Autonomic Failure Syndromes (Pure Autonomic Failure)
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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
- Male gender
- Medications: tricyclic antidepressants, antihypertensives, vasodilators, diuretics, antiparkinsonian agents
- Avoid abrupt change in posture and standing motionless for extended periods.
- Avoid large meals, hot environments.
Commonly Associated Conditions