Hypotension
<p>From: <a href="https://www.hindawi.com/journals/isrn/2013/784520/">A Review of Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Fatigue Syndrome</a></p>
<p>A vascular aetiology of CFS has also been proposed. This is a current research interest of our group and is exemplified by the relationship and overlap between CFS and postural orthostatic tachycardia syndrome (POTS) [<a href="https://www.hindawi.com/journals/isrn/2013/784520/#B79">79</a>, <a href="https://www.hindawi.com/journals/isrn/2013/784520/#B80">80</a>] which typically presents with fatigue, dizziness, and an inability to exercise. HPA axis dysregulation, particularly hypocortisolaemia, can cause hypotension and may possibly mediate the fatigue experienced by CFS patients by inducing orthostatic hypotension and hence reducing cerebral perfusion [<a href="https://www.hindawi.com/journals/isrn/2013/784520/#B81">81</a>].</p>
<p>From: The connection between chronic fatigue syndrome and neurally mediated hypotension
<a id="null" class="null" href="https://www.mdedge.com/sites/default/files/issues/articles/media_1e554cf_ccjm65_5-0261.pdf">https://www.mdedge.com/sites/default/files/issues/articles/media_1e554cf_ccjm65_5-0261.pdf</a></p>
<p>Rowe and colleagues at Johns Hopkins University1 described seven consecutive nonsyncopal adolescents with chronic postexertional fatigue, who experienced significant hypotension during upright tilt-table testing. Four of these patients satisfied strict criteria for chronic fatigue syndrome. The same investigators subsequently described 23 adult patients with strictly defined chronic fatigue syndrome, 22 of whom experienced abnormal responses to upright tilt testing.2 Only 4 of 14 control patients in this study experienced an abnormal response. The most consistent pattern in these studies was the vasovagalreaction.1 . 2 Patients with chronic fatigue syndrome did not differ from control subjects in their mean blood pressure before the test: 119/72 mm Hg in the chronic fatigue group, vs 118/75 in the control group. However, at termination, the mean blood pressure had decreased to 65/38 mm Hg in the chronic fatigue group, vs 118/66 in the control group (P < .001). Similarly, the mean heart rate at baseline was 75 in the chronic fatigue group and 68 in the control group; at termination, the mean heart rate was 77 in patients with chronic fatigue syndrome, vs 120 in the control group.2</p>