Identifying novel pathomechanisms in classical orthostatic hypotension using unbiased, large-scale, plasma proteomic profiling

Orthostatic hypotension (OH) is defined as a sustained decrease in blood pressure (BP) upon assuming upright posture. OH is a hallmark of failure of the autonomic nervous system and associated with increased risk of falls, syncope, cardiovascular (CV) morbidity, and mortality. The diagnosis remains largely overlooked in clinical practice and epidemiological studies. Idiopathic OH occurs in nearly 40% of patients with moderate-to-severe OH despite extensive evaluation. Given the high prevalence of OH in the community, and the rapidly expanding older population, this is an area where further research is urgently needed. To date, the underlying pathomechanisms are not completely understood. Proteomics is a large-scale study of proteins that enables a systematic unbiased view on disease and health, allowing stratification of patients based on their protein background. We aim to investigate the proteomic profile and pathomechanisms associated with classical orthostatic hypotension in this cross-sectional, case-control study. This study will aid in identifying underlying pathomechanisms that are currently largely unexplored in orthostatic hypotension, allowing stratification of patients based on their protein background.