title: Orthostatic hypertension: An underestimated cause of orthostatic intolerance.
abstract: OBJECTIVE
  To investigate the frequency and mechanism of orthostatic hypertension (OHT) in patients with orthostatic intolerance.
  
  
  METHODS
  We retrospectively reviewed 1033 consecutive case series of orthostatic intolerance that underwent autonomic function tests including a head-up tilt test. OHT was defined as a paradoxical orthostatic increase in systolic blood pressure (BP) of at least 20 mmHg during the tilt. We collected autonomic parameters during the standardized autonomic function tests, which included the beat-to-beat derived hemodynamic parameters during the tilt table test and compared them with age and sex-matched normal controls and the orthostatic hypotension (OH) group with orthostatic symptoms.
  
  
  RESULTS
  We identified 38 (3.7%) patients who showed OHT during the tilt. The increase in mean systolic BP during the tilt was 26.5 mmHg. Approximately 87% (33/38) of the OHT patients showed an increase in total peripheral resistance during the tilt. The mean increase in total peripheral resistance from a supine baseline was significantly higher in OHT patients compared to normal controls, but the OH group showed a decrease in mean total peripheral resistance during the tilt.
  
  
  CONCLUSIONS
  A select few patients with orthostatic dizziness can show OHT during the tilt and they have signs of increased peripheral resistance.
  
  
  CONCLUSIONS
  OHT may be considered in the differential diagnosis of orthostatic intolerance.
authors.affiliation: Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea; Brain Research Institute, Keimyung University School of Medicine, Daegu, South Korea.
authors.forename: Hyung
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea; Brain Research Institute, Keimyung University School of Medicine, Daegu, South Korea. Electronic address: kha0206@dsmc.or.kr.
authors.forename: Hyun-Ah
authors.initials: HA
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D054971:Orthostatic Intolerance / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D011187:Posture / Q000502:physiology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D018667:Tilt-Table Test / Q000379:methods
keywords: Autonomic nervous system diseases; Blood pressure; Hypertension; Orthostatic intolerance