Orthostatic hypotension (OH) results from a failure of neural and circulatory mechanisms to compensate for the reduction in venous return that normally occurs on assuming the upright posture. OH is defined as a fall in systolic blood pressure of at least 20 mm Hg or diastolic blood pressure of at least 10 mm Hg measured within 3 minutes of standing.1 OH can result from side effect of medications, intravascular volume loss, systemic diseases that involve autonomic nerves (e.g., diabetes mellitus or amyloidosis), and in rare cases it can be the initial sign of a primary autonomic failure syndrome (multiple system atrophy, pure autonomic failure and Parkinson`s disease). Severe OH can be a dramatic medical condition, with affected patients unable to stand but for few seconds before disabling symptoms of cerebral hypoperfusion and syncope ensue. Asymptomatic OH is a far more common condition, but one that is often unrecognized. It is a frequent finding in the elderly with prevalence reported between 6% to 35% or more, depending on the age group and associated co-morbidities