The most common cause of orthostatic hypotension is poor postural adjustment. The most severe form of orthostatic hypotension is of unknown etiology; the primary disorder is a degeneration of the peripheral autonomic nervous system, resulting in a decrease in production of catecholamine. Physiologically, there is a failure of arteriolar and venous vasoconstriction and a lack of cardiac response, both in rate and in contractility to sympathetic stimulation. Total and central cardiopulmonary blood volumes are contracted. The application of hydrostatic counterpressure by the use of an elasticized garment is helpful in the management of orthostatic hypotension, especially when used with sodium-retaining steroids to increase intravascular volume.

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http://dx.doi.org/10.1159/000169820DOI Listing

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