ABNORMALITIES OF AUTONOMIC NERVOUS-SYSTEM IN HYPERADRENERGIC ORTHOSTATIC HYPOTENSION - DESCRIPTION OF A CASE

Hyperadrenergic orthostatic hypotension was diagnosed in a 27-year-old man because of recurrent episodes of hypotension associated with high plasma noradrenaline levels. In this patient, laboratory tests were p erformed to evaluate autonomic nervous system function. Decreased resp onse to Valsalva maneuver and carotid sinus massage indicated decrease d baroreflex and vagal responsiveness, respectively. Cardiovascular re sponse to the handgrip was reduced in comparison to controls. Passive leg raise showed normal reduction of plasma norepinephrine, indicating normal responsiveness of cardiopulmonary receptors. 'Non-dipper' prof ile in the ambulatory blood pressure monitoring provided further evide nce for an impaired autonomic control of cardiovascular function in th is patient. This report suggests the presence of autonomic dysfunction in hyperadrenergic orthostatic hypotension.