Orthostatic hypotension can be a real challenge in medicine and often occurs in elderly patients, with comorbidities- especially those for which the autonomic nervous system has started to breakdown, and often on other medication. We often get stuck between giving BOTH anti-hypertensive medicines for when they go too high - often in the lying down position -- and medicine to increase blood pressure like Fludrocortisone, Midodrine or Salt Tabs for when people are up and about... though the medicine effect durations don't really make it easy to time administration that way. It can often feel like being stuck between a rock and a hard place. From what I've read about the Yohimbine constituent- it seems to increase the Norepinephrine/block Alpha2receptors and so would have a BP increasing effect... I am curious if Yohimbe as a whole herb would be expected to have the same problem or if it might be more 'modulatory' to blood pressure thereby having some therapeutic potential for some of the above challenging cases? If not, would you think of better herbs for 'normalizing' blood pressure in those situations rather than just ones that increase or decrease blood pressure?

It is not modulatory to BP and is CI with many medications, I very rarely use it , it is more like a drug than most herbs. I would try using cardiovascular trophorestoratives like Hawthorn, Cactus, small amounts of Asian white Ginseng, Arjuna, Amla, Astragalus, Dang Gui, possibly Rhodiola (all of course depending on the specifics of the patient)