{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:48:46Z","timestamp":1753876126223,"version":"3.41.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Primary autonomic failure (PAF) or Bradbury Eggleston syndrome is a neurodegenerative disorder of the autonomic nervous system characterized by orthostatic hypotension.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We report the case of a 76-year-old patient with a history of hypertension, who presented with exercise-induced fatigue. He exhibited systolic hypertension and resting bradycardia in the supine position, with orthostatic hypotension without reactive tachycardia, suggesting dysautonomia. Neurological examination was unremarkable. The patient underwent cardiovascular autonomic testing, revealing evidence of beta-sympathetic deficiency associated with neurogenic orthostatic hypotension. Causes of secondary dysautonomia were excluded. The patient was diagnosed with PAF. Even if managing the combination of supine hypertension and orthostatic hypotension was challenging, significant improvements in functional and haemodynamic status were observed with a personalized management approach.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Throughout this case report, we emphasize the critical need for an evaluation of autonomic function and blood pressure\u2019s dynamics in hypertensive patients experiencing orthostatic symptoms, enabling the implementation of tailored therapeutic strategies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae073","type":"journal-article","created":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T15:02:45Z","timestamp":1707145365000},"source":"Crossref","is-referenced-by-count":0,"title":["Primary autonomic failure: a complex case of orthostatic hypotension in a hypertensive elderly patient"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7895-062X","authenticated-orcid":false,"given":"Samah","family":"El-Mhadi","sequence":"first","affiliation":[{"name":"Cardiology A Department, Ibn Sina University Hospital Center , Rabat , Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Najat","family":"Mouine","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mohammed V Military Hospital , Rabat , Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Halima","family":"Benjelloun","sequence":"additional","affiliation":[{"name":"Cardiology A Department, Ibn Sina University Hospital Center , Rabat , Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Souad","family":"Aboudrar","sequence":"additional","affiliation":[{"name":"Exercise physiology and autonomic nervous system team, Laboratory of Physiology, Mohammed V University , Rabat , Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustapha","family":"El Bakkali","sequence":"additional","affiliation":[{"name":"Exercise physiology and autonomic nervous system team, Laboratory of Physiology, Mohammed V University , Rabat , Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,2,5]]},"reference":[{"key":"2024022817033519900_ytae073-B1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/S0002-8703(25)90007-5","article-title":"Postural hypotension: a report of three cases","volume":"1","author":"Bradbury","year":"1925","journal-title":"Am Heart J"},{"key":"2024022817033519900_ytae073-B2","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1002\/ana.24877","article-title":"Natural history of pure autonomic failure: a United States prospective cohort","volume":"81","author":"Kaufmann","year":"2017","journal-title":"Ann Neurol"},{"key":"2024022817033519900_ytae073-B3","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1212\/WNL.46.5.1470","article-title":"Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. The consensus committee of the American Autonomic Society and the American Academy of Neurology","volume":"46","year":"1996","journal-title":"Neurology"},{"key":"2024022817033519900_ytae073-B4","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1212\/WNL.0000000000003737","article-title":"Pure autonomic failure: predictors of conversion to clinical CNS involvement","volume":"88","author":"Singer","year":"2017","journal-title":"Neurology"},{"key":"2024022817033519900_ytae073-B5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1212\/WNL.31.1.1","article-title":"Pharmacologic distinction of different orthostatic hypotension syndromes","volume":"31","author":"Polinsky","year":"1981","journal-title":"Neurology"},{"key":"2024022817033519900_ytae073-B6","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1007\/s10286-018-0529-8","article-title":"Consensus statement on the definition of neurogenic supine hypertension in cardiovascular autonomic failure by the American Autonomic Society (AAS) and the European Federation of Autonomic Societies (EFAS): endorsed by the European Academy of Neurology (EAN) and the European Society of Hypertension (ESH)","volume":"28","author":"Fanciulli","year":"2018","journal-title":"Clin Auton Res"},{"key":"2024022817033519900_ytae073-B7","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1007\/s00415-016-8375-x","article-title":"The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension","volume":"264","author":"Gibbons","year":"2017","journal-title":"J Neurol"},{"key":"2024022817033519900_ytae073-B8","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1016\/j.mayocp.2019.03.009","article-title":"Pure autonomic failure","volume":"94","author":"Coon","year":"2019","journal-title":"Mayo Clin Proc"},{"key":"2024022817033519900_ytae073-B9","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1001\/archneur.63.4.noc50340","article-title":"Pyridostigmine treatment trial in neurogenic orthostatic hypotension","volume":"63","author":"Singer","year":"2006","journal-title":"Arch Neurol"},{"key":"2024022817033519900_ytae073-B10","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.pharmthera.2011.05.009","article-title":"Pharmacotherapy of autonomic failure","volume":"134","author":"Shibao","year":"2012","journal-title":"Pharmacol Ther"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytae073\/56585369\/ytae073.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/8\/2\/ytae073\/56777785\/ytae073.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/8\/2\/ytae073\/56777785\/ytae073.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T17:04:26Z","timestamp":1709139866000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytae073\/7601057"}},"subtitle":[],"editor":[{"given":"Silvia","family":"Castelletti","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Panteleimon E","family":"Papakonstantinou","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Luke Joseph","family":"Laffin","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Ralph Mark Louis","family":"Neijenhuis","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,2,1]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytae073","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2024,2]]},"published":{"date-parts":[[2024,2,1]]},"article-number":"ytae073"}}