title: Clinical implications of delayed orthostatic hypotension: A 10-year follow-up study.
abstract: OBJECTIVE
  To define the long-term outcome of delayed orthostatic hypotension (OH).
  
  
  OBJECTIVE
  Delayed OH is an early and milder form of OH that progresses over time.
  
  
  METHODS
  We reviewed the medical records of 230 previously reported patients who completed autonomic testing at our center from January 1, 2002, through December 31, 2003. All available information on clinical diagnosis, mortality, medication use, and autonomic testing were extracted and included in the reported outcomes. Standard criteria were used to define OH and delayed OH.
  
  
  RESULTS
  Forty-eight individuals with delayed OH, 42 individuals with OH, and 75 controls had complete follow-up data. Fifty-four percent of individuals with delayed OH progressed to OH. Thirty-one percent of individuals with delayed OH developed an α-synucleinopathy. The 10-year mortality rate in individuals with delayed OH was 29%, in individuals with baseline OH was 64%, and in controls was 9%. The 10-year mortality of individuals who progressed to OH was 50%. Progression to OH was associated with developing an α-synucleinopathy, baseline diabetes, and abnormal baseline autonomic test results.
  
  
  CONCLUSIONS
  Delayed OH frequently progresses to OH with a high associated mortality.
authors.affiliation: From the Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. cgibbons@bidmc.harvard.edu.
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Gibbons
authors.affiliation: From the Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors.forename: Roy
authors.initials: R
authors.lastname: Freeman
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011187:Posture / Q000502:physiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D018667:Tilt-Table Test / Q000639:trends; D013997:Time Factors