Davis, S D, Kator, S F, Wonnett, J A et al. · The American journal of the medical sciences · 2000 · DOI
This study tested whether fatigued Gulf War veterans have problems with blood pressure control when standing up quickly (a condition called neurally mediated hypotension), similar to what researchers have seen in ME/CFS patients. The researchers tilted 14 fatigued Gulf War veterans on a special table and compared their responses to two groups of unfatigued veterans and non-veterans. They found that fatigued veterans were more likely to experience dangerous drops in blood pressure during the test, suggesting their autonomic nervous system (the part that automatically controls heart rate and blood pressure) may not be working properly.
This study provides evidence that fatigued Gulf War veterans share a specific physiological abnormality—neurally mediated hypotension—with ME/CFS patients, suggesting a possible common biological mechanism underlying chronic fatigue. Understanding autonomic dysfunction could help explain why ME/CFS patients experience symptoms like dizziness, brain fog, and reduced exercise tolerance. This finding may eventually lead to targeted treatments for autonomic problems in ME/CFS.
This study does not prove that neurally mediated hypotension causes ME/CFS, only that the two conditions may co-occur. The small sample size (14 fatigued veterans) limits generalizability to all Gulf War veterans or ME/CFS patients. The cross-sectional design cannot establish whether autonomic dysfunction develops before, during, or after fatigue symptoms onset.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Davis, S D, Kator, S F, Wonnett, J A, Pappas, B L, & Sall, J L (2000). Neurally mediated hypotension in fatigued Gulf War veterans: a preliminary report.. The American journal of the medical sciences. https://doi.org/10.1097/00000441-200002000-00004
BibTeX
@article{mecfsatlas-davis-2000-neurally-mediated,
author = {Davis, S D and Kator, S F and Wonnett, J A and Pappas, B L and Sall, J L},
title = {Neurally mediated hypotension in fatigued Gulf War veterans: a preliminary report.},
journal = {The American journal of the medical sciences},
year = {2000},
doi = {10.1097/00000441-200002000-00004},
note = {PubMed: 10698092},
url = {https://www.mecfsatlas.com/evidence/davis-2000-neurally-mediated},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/davis-2000-neurally-mediated
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