A case of neurogenic orthostatic hypertension

A patient with orthostatic hypertension of neurogenic origin is reported. The Schellong and head-up tilt tests produced a sudden moderate to marked increase of the blood pressure, but the plasma renin activity and plasma aldosterone level showed a normal response. The cold pressor test also produced a moderate to marked increase in the blood pressure. Pharmacological cardiovascular autonomic nervous function tests showed a decrease of parasympathetic tone and denervation hypersensitivity of the sympathetic nerve terminals. These findings suggest that the orthostatic hypertension in this patient was mainly due to sympathetic denervation hypersensitivity.