A degenerative disorder of the autonomic nervous system presenting in middle to late life, affecting men more than women, characterized by abnormal low blood pressure in standing position. There is a gradual onset of postural hypotension with fixed heart rate, heart intolerance, anhidrosis, nocturnal polyuria; deterioration of abdominal, urinary, and anal sphincter functions, visual disturbances, and impotency. It usually occurs in older males in the summer months and is worse in the morning, after meals or exercise, or in hot weather. Patients also complain of pain in the neck or back of the head, relieved by lying down. The syndrome is due primarily to impaired peripheral vasoconstriction, acceleration of heart rate and maintenance of cardiac output in response to the assumption of the upright position. Depletion of the sympathetic nerve endings and their inability to take up norepinephrine is believed to be the cause.
- S. Bradbury, C. Eggleston:
Postural hypotension: A report of three cases.
American Heart Journal, St. Louis, 1925, 1: 73-86.