{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:26:58Z","timestamp":1790008018124,"version":"4.0.1"},"reference-count":97,"publisher":"Portland Press Ltd.","issue":"3","content-domain":{"domain":["portlandpress.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2007,2,1]]},"abstract":"<jats:p>Several studies have shown that standing up is a frequent (3\u201310%) trigger of loss of consciousness both in young and old subjects. An exaggerated transient BP (blood pressure) fall upon standing is the underlying cause. IOH (initial orthostatic hypotension) is defined as a transient BP decrease within 15\u00a0s after standing, &amp;gt;40\u00a0mmHg SBP (systolic BP) and\/or &amp;gt;20\u00a0mmHg DBP (diastolic BP) with symptoms of cerebral hypoperfusion. It differs distinctly from typical orthostatic hypotension (i.e. BP decrease &amp;gt;20\u00a0mmHg SBP and\/or &amp;gt;10\u00a0mmHg DBP after 3\u00a0min of standing) as the BP decrease is transient. Only continuous beat-to-beat BP measurement during an active standing-up manoeuvre can document this condition. As IOH is only associated with active rising, passive tilting is of no diagnostic value. The pathophysiology of IOH is thought to be a temporal mismatch between cardiac output and vascular resistance. The marked decrease of vascular resistance during rising is similar to that observed at the onset of leg exercise and is absent during head-up tilting. It is attributed to vasodilatation in the working muscle through local mechanisms. Standing up causes an initial increase in venous return through the effects of contraction of leg and abdominal muscles. The consequent sudden increase in right atrial pressure may contribute to the fall in systemic vascular resistance through a reflex effect. This review alerts clinicians and clinician scientists to a common, yet often neglected, condition that occurs only upon an active change of posture and discusses its epidemiology, pathophysiology and management.<\/jats:p>","DOI":"10.1042\/cs20060091","type":"journal-article","created":{"date-parts":[[2007,3,15]],"date-time":"2007-03-15T05:38:01Z","timestamp":1173937081000},"page":"157-165","update-policy":"https:\/\/doi.org\/10.1042\/crossmark_policy","source":"Crossref","is-referenced-by-count":333,"title":["Initial orthostatic hypotension: review of a forgotten condition"],"prefix":"10.1042","volume":"112","author":[{"given":"Wouter","family":"Wieling","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Academic Medical Center\/University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.\u00a0T.\u00a0Paul","family":"Krediet","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Academic Medical Center\/University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nynke","family":"van\u00a0Dijk","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Academic Medical Center\/University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Clinical Epidemiology and Biostatistics (NvD), Academic Medical Center\/University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Linzer","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Wisconsin, Madison, Wisconsin, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael\u00a0E.","family":"Tschakovsky","sequence":"additional","affiliation":[{"name":"School of Physical and Health Education, Queen's University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"288","published-online":{"date-parts":[[2007,1,3]]},"reference":[{"key":"2021120120410166400_B1","first-page":"1","article-title":"Abnormal static circulatory phenomena and their symptoms: arterial orthostatic anemia as neglected clinical picture","volume":"33","author":"Bjure","year":"1927","journal-title":"Upsala L\u00e4karef\u00f6ren. 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