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Updated: May 25, 2026

Quantitative Autonomic Testing
Published on: July 19, 2011
Alterations in cardiovascular autonomic function tests in idiopathic hyperhidrosis
Milena De Marinis1, Elisa Colaizzo, Rosa Anna Nives Petrelli
1Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy. m.de.marinis@mclink.it
Idiopathic hyperhidrosis involves complex autonomic dysfunction, with patients showing increased parasympathetic function and a higher risk of postural hypotension, potentially linked to dehydration and severe sweating.
Area of Science:
- Cardiology
- Autonomic Neuroscience
- Dermatology
Background:
- Idiopathic hyperhidrosis is characterized by excessive sweating without a known cause.
- Autonomic nervous system dysfunction may contribute to hyperhidrosis symptoms.
- Cardiovascular autonomic function in hyperhidrosis patients requires further investigation.
Purpose of the Study:
- To assess sympathetic and parasympathetic nervous system functions in patients with idiopathic hyperhidrosis.
- To investigate the relationship between hyperhidrosis, postural hypotension, and autonomic responses.
- To explore potential contributing factors like dehydration in severe cases.
Main Methods:
- Cardiovascular autonomic function tests were conducted on 35 patients with idiopathic hyperhidrosis and 35 controls.
- Tests included orthostatism, tilt tests, cold pressor test, deep breathing, Valsalva maneuver, and hyperventilation.
- Thermoregulatory sweat tests (TST) evaluated sweating quantitatively (skin conductance) and qualitatively.
Main Results:
- Patients exhibited greater blood pressure falls during upright tests compared to controls (p<0.05).
- 34% of patients had postural hypotension, with significantly greater blood pressure and heart rate changes (p<0.001).
- Patients showed markedly increased parasympathetic function (p<0.001) and a correlation between skin conductance and postural hypotension.
Conclusions:
- Idiopathic hyperhidrosis is a complex autonomic dysfunction involving pathways beyond sweating.
- Postural hypotension in severe hyperhidrosis may be exacerbated by dehydration and pronounced sweating.
- Increased parasympathetic activity is a significant finding in idiopathic hyperhidrosis patients.
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