Objective: To determine the efficacy and safety of non-pharmacological interventions for orthostatic hypotension (OH) secondary to aging. Methods: A total of 150 orthostatic challenges were performed in 25 older people (60-92 years) to determine cardiovascular responses to bolus-water drinking, compression stockings, abdominal compression and physical counter-manoeuvres. Primary outcome was response rate, as assessed by proportion of participants whose systolic drop improved by ≥10 mmHg. Results: The response rate to bolus water drinking was 56% (95% confidence interval 36.7, 74.2), with standing systolic BP (SBP) increasing by 12 mmHg (95%CI 4, 20). Physical counter-manoeuvres were efficacious in 44% (95%CI 25.8, 63.3) but had little effect on standing SBP [+7.5 mmHg (95%CI -1, 16)]. Abdominal compression was efficacious in 52% (95%CI 32.9, 70.7) and improved standing SBP [+10 mmHg (95%CI 2, 8). Compression stockings were the least efficacious therapy, 32% (95%CI 16.1, 51.4) and had little effect on standing SBP [+6 mmHg (95%CI -1, 13). No intervention improved symptoms during standing. There were no adverse events. Conclusions: Bolus water drinking should become the standard first line non-pharmacological intervention, whereas compression stockings should be disregarded in this population. Classification of Evidence: This study provides Class III evidence that for older people with orthostatic hypotension, bolus water drinking is superior to other non-pharmacological interventions in decreasing systolic BP drop.