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Syndrome of Supine Hypertension with Orthostatic Hypotension: Pathophysiology and Clinical Approach

[ Vol. 16 , Issue. 1 ]


Aamir Ahmed, Mohammed Ruzieh*, Shaffi Kanjwal and Khalil Kanjwal   Pages 48 - 54 ( 7 )


This article is intended to provide guidance and clinical considerations for physicians managing patients suffering from supine hypertension with orthostatic hypotension, referred to as “SH-OH”. We review the normal physiologic response to orthostasis, focusing on the appropriate changes to autonomic output in this state. Autonomic failure is discussed with a generalized overview of the disease and examination of specific syndromes that help shed light on the pathophysiology of SH-OH. The goal of this review is to provide a better framework for clinical evaluation of these patients, review treatment options, and ultimately work toward achieving a better quality of life for patients afflicted with this disease.


Orthostatic hypotension, supine hypertension, autonomic failure, dysautonomia, blood pressure, orthostatic posture.


Department of Internal Medicine, Rush University, Chicago, IL 60612, Penn State Heart and Vascular Institute. Hershey, PA 17033, St Mary's of Michigan, McLaren Greater Lansing Hospital, Lansing, MI 48910

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