A 10-year-long study of patients at an institution has indicated that delayed orthostatic hypotension (DOH) is an earlier, milder form of orthostatic hypotension (OH). Study data showed that over a decade follow-up, 54% of patients having DOH progressed to OH and that a 10-year mortality of patients who progressed to OH was 50%, Christopher H.

The research was reported online by Gibbons, MD, of Beth Israel Deaconess Medical Center, Harvard Medical School in Boston, and colleagues in Neurology.

The investigators said the rise in mortality in individuals with DOH was linked to abnormalities in baseline autonomic test outcomes, progression to OH, the presence of diabetes, and an alpha-synucleinopathy development.

Gibbons said, “Our data suggest DOH falls along continuum of severity and associated mortality risk associated with generalized autonomic dysfunction and OH alone. The magnitude of mortality in DOH approaches that associated with autonomic dysfunction in individuals with diabetes and other neurodegenerative disorders”.

Presently, OH is defined as 20 mm drop in Hg in systolic blood pressure or 10 mm Hg in diastolic pressure within 3 minutes of assuming a standing position. However, there are some pressure drops that take place after the 3-minute window, and such cases have been dubbed delayed OH.

The investigators noted that now, this delayed syndrome has been identified as a potential cause of orthostatic intolerance, but no longitudinal data is available. Besides, it is also unknown that if delayed OH is an early OH presentation, or a more benign or non-progressive kind of orthostatic intolerance.