The role of delayed orthostatic hypotension in the pathogenesis of chronic fatigue

Past studies have shown that severe fatigue was the presenting

symptom in six of seven patients with delayed orthostatic

hypotension and that tilt table-induced hypotension was found

in 22 of 23 patients with the chronic fatigue syndrome. We

have determined the prevalence of fatigue, volunteered in

response to a nonspecific pre-examination questionnaire used

in 431 patients, each subsequently diagnosed as having one of

eight neurological or endocrine disorders. The results show

that fatigue is a very common symptom in patients with delayed

orthostatic hypotension (n = 21), as well as both primary (n =

30) and secondary (n = 106) hypocortisolism: 70-83% in all

groups. In contrast, fatigue was an uncommon complaint in

patients with multiple system atrophy (MSA) (n = 30),

pituitary disorders without hypocortisolism (n = 106) or

idiopathic hirsutism (n = 96): 7-33% in all groups, and was

intermediate in prevalence in patients with acute

hyperadrenergic orthostatic hypotension (n = 32): 41%. It is

concluded that fatigue commonly results from delayed

orthostatic hypotension and all forms of hypocortisolism but

is less common in patients with acute orthostatic hypotension,

both idiopathic and due to MSA, which more commonly present

with lightheadedness or syncope.

1 Star2 Stars3 Stars4 Stars5 Stars (53 votes, average: 3.15 out of 5)

Leave a Reply