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Neurogenic Orthostatic Hypotension in Parkinson Disease: A Primer
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 approxima...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Healthcare
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946781/ https://www.ncbi.nlm.nih.gov/pubmed/31456212 http://dx.doi.org/10.1007/s40120-019-00152-9 |
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author | Cutsforth-Gregory, Jeremy K. Low, Phillip A. |
author_facet | Cutsforth-Gregory, Jeremy K. Low, Phillip A. |
author_sort | Cutsforth-Gregory, Jeremy K. |
collection | PubMed |
description | 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). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40120-019-00152-9) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6946781 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-69467812020-01-30 Neurogenic Orthostatic Hypotension in Parkinson Disease: A Primer Cutsforth-Gregory, Jeremy K. Low, Phillip A. Neurol Ther Review 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). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40120-019-00152-9) contains supplementary material, which is available to authorized users. Springer Healthcare 2019-08-27 /pmc/articles/PMC6946781/ /pubmed/31456212 http://dx.doi.org/10.1007/s40120-019-00152-9 Text en © The Author(s) 2019 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Review Cutsforth-Gregory, Jeremy K. Low, Phillip A. Neurogenic Orthostatic Hypotension in Parkinson Disease: A Primer |
title | Neurogenic Orthostatic Hypotension in
Parkinson Disease: A Primer |
title_full | Neurogenic Orthostatic Hypotension in
Parkinson Disease: A Primer |
title_fullStr | Neurogenic Orthostatic Hypotension in
Parkinson Disease: A Primer |
title_full_unstemmed | Neurogenic Orthostatic Hypotension in
Parkinson Disease: A Primer |
title_short | Neurogenic Orthostatic Hypotension in
Parkinson Disease: A Primer |
title_sort | neurogenic orthostatic hypotension in
parkinson disease: a primer |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946781/ https://www.ncbi.nlm.nih.gov/pubmed/31456212 http://dx.doi.org/10.1007/s40120-019-00152-9 |
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