Academic literature on the topic 'Orthostatic hypotension (OH)'
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Journal articles on the topic "Orthostatic hypotension (OH)"
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Listratov, A. I., O. D. Ostroumova, E. V. Aleshkovich, and M. S. Chernyaeva. "Drug-induced orthostatic hypotension." Medical alphabet, no. 3 (April 15, 2022): 14–22. http://dx.doi.org/10.33667/2078-5631-2022-3-14-22.
Full textAbstract:
Orthostatic hypotension (OH) is one of the most significant symptoms in clinical practice. The development of OH in the short term is associated with such consequences as falls, decreased adherence to treatment, in the long term, OH is associated with dementia and an increase in overall mortality. One of the leading factors in the development of OH is drugs in this case, the term ‘drug-induced’ (DI) OH is used. The leading drugs that induce this symptom include antihypertensive drugs, vasodilators, as well as alpha-blockers and antidepressants. The risk factors for DI OH are old age, concomitant diseases, in particular arterial hypertension (AH). The question of OH in patients with AH is difficult. Оn the one hand, AH is a risk factor for OH, in addition, antihypertensive drugs are inducers of OH and an increase in the amount of antihypertensive drugs can lead to an increase in the risk of developing OH. On the other hand, optimal therapy for AH on the contrary, leads to a decrease in the severity of OH. The basis of the treatment of DI OH is the correction of therapy with the drug withdrawal or replacement. The leading methods of prevention and treatment are non-pharmacological, requiring the active participation of the patient – a certain algorithm for accepting an upright position, changing eating behavior and counter maneuvers. Pharmacological therapies play a minor role. Informing doctors, as well as the patients themselves, about the problem of DI OH plays an important role in the prevention of its consequences.
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Aksenova, A. V., Sh B. Gorieva, A. N. Rogoza, O. A. Sivakova, T. E. Esaulova, and I. E. Chazova. "State of the art for diagnosis and treatment of orthostatic hypotension." Systemic Hypertension 15, no. 2 (June 15, 2018): 32–42. http://dx.doi.org/10.26442/2075-082x_2018.2.32-42.
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This paper presents state of the art of the problem of diagnosis and treatment of orthostatic hypotension (OH). It focuses on the developed algorithms for diagnostics of classical orthostatic hypotension (COH), initial orthostatic hypotension (IOH) and delayed orthostatic hypotension (DOH). It describes the necessary methods for the differential diagnosis of the OH causes. Comparative analysis of the European Society of Cardiology and American College of Cardiology/American Heart Association/Society of Cardiac Rhythm was performed. The treatment options for different groups of patients with orthostatic hypotension are described.
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Hiorth, Ylva Hivand, Kenn Freddy Pedersen, Ingvild Dalen, Ole-Bjørn Tysnes, and Guido Alves. "Orthostatic hypotension in Parkinson disease." Neurology 93, no. 16 (September 16, 2019): e1526-e1534. http://dx.doi.org/10.1212/wnl.0000000000008314.
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ObjectiveTo determine the frequency, evolution, and associated features of orthostatic hypotension (OH) over 7 years of prospective follow-up in a population-based, initially drug-naive Parkinson disease (PD) cohort.MethodsWe performed repeated lying and standing blood pressure measurements in 185 patients with newly diagnosed PD and 172 matched normal controls to determine the occurrence of (1) OH using consensus-based criteria and (2) clinically significant OH (mean arterial pressure in standing position ≤75 mm Hg). We applied generalized estimating equations models for correlated data to investigate associated features of these 2 outcomes in patients with PD.ResultsOH was more common in patients with PD than controls at all visits, with the relative risk increasing from 3.0 (95% confidence interval [CI] 1.6–5.8; p < 0.001) at baseline to 4.9 (95% CI 2.4–10.1; p < 0.001) after 7 years. Despite a high cumulative prevalence of OH (65.4%) and clinically significant OH (29.2%), use of antihypotensive drugs was very rare (0.5%). OH was independently associated with older age (odds ratio [OR] 1.06 per year; 95% CI 1.03–1.10), lower Mini-Mental State Examination score (OR 0.91 [0.85–0.97] per unit), and longer follow-up time (OR 1.12 [1.03–1.23] per year). Clinically significant OH was associated with the same characteristics, in addition to higher levodopa equivalent dosage (OR 1.16 [1.07–1.25] per 100 mg).ConclusionsIn this population-based study, we found OH to be a very frequent but undertreated complication in early PD, with associations to both disease-specific symptoms and drug treatment. Our findings suggest that clinicians should more actively assess and manage OH abnormalities in PD.
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Schell, Kathleen, Denise Lyons, and Barry Bodt. "Orthostatic Hypotension and Falls in Hospitalized Older Adults." Clinical Nursing Research 30, no. 5 (January 10, 2021): 699–706. http://dx.doi.org/10.1177/1054773820986682.
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The aim of this retrospective study was to determine the prevalence of orthostatic hypotension (OH) among a convenience sample of older adults on two Acute Care of the Elderly (ACE) units of the ChristianaCare™ in Delaware. Another aim was to determine if subjects with documented OH experienced falls. Retrospective de-identified data was obtained from electronic medical records for the years 2015 to 2018. Among all patients who had valid first orthostatic vital sign (OVS) readings ( n = 7,745), 39.2% had orthostatic hypotension on the first reading. Among the patients, 42.8% were found to be hypotensive during OVS. Thirty-one (0.9%) of those with OH fell at some point during their stay. The odds ratio for falls in the presence of OH was 1.34 with a 95% confidence interval (0.82, 2.21), but a chi-square test failed to find significance ( p = .2494). The results could not determine if OVS should be mandatory in fall prevention protocols.
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Mar, Philip L., Cyndya A. Shibao, Emily M. Garland, Bonnie K. Black, Italo Biaggioni, André Diedrich, Sachin Y. Paranjape, David Robertson, and Satish R. Raj. "Neurogenic hyperadrenergic orthostatic hypotension: a newly recognized variant of orthostatic hypotension in older adults with elevated norepinephrine (noradrenaline)." Clinical Science 129, no. 2 (April 24, 2015): 107–16. http://dx.doi.org/10.1042/cs20140766.
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Neurogenic hyperadrenergic orthostatic hypotension (hyperOH) is neurogenic orthostatic hypotension (OH) that is associated with paradoxically elevated levels of norepinephrine (NE) (noradrenaline). This condition has not been extensively studied. Our study finds this population has less severe adrenergic dysfunction compared with classic OH populations.
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Shibao, Cyndya A., and Italo Biaggioni. "Management of Orthostatic Hypotension, Postprandial Hypotension, and Supine Hypertension." Seminars in Neurology 40, no. 05 (October 2020): 515–22. http://dx.doi.org/10.1055/s-0040-1713886.
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AbstractThis review provides recommendations for the treatment of neurogenic orthostatic hypotension (nOH), postprandial hypotension, and supine hypertension. It focuses on novel treatment strategies and new insights into the mechanism underlying these conditions. Our goal is to provide practical advice for clinicians on how to screen, diagnose, and treat these conditions with nonpharmacological and pharmacological approaches. For each disorder, we offered a stepwise recommendation on how to apply these new concepts to successfully ameliorate the symptoms associated with OH to prevent syncope and falls. The management of OH in patients who also have supine hypertension requires special considerations and pharmacotherapy. It is noteworthy that there are few therapeutic options for OH and only two Food and Drug Administration–approved drugs for the treatment of OH and nOH based on randomized clinical trials. We will use these studies to develop evidence-based guidelines for OH. The research is limited for postprandial hypotension and supine hypertension, and therefore the recommendations will be based on small studies, clinical expertise, and, above all, an understanding of the underlying pathophysiology.
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O'Brien, Michelle, Jennifer Britton, Miriam Clarke, and Orla Collins. "226 Staff Knowledge of Orthostatic Hypotension." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.136.
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Abstract Background The prevalence of orthostatic hypotension increases with age(1). The aim of this audit was to assess healthcare provider’s knowledge of identifying and measuring orthostatic hypotension (OH) in the acute setting. Early identification and management of OH is an important step to prevent adverse outcomes and improve patient’s overall functional performance. Methods Fifty-one questionnaires were distributed to a random selection of non-consultant doctors and nurses in our hospital. The questionnaires included questions regarding basic knowledge of OH and its measurement. Questions were based on international guidelines on the appropriate measurement and assessment of OH(1). An education session was then offered to junior doctors and nurses, and subsequently carried out by a senior nurse. Staff were educated on OH and how to correctly assess it. Doctors and nurses were subsequently reassessed using the same questionnaire. Results Initial results showed that many of the respondents were interns (37%) and nurses (35%). 94% of respondents had never received formal training in the evaluation of OH. 51% knew that a patient should lie supine for 5 minutes prior to initial BP assessment. 61% knew to take the BP at 1-minute post standing, and 45% knew that the BP should again be taken at 3 minutes. 71% knew to take the pulse alongside the BP checks. The education sessions and repeat audit are ongoing. Conclusion Many of the hospital staff who assess for OH have not received specific training on how to evaluate and diagnose OH. It is our aim to educate front line staff as to the importance of looking for OH and how to diagnose it.
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Park, Kee Hong. "Diagnosis of orthostatic hypotension in older people." Journal of Geriatric Neurology 1, no. 2 (September 15, 2022): 45–52. http://dx.doi.org/10.53991/jgn.2022.00094.
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Orthostatic hypotension (OH) can be classified to classic OH, delayed OH, initial OH, and delayed blood pressure recovery. It causes various symptoms such as lightheadedness, dizziness, visual blurring, and fall. Furthermore, the importance of OH is emphasized because it increases morbidity and mortality, especially in the elderly. Because neurogenic and non-neurologic components cause OH, an appropriate diagnosis is required to differentiate it.
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Fanciulli, Alessandra, Fabian Leys, Cristian Falup-Pecurariu, Roland Thijs, and Gregor K. Wenning. "Management of Orthostatic Hypotension in Parkinson’s Disease." Journal of Parkinson's Disease 10, s1 (September 1, 2020): S57—S64. http://dx.doi.org/10.3233/jpd-202036.
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Orthostatic hypotension (OH) is a common non-motor feature of Parkinson’s disease that may cause unexplained falls, syncope, lightheadedness, cognitive impairment, dyspnea, fatigue, blurred vision, shoulder, neck, or low-back pain upon standing. Blood pressure (BP) measurements supine and after 3 minutes upon standing screen for OH at bedside. The medical history and cardiovascular autonomic function tests ultimately distinguish neurogenic OH, which is due to impaired sympathetic nerve activity, from non-neurogenic causes of OH, such as hypovolemia and BP lowering drugs. The correction of non-neurogenic causes and exacerbating factors, lifestyle changes and non-pharmacological measures are the cornerstone of OH treatment. If these measures fail, pharmacological interventions (sympathomimetic agents and/or fludrocortisone) should be introduced stepwise depending on the severity of symptoms. About 50% of patients with neurogenic OH also suffer from supine and nocturnal hypertension, which should be monitored for with in-office, home and 24 h-ambulatory BP measurements. Behavioral measures help prevent supine hypertension, which is eventually treated with non-pharmacological measures and bedtime administration of short-acting anti-hypertensive drugs in severe cases. If left untreated, OH impacts on activity of daily living and increases the risk of syncope and falls. Supine hypertension is asymptomatic, but often limits an effective treatment of OH, increases the risk of hypertensive emergencies and, combined with OH, facilitates end-organ damage. A timely management of both OH and supine hypertension ameliorates quality of life and prevents short and long-term complications in patients with Parkinson’s disease.
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Soysal, Pinar, Suleyman Emre Kocyigit, Ozge Dokuzlar, Esra Ates Bulut, Lee Smith, and Ahmet Turan Isik. "Relationship between sarcopenia and orthostatic hypotension." Age and Ageing 49, no. 6 (July 2, 2020): 959–65. http://dx.doi.org/10.1093/ageing/afaa077.
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Abstract Background The relationship between sarcopenia and orthostatic hypotension (OH) is unclear. Objectives The aim of the present study was to investigate associations between sarcopenia/sarcopenia severity and OH. Design A total of 511 patients attending a geriatric outpatient clinic were included. OH was defined as a decrease in systolic and/or diastolic blood pressure of ≥ 20 mmHg and/or ≥ 10 mmHg, respectively, when one transitions from the supine to an upright position. OH was measured by the Head-up Tilt Table test at 1, 3 and 5 min (OH1, OH3 and OH5, respectively). Sarcopenia and its severity were defined according to the revised European consensus on definition and diagnosis. Results The mean age of the sample was 75.40 ± 7.35 years, and 69.9% were female. The prevalence of probable sarcopenia, sarcopenia and severe sarcopenia was 42.2%, 6.06% and 11.1%, respectively. After adjustment for all covariates, systolic OH1, OH1 and systolic OH5 were statistically significantly different between severe sarcopenia and the robust group (odds ratio [OR]: 3.26, confidence interval [CI] 0.98–10.84; P = 0.05 for systolic OH1; OR 4.31, CI 1.31–14.15; P = 0.016 for OH1; OR 4.09, CI 1.01–16.55; P = 0.048 for systolic OH5). Only systolic OH1 was statistically different between the sarcopenia and severe sarcopenia groups (OR 2.64, CI 1.87–8.73; P = 0.012). OH1 and OH5 were statistically significant different between severe sarcopenia and probable sarcopenia groups (P < 0.05); there was no relationship between the robust group and probable sarcopenia (P > 0.05). Conclusions There is a close relationship between sarcopenia and severe sarcopenia and OH in older adults. Therefore, when a healthcare practitioner is evaluating an older patient with sarcopenia, OH should also be evaluated, and vice versa.
Books on the topic "Orthostatic hypotension (OH)"
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Cohen, Jeffrey A., Justin J. Mowchun, Victoria H. Lawson, and Nathaniel M. Robbins. A 44-Year-Old Male with Subacute Onset of Syncope. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190491901.003.0032.
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Syncope in a patient with orthostatic hypotension (OH) may indicate autonomic dysfunction. The definition of OH is presented. Clinical features of parasympathetic and sympathetic function are discussed. The differential of acute autonomic dysfunction includes a number of conditions. An autoimmune etiology may occur autoimmune autonomic ganglionopathy. Serologic testing can assist in this diagnosis. If autoimmune immune modulating therapies may be indicated. Autonomic neuropathy may be a paraneoplastuc syndrome. Autonomic testing can also help with documenting autonomic neuropathy as well as the whether the defects are predominately parasympathetic or sympathetic. Amyloid should be considered as should diabetes but both have a more chronic course. An appropriate tissue biopsy with Congo Red staining can help to confirm the diagnosis of amyloid.
Book chapters on the topic "Orthostatic hypotension (OH)"
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Fedorowski, Artur. "Orthostatic intolerance: orthostatic hypotension and postural orthostatic tachycardia syndrome." In ESC CardioMed, 2032–37. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0472.
Full textAbstract:
The impairment of adaptive mechanisms during orthostatic challenge may evoke orthostatic intolerance, a heterogeneous condition, in which the standing position elicits a fall in blood pressure and/or excessive tachycardia, accompanied by a wide spectrum of subjective symptoms such as dizziness, discomfort, nausea, and palpitations. Apart from chronic and potentially debilitating symptoms, orthostatic intolerance may occasionally lead to sudden loss of consciousness and fall injuries. Consequently, orthostatic intolerance should be considered as a possible cause of unexplained syncope. Two main forms of orthostatic intolerance are orthostatic hypotension (OH) and postural orthostatic tachycardia syndrome (POTS). Clinical variants of OH include initial, classical, and delayed forms. The prevalence of OH increases with age, ranging from less than 5% under 40 years to about 20% above 70 years of age, and is higher in chronic diseases, such as hypertension and diabetes, reaching above 35% in Parkinson’s disease and advanced kidney failure. The presence of OH is associated with a higher mortality and an increased incidence of cardiovascular disease, with the majority of patients being asymptomatic in normal conditions. In contrast, POTS affects predominantly young women (70–80%) within an age range of 15–40 years and is usually accompanied by non-specific symptoms: deconditioning, headache, cognitive impairment, and gastrointestinal dysfunction. Management of orthostatic intolerance includes both non-pharmacological and pharmacological methods with limited efficacy in the severe cases. Empirical treatment with vasoactive and volume expanding drugs for OH and POTS, and rhythm controlling therapy for POTS are recommended. Future studies on syndromes of orthostatic intolerance should focus on mechanisms leading to OH and POTS, novel diagnostic methods, and more effective therapeutic options.
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Fedorowski, Artur. "Orthostatic intolerance: orthostatic hypotension and postural orthostatic tachycardia syndrome." In ESC CardioMed, 2032–37. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0472_update_001.
Full textAbstract:
The impairment of adaptive mechanisms during orthostatic challenge may evoke orthostatic intolerance, a heterogeneous condition, in which the standing position elicits a fall in blood pressure and/or excessive tachycardia, accompanied by a wide spectrum of subjective symptoms such as dizziness, discomfort, nausea, and palpitations. Apart from chronic and potentially debilitating symptoms, orthostatic intolerance may occasionally lead to sudden loss of consciousness and fall injuries. Consequently, orthostatic intolerance should be considered as a possible cause of unexplained syncope. Two main forms of orthostatic intolerance are orthostatic hypotension (OH) and postural orthostatic tachycardia syndrome (POTS). Clinical variants of OH include initial, classical, and delayed forms. The prevalence of OH increases with age, ranging from less than 5% under 40 years to about 20% above 70 years of age, and is higher in chronic diseases, such as hypertension and diabetes, reaching above 35% in Parkinson’s disease and advanced kidney failure. The presence of OH is associated with a higher mortality and an increased incidence of cardiovascular disease, with the majority of patients being asymptomatic in normal conditions. In contrast, POTS affects predominantly young women (70–80%) within an age range of 15–40 years and is usually accompanied by non-specific symptoms: deconditioning, headache, cognitive impairment, and gastrointestinal dysfunction. Management of orthostatic intolerance includes both non-pharmacological and pharmacological methods with limited efficacy in the severe cases. Empirical treatment with vasoactive and volume expanding drugs for OH and POTS, and rhythm controlling therapy for POTS are recommended. Future studies on syndromes of orthostatic intolerance should focus on mechanisms leading to OH and POTS, novel diagnostic methods, and more effective therapeutic options.