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Orthostatic hypotension: managing a difficult problem.

Pearl K Jones1, Brett H Shaw2, Satish R Raj2,3

  • 1a 1 Department of Neurology, University of Texas Health Sciences Center, San Antonio, TX, USA.

Expert Review of Cardiovascular Therapy
|October 3, 2015
PubMed
Summary
This summary is machine-generated.

Orthostatic hypotension (OH) causes hospitalizations and is linked to poor outcomes. Early diagnosis and treatment, focusing on neurogenic causes, are crucial for managing this condition and preventing complications.

Keywords:
Parkinson’s diseaseautonomic failureautonomic nervous systemdroxidopamultiple system atrophyorthostatic hypotensionorthostatic intoleranceperipheral neuropathy

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Area of Science:

  • Cardiology
  • Neurology
  • Geriatrics

Background:

  • Orthostatic hypotension (OH) is a common cause of hospitalization, morbidity, and mortality.
  • It increases the risk of cardiovascular events and falls.
  • Understanding neurogenic OH is vital for effective management.

Purpose of the Study:

  • To review the pathophysiology, clinical features, diagnostic work-up, and treatment of neurogenic orthostatic hypotension.
  • To emphasize the importance of identifying the etiology of OH.
  • To guide therapeutic strategies for OH patients.

Main Methods:

  • Literature review focusing on neurogenic orthostatic hypotension.
  • Analysis of diagnostic approaches including orthostatic vital signs, history, and physical examination.
  • Evaluation of non-pharmacologic and pharmacologic treatment options.

Main Results:

  • Neurogenic OH arises from central or peripheral lesions.
  • Initial evaluation involves vital signs, history, and physical exam.
  • Non-pharmacologic interventions are the first-line treatment, followed by medication selection.

Conclusions:

  • Accurate diagnosis of OH etiology is essential.
  • Management involves non-pharmacologic measures and targeted pharmacotherapy.
  • This review provides a comprehensive overview for clinicians managing neurogenic OH.