Related Experiment Video
Updated: May 16, 2026
14:09
Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
Neurogenic orthostatic hypotension: pathophysiology, evaluation, and management
Manuela Metzler1, Susanne Duerr, Roberta Granata
1Autonomic Function Laboratory, Division of Neurobiology, Department of Neurology, Innsbruck Medical University, Anichstrasse 35, Innsbruck, Austria.
Journal of Neurology
|November 27, 2012
Summary
Neurogenic orthostatic hypotension, a sign of autonomic dysfunction, stems from noradrenergic neurotransmission failure. This review covers its presentation, causes, and management, particularly in neurodegenerative conditions.
Area of Science:
- Cardiovascular autonomic dysfunction
- Neurodegenerative disorders
- Autonomic neuropathies
Background:
- Neurogenic orthostatic hypotension (NOH) is a treatable cardiovascular autonomic dysfunction.
- It results from noradrenergic neurotransmission failure in various autonomic disorders.
- NOH often co-occurs with bowel and bladder dysregulation.
Purpose of the Study:
- To review the clinical presentation of NOH.
- To explore the pathophysiology and epidemiology of NOH.
- To outline the evaluation and management strategies for NOH, with a focus on neurodegenerative conditions.
Main Methods:
- Literature review of neurogenic orthostatic hypotension.
- Focus on neurodegenerative disorders associated with autonomic failure.
- Synthesis of information on clinical presentation, pathophysiology, epidemiology, evaluation, and management.
Main Results:
- NOH is linked to pure autonomic failure, Parkinson's disease with autonomic failure, multiple system atrophy, and diabetic/nondiabetic autonomic neuropathies.
- Autonomic dysregulation in other systems (bowel, bladder) is common.
- The review consolidates current knowledge on NOH.
Conclusions:
- Neurogenic orthostatic hypotension is a key indicator of underlying autonomic disorders.
- Effective management strategies exist, especially when focusing on neurodegenerative causes.
- Further research and clinical attention are warranted for comprehensive patient care.
Related Concept Videos
01:30Alterations in Blood Pressure
Alterations in blood pressure, such as hypertension (high blood pressure) and hypotension (low blood pressure), significantly affect human health. Understanding these conditions' classifications, causes, and symptoms is essential for effective management and treatment.
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart beats)...
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart beats)...
01:23Hypertension V: Nursing Management
The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
01:29Hypertension II: Pathophysiology
Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
01:25Dysrhythmias VII: Nursing Management of Dysrhythmias
Nursing management of dysrhythmias involves the following:AssessmentSubjective Assessment:The initial step involves gathering patient-reported symptoms such as dizziness, palpitations, and chest discomfort. It is crucial to collect a detailed history, including previous heart conditions, current medication use, and lifestyle factors like caffeine and alcohol consumption.Objective Assessment:This involves observing clinical signs such as jugular venous distention, cool and pale skin, and...
01:18Hypertension and Regulation of Blood Pressure
Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...