Orthostatic intolerance and the postural tachycardia syndrome: Genetic and environment pathophysiologies

David Robertson, John R. Shannon, Italo Biaggioni, Andrew C. Ertl, André Diedrich, Robert Carson, Raffaello Furlan, Giris Jacob, Jens Jordan

Research output: Contribution to journalArticlepeer-review


Orthostatic intolerance is a common problem for inbound space travelers. There is usually tachycardia on standing but blood pressure may be normal, low or, rarely, elevated. This condition is analogous to the orthostatic intolerance that occurs on Earth in individuals with orthostatic tachycardia, palpitations, mitral valve prolapse, and light-headedness. Our studies during the Neurolab mission indicated that sympathetic nerve traffic is raised in microgravity and that plasma norepinephrine is higher than baseline supine levels but lower than baseline upright levels. A subgroup of patients with familial orthostatic intolerance differ from inbound space travelers in that they have an alanine-to-to-proline mutation at amino acid position 457 in their norepinephrine transporter gene. This leads to poor clearance of norepinephrine from synapses, with consequent raised heart rate. Clinical features of these syndromes are presented.

Original languageEnglish
JournalPflugers Archiv European Journal of Physiology
Issue number2-3 SUPPL.
Publication statusPublished - 2001


  • Autonomic
  • Microgravity
  • Orthostatic intolerance
  • Postural tachycardia syndrome
  • Sympathetic

ASJC Scopus subject areas

  • Physiology


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