Background/Objectives: Patients with postural orthostatic tachycardia syndrome (POTS) or neurogenic orthostatic hypotension (nOH) experience vertigo, confusion, and syncope. Compression garments help reduce venous pooling in these patients, thereby increasing cardiac output. We aimed to determine end-user opinions of compression products intended to alleviate symptoms for POTS and nOH. Methods: This was a survey study sampling participants diagnosed with POTS or nOH. The data collected included demographics, medical history, and compression garments previously used. The participants rated their most frequently used garment across comfort, aesthetic appeal, ease of use, durability, cost-effectiveness, efficacy, and consistency on the Likert scale (1–5). One-way ANOVA was used to compare the design criteria ratings across garments. For all tests α = 0.05. Results: Of the 330 POTS and 28 nOH participants surveyed (mean age 37.9, mean BMI 27.5, 95.0% women, 90.5% White), 354 (98.9%) reported trying at least one compression garment since their diagnosis. The majority of participants reported using leg compression most frequently rather than shapewear or abdominal compression (65.4% vs. 20.1% vs. 13.4%, respectively). Approximately 67.0% of participants tried multiple product types. Shapewear was reported to have greater concealability compared to abdominal or leg compression garments (mean 3.43 vs. 2.90 vs. 2.91, respectively; p < 0.01). Shapewear and abdominal compression were rated to be less comfortable compared to leg compression (2.67 vs. 2.94 vs. 3.05, respectively; p = 0.03). Conclusions: The existing compression products do not fully meet needs of individuals with POTS or nOH, as evidenced by participant ratings on multiple domains. There is potential consumer demand for novel adjustable abdominal compression garments that are low-profile and comfortable when disengaged.

A 52-year-old man with ischemic cardiomyopathy presented with progressive, severe orthostatic hypotension refractory to medical therapy. Standard abdominal and leg compression devices were used without success. A novel, inflatable abdominal compression device was created that alleviated the patient's symptoms and maintained his blood pressure.

Introduction: Abdominal compression is recommended to manage orthostatic intolerance in dysautonomia, but the hemodynamic effects of different compression parameters remain poorly understood. This study investigated how surface area and pressure magnitude of abdominal compression affect blood pressure and heart rate responses during active stand tests in healthy volunteers. Understanding how abdominal compression modulates hemodynamics during standing in healthy individuals will help us better understand how compression can be optimized to benefit those with dysautonomia. Methods: Two compression devices were developed: one applying circumferential pressure (40 mmHg) over a higher surface area (HSA), and another applying focal pressure to the epigastrium at either 95 mmHg (LSA-LP) or 140 mmHg (LSA-HP). Forty-seven healthy participants completed randomized 3-min active stand tests with each device and a control condition. Heart rate was measured immediately upon standing (0 min) and at 15 s, 30 s, 1 min, 2 min, and 3 min afterward. Blood pressure was measured at 1-min intervals. All measurements were normalized to supine baseline values and presented as mean ± SEM. Results: All compression modalities significantly reduced the initial heart rate increase immediately upon standing compared to control (HSA: 2.0 ± 1.1 bpm, LSA-LP: 1.8 ± 1.0 bpm, LSA-HP: 2.7 ± 1.7 bpm vs. control: 6.0 ± 1.2 bpm; all p < 0.01). HSA compression showed greater hemodynamic effects than LSA-LP, with a significantly lower normalized heart rate at 0 min (p = 0.031). HSA compression was associated with higher systolic blood pressure compared to control at 3 min (7.2 ± 0.9 vs. 3.6 ± 0.9 mmHg; p = 0.006), and LSA-HP at 1 min (7.2 ± 1.0 vs. 3.8 ± 1.5 mmHg; p = 0.049). No significant differences were found between LSA-HP and LSA-LP across any timepoint. Discussion: Surface area appears to be a more critical factor than pressure magnitude in stabilizing hemodynamics during orthostatic stress, with significant effects observed immediately upon standing. These findings provide physiological insights for optimizing compression therapy in orthostatic disorders and suggest that wider-area compression garments may offer superior hemodynamic benefits compared to focal compression.