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Autonomic Failure Syndromes (Pure Autonomic Failure)

Autonomic Failure Syndromes (Pure Autonomic Failure) is a topic covered in the 5-Minute Clinical Consult.

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  • Blood pressure drop with inadequate compensatory rise in heart rate while standing attributed to autonomic system impairment (1)
  • Maintaining upright posture is difficult for patients with this disorder. They are at increased risk for fall and syncope.


Unconfirmed, area of ongoing research (2)

  • Male > female (2)
  • Starts at middle age and progresses through life
  • True prevalence currently unknown

Etiology and Pathophysiology

  • Area of ongoing research; may stem from neurodegenerative disease or from systemic illness affecting the peripheral nervous system (1)
  • Homeostatic mechanisms that typically regulate blood pressure fluctuations are impaired.
  • Affects sympathetic and parasympathetic nervous systems with sparing of adrenal medulla (usually) (2)

No specific genetic component identified

Risk Factors

  • Male gender
  • Medications: tricyclic antidepressants, antihypertensives, vasodilators, diuretics, antiparkinsonian agents

General Prevention

  • Avoid abrupt change in posture and standing motionless for extended periods.
  • Avoid large meals, hot environments.

Commonly Associated Conditions

Not applicable

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Stephens, Mark B., et al., editors. "Autonomic Failure Syndromes (Pure Autonomic Failure)." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816838/all/Autonomic_Failure_Syndromes__Pure_Autonomic_Failure_.
Autonomic Failure Syndromes (Pure Autonomic Failure). In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816838/all/Autonomic_Failure_Syndromes__Pure_Autonomic_Failure_. Accessed April 24, 2019.
Autonomic Failure Syndromes (Pure Autonomic Failure). (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816838/all/Autonomic_Failure_Syndromes__Pure_Autonomic_Failure_
Autonomic Failure Syndromes (Pure Autonomic Failure) [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 24]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816838/all/Autonomic_Failure_Syndromes__Pure_Autonomic_Failure_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Autonomic Failure Syndromes (Pure Autonomic Failure) ID - 816838 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816838/all/Autonomic_Failure_Syndromes__Pure_Autonomic_Failure_ PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -