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Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
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Heart failure and orthostatic hypotension.

Oleg Gorelik1, Leonid Feldman2, Natan Cohen3

  • 1Department of Internal Medicine "F", Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Zerifin, 70300, Israel. internal6@asaf.health.gov.il.

Heart Failure Reviews
|February 17, 2016
PubMed
Summary

Orthostatic hypotension (OH), a common issue in heart failure (HF), presents challenges in management. Non-pharmacologic interventions are often preferred due to adverse effects of medications in HF patients.

Keywords:
Blood pressureHeart failureOrthostatic hypotensionPostural hypotension

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Area of Science:

  • Cardiology
  • Nephrology
  • Geriatrics

Background:

  • Orthostatic hypotension (OH) is defined as a significant drop in blood pressure upon standing.
  • OH frequently co-occurs with heart failure (HF), impacting patient health.
  • A comprehensive review on the HF-OH relationship is lacking.

Purpose of the Study:

  • To review the pathophysiology, evaluation, prevalence, risk factors, prognosis, and management of OH in HF patients.
  • To examine the incidence of HF in patients with OH.
  • To synthesize current information on the concomitant occurrence of HF and OH.

Main Methods:

  • Literature review of existing studies on OH and HF.
  • Analysis of prevalence data, risk factors, and prognostic implications.
  • Discussion of management strategies, including non-pharmacologic approaches.

Main Results:

  • OH prevalence in HF varies widely (8% to 83%) depending on the population.
  • HF severity, non-ischemic etiology, bed rest, hypertension, and polypharmacy are key risk factors for OH in HF.
  • OH is linked to an increased risk of developing HF.

Conclusions:

  • OH is a common and symptomatic comorbidity in HF patients.
  • Management of OH in HF often relies on non-pharmacologic interventions due to medication side effects.
  • Further longitudinal studies are needed to clarify the prognostic significance and optimal management of OH in HF.