Hemodynamic orthostatic dizziness/vertigo: clinical features, comorbidities, and complications in a tertiary care cohort

Background and objectives. Hemodynamic orthostatic dizziness/vertigo (HODV) is characterized by dizziness, unsteadiness, or vertigo triggered by postural changes due to hemodynamic instability. The diagnostic criteria for HODV were first introduced in 2019, and publications using these criteria are still limited. This study aimed to describe the profile and characteristics of HODV patients at the Neuro-ophthalmology and Neuro-otology Diagnostic Clinic (NONOT), Cipto Mangunkusumo Hospital (RSCM), from November 2021 to October 2024. It also evaluated associations between age, sex, comorbidities, and medication with HODV diagnosis according to the International Classification of Vestibular Disorders (ICVD), assessed associations with the type of orthostatic disorder, and analyzed complications in relation to ICVD HODV diagnosis. Materials and methods. This descriptive study included patients from the NONOT clinic, RSCM, between November 2021 and October 2024. Results. A total of 86 subjects (mean age 56.35 ± 16.70 years; 58.1% female) were enrolled. Vertigo was the most common symptom (43.0%), and 52.3% were diagnosed with definite HODV. Orthostatic hypertension (27.9%) was the most frequent orthostatic disorder. Common comorbidities included hypertension, diabetes mellitus, heart disease, chronic kidney disease, and Parkinson’s disease. Medications affecting orthostatic regulation and complications such as cerebral small vessel disease, syncope, falls, and injuries were identified. Conclusions. HODV is a prevalent and clinically significant condition. Application of ICVD criteria facilitates accurate diagnosis. Associations with comorbidities, medications, and complications highlight the importance of early recognition to reduce morbidity.