Neurogenic Orthostatic Hypotension in Parkinson Disease: A Primer

Autor: Jeremy K. Cutsforth-Gregory, Phillip A. Low
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Neurology and Therapy, Vol 8, Iss 2, Pp 307-324 (2019)
Druh dokumentu: article
ISSN: 2193-8253
2193-6536
DOI: 10.1007/s40120-019-00152-9
Popis: Abstract Abstract Parkinson disease (PD) is associated with a variety of motor and non-motor clinical manifestations, including cardiovascular autonomic dysfunction. Neurogenic orthostatic hypotension (nOH) is a potentially serious manifestation of cardiovascular sympathetic failure that occurs in approximately 30% of patients with PD. Here we review the pathophysiology and effects of the condition as well as treatment considerations for patients with PD and nOH. Screening for nOH using orthostatic symptom questionnaires, orthostatic blood pressure measurements, and specialized autonomic testing is beneficial for the identification of symptomatic and asymptomatic cases because cardiac sympathetic denervation and nOH can occur even at early (premotor) stages of PD. Symptoms of nOH, such as orthostatic lightheadedness, in patients with PD, have been shown to adversely affect patient safety (with increased risk of falls) and quality of life and should prompt treatment with non-pharmacologic and, occasionally, pharmacologic measures. Patients with nOH are also at increased risk of supine hypertension, which requires balancing various management strategies. Funding Lundbeck (Deerfield, IL).
Databáze: Directory of Open Access Journals
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