The clinical significance of vestibular system hemodynamic control

Aims: The otoliths of the vestibular system in the inner ear not only provide sensory information for body movements and balance but also have indirect autonomic effects. Vestibular dysfunction has clinical significance in a wide range of disorders including bone hemostasis, cognitive function, and cardiovascular system. This study aimed to discuss only the clinical significance of vestibular system hemodynamic control and the consequences of its dysfunction in orthostasis. Methods: The time window for this review was 1990-2024, and the databases used included Google Scholar, PubMed, Scopus, and Web of Science. Only full-text articles in English were cited. Findings: Recent evidences indicated vestibular-induced sympathetic activation and shifted the hypothesis of vestibular feed-forward control of blood pressure during orthostasis toward a well-documented fact. As an input source for cardiovascular reflexes, the vestibular system must be considered in etiologies, pathogenesis, diagnosis, and therapeutic interventions of orthostatic intolerance states. Conclusion: The vestibular system by itself has clinical significance in managing patients suffering from orthostatic hypotension and syncope. Vestibular dysfunction may be one of the underlying causes of orthostatic hypotension.