.S72316.

Article  PubMed  PubMed Central  Google Scholar 

Kleipool EEF, Trappenburg MC, Rhodius-Meester HFM, Lemstra AW, Van Der Flier WM, Peters MJL, et al. Orthostatic hypotension: an important risk factor for clinical progression to mild cognitive impairment or dementia: the Amsterdam Dementia Cohort. J Alzheimers Dis. 2019;71(1):317–25. https://doi.org/10.3233/JAD-190402.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Wolters FJ, Mattace-Raso FUS, Koudstaal PJ, Hofman A, Ikram MA. Orthostatic hypotension and the long-term risk of dementia: a population-based study. PLoS Med. 2016;13(10):e1002143. https://doi.org/10.1371/journal.pmed.1002143.

Article  PubMed  PubMed Central  Google Scholar 

Wolters FJ, Zonneveld HI, Hofman A, Van Der Lugt A, Koudstaal PJ, Vernooij MW, et al. Cerebral perfusion and the risk of dementia: a population-based study. Circulation. 2017;136(8):719–28. https://doi.org/10.1161/CIRCULATIONAHA.117.027448.

Article  PubMed  Google Scholar 

Byun JI, Moon J, Kim DY, Shin H, Sunwoo JS, Lim JA, et al. Efficacy of single or combined midodrine and pyridostigmine in orthostatic hypotension. 2017. Report.

Strassheim V, Newton JL, Tan MP, Frith J. Droxidopa for orthostatic hypotension: a systematic review and meta-analysis. J Hypertens. 2016;34(10):1933–41. https://doi.org/10.1097/HJH.0000000000001043.

Article  CAS  PubMed  Google Scholar 

Kim MJ, Farrell J. Orthostatic hypotension: a practical approach. Am Fam Physician. 2022;105(1):39–49.

PubMed  Google Scholar 

Veazie S, Peterson K, Ansari Y, Chung KA, Gibbons CH, Raj SR, et al. Fludrocortisone for orthostatic hypotension. Cochrane Database Syst Rev. 2021;5(5):CD012868. https://doi.org/10.1002/14651858.CD012868.pub2.

Article  PubMed  PubMed Central  Google Scholar 

Palma JA, Kaufmann H. Management of orthostatic hypotension. Continuum (Minneap Minn). 2020;26(1):154–77. https://doi.org/10.1212/CON.0000000000000816.

Article  PubMed  PubMed Central  Google Scholar 

Gibbons CH, Schmidt P, Biaggioni I, Frazier-Mills C, Freeman R, Isaacson S, et al. The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension. J Neurol. 2017;264(8):1567–82. https://doi.org/10.1007/s00415-016-8375-x.

Article  PubMed  PubMed Central  Google Scholar 

Covidence systematic review software. Veritas Health Innovation, Melbourne, Australia. https://www.covidence.org. Accessed 13 May 2026.

Clark E, Burkett K, Stanko-Lopp D. Let evidence guide every new decision (LEGEND): an evidence evaluation system for point-of-care clinicians and guideline development teams. J Eval Clin Pract. 2009;15(6):1054–60. https://doi.org/10.1111/j.1365-2753.2009.01314.x.

Article  PubMed  Google Scholar 

Hohler AD, Amariei DE, Katz DI, Depiero TJ, Allen VB, Boyle S, et al. Treating orthostatic hypotension in patients with Parkinson’s disease and atypical parkinsonism improves function. J Parkinsons Dis. 2012;2(3):235–40. https://doi.org/10.3233/JPD-2012-012101.

Article  PubMed  Google Scholar 

Mcdonell KE, Shibao CA, Biaggioni I, Hartman A, Robertson D, Claassen DO. Cognitive and behavioral changes in patients treated with droxidopa for neurogenic orthostatic hypotension: a retrospective review. 2019. Report. www.cogbehavneurol.com. Accessed 13 May 2026.

Freidenberg DL, Shaffer LE, Macalester S, Fannin EA. Orthostatic hypotension in patients with dementia: clinical features and response to treatment. 2013. Report. http://journals.lww.com/cogbehavneurol. Accessed 13 May 2026.

Phillips AA, Warburton DER, Ainslie PN, Krassioukov AV. Regional neurovascular coupling and cognitive performance in those with low blood pressure secondary to high-level spinal cord injury: improved by alpha-1 agonist midodrine hydrochloride. J Cereb Blood Flow Metab. 2014;34(5):794–801. https://doi.org/10.1038/jcbfm.2014.3.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Wecht JM, Weir JP, Katzelnick CG, Chiaravalloti ND, Kirshblum SC, Dyson-Hudson TA, et al. Double-blinded, placebo-controlled crossover trial to determine the effects of midodrine on blood pressure during cognitive testing in persons with SCI. Spinal Cord. 2020;58(9):959–69. https://doi.org/10.1038/s41393-020-0448-0.

Article  PubMed  PubMed Central  Google Scholar 

Iseli R, Nguyen VTV, Sharmin S, Reijnierse EM, Lim WK, Maier AB. Orthostatic hypotension and cognition in older adults: a systematic review and meta-analysis. Exp Gerontol. 2019;120:40–9. https://doi.org/10.1016/j.exger.2019.02.017.

Article  PubMed  Google Scholar 

Kaufmann H, Norcliffe-Kaufmann L, Palma JA. Droxidopa in neurogenic orthostatic hypotension. Expert Rev Cardiovasc Ther. 2015;13(8):875–91. https://doi.org/10.1586/14779072.2015.1057504.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Khalil I, Sayad R, Kedwany A, Sayed H, Caprara AL, Rissardo J. Cardiovascular dysautonomia and cognitive impairment in Parkinson’s disease. Med Int. 2024;4(6):70. https://doi.org/10.3892/mi.2024.194.

Article  Google Scholar 

McDonald C, Newton JL, Burn DJ. Orthostatic hypotension and cognitive impairment in Parkinson’s disease: causation or association? Mov Disord. 2016;31(7):937–46. https://doi.org/10.1002/mds.26632.

Article  CAS  PubMed  Google Scholar 

Buckley A, Carey D, Meaney JM, Kenny R, Harbison J. Is there an association between orthostatic hypotension and cerebral white matter hyperintensities in older people? The Irish longitudinal study on ageing. JRSM Cardiovasc Dis. 2020;9:2048004020954628. https://doi.org/10.1177/2048004020954628.

Article  PubMed  PubMed Central