Abstract
Orthostatic hypotension is a condition commonly affecting the elderly and is often accompanied by disabling presyncopal symptoms, syncope and impaired quality of life. The pathophysiology of orthostatic hypotension is linked to abnormal blood pressure regulatory mechanisms and autonomic insufficiency. As part of its diagnostic evaluation, a comprehensive history and medical examination focused on detecting symptoms and physical findings of autonomic neuropathy should be performed. In individuals with substantial falls in blood pressure upon standing, autonomic function tests are recommended to detect impairment of autonomic reflexes. Treatment should always follow a stepwise approach with initial use of nonpharmacologic interventions including avoidance of hypotensive medications, high-salt diet and physical counter maneuvers. If these measures are not sufficient, medications such as fludrocortisone and midodrine can be added. The goals of treatment are to improve symptoms and to make the patient as ambulatory as possible instead of targeting arbitrary blood pressure values.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 304-312 |
| Number of pages | 9 |
| Journal | Current Hypertension Reports |
| Volume | 15 |
| Issue number | 4 |
| DOIs | |
| State | Published - Aug 1 2013 |
Fingerprint
All Science Journal Classification (ASJC) codes
- Internal Medicine
Cite this
}
Current concepts in orthostatic hypotension management. / Arnold, Amy; Shibao, Cyndya.
In: Current Hypertension Reports, Vol. 15, No. 4, 01.08.2013, p. 304-312.Research output: Contribution to journal › Article
TY - JOUR
T1 - Current concepts in orthostatic hypotension management
AU - Arnold, Amy
AU - Shibao, Cyndya
PY - 2013/8/1
Y1 - 2013/8/1
N2 - Orthostatic hypotension is a condition commonly affecting the elderly and is often accompanied by disabling presyncopal symptoms, syncope and impaired quality of life. The pathophysiology of orthostatic hypotension is linked to abnormal blood pressure regulatory mechanisms and autonomic insufficiency. As part of its diagnostic evaluation, a comprehensive history and medical examination focused on detecting symptoms and physical findings of autonomic neuropathy should be performed. In individuals with substantial falls in blood pressure upon standing, autonomic function tests are recommended to detect impairment of autonomic reflexes. Treatment should always follow a stepwise approach with initial use of nonpharmacologic interventions including avoidance of hypotensive medications, high-salt diet and physical counter maneuvers. If these measures are not sufficient, medications such as fludrocortisone and midodrine can be added. The goals of treatment are to improve symptoms and to make the patient as ambulatory as possible instead of targeting arbitrary blood pressure values.
AB - Orthostatic hypotension is a condition commonly affecting the elderly and is often accompanied by disabling presyncopal symptoms, syncope and impaired quality of life. The pathophysiology of orthostatic hypotension is linked to abnormal blood pressure regulatory mechanisms and autonomic insufficiency. As part of its diagnostic evaluation, a comprehensive history and medical examination focused on detecting symptoms and physical findings of autonomic neuropathy should be performed. In individuals with substantial falls in blood pressure upon standing, autonomic function tests are recommended to detect impairment of autonomic reflexes. Treatment should always follow a stepwise approach with initial use of nonpharmacologic interventions including avoidance of hypotensive medications, high-salt diet and physical counter maneuvers. If these measures are not sufficient, medications such as fludrocortisone and midodrine can be added. The goals of treatment are to improve symptoms and to make the patient as ambulatory as possible instead of targeting arbitrary blood pressure values.
UR - http://www.scopus.com/inward/record.url?scp=84880921952&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84880921952&partnerID=8YFLogxK
U2 - 10.1007/s11906-013-0362-3
DO - 10.1007/s11906-013-0362-3
M3 - Article
C2 - 23832761
AN - SCOPUS:84880921952
VL - 15
SP - 304
EP - 312
JO - Current Hypertension Reports
JF - Current Hypertension Reports
SN - 1522-6417
IS - 4
ER -