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| http://dx.doi.org/10.11909/j.issn.1671-5411.2021.09.001 | DOI Listing |
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Neurogenic Orthostatic Hypotension in Parkinson Disease-A Narrative Review of Diagnosis and Management.
J Clin Med
January 2025
Department of Medical Specialities I, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania.
Neurogenic orthostatic hypotension (NOH) is a significant non-motor manifestation of Parkinson's disease (PD), that substantially affects patient disability and has a powerful impact on the quality of life of PD patients, while also contributing to increased healthcare costs. This narrative review aims to summarize key insights into the diagnosis and management of NOH in individuals with PD. For diagnosing NOH, a recently introduced and valuable metric is the ΔHr/ΔSBP index.
View Article and Find Full Text PDFHypotensive Episodes Identified on 24-Hour Ambulatory Blood Pressure and Impaired Cognitive Function: Insights From the SPRINT Study.
Hypertension
January 2025
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (W.Z., D.H., M.A.M., Y.M.).
Background: Hypotensive episodes detected by 24-hour ambulatory blood pressure (BP) monitoring capture daily cumulative hypotensive stress and could be clinically relevant to cognitive impairment, but this relationship remains unclear.
Methods: We included participants from the Systolic Blood Pressure Intervention Trial (receiving intensive or standard BP treatment) who had 24-hour ambulatory BP monitoring measured near the 27-month visit and subsequent biannual cognitive assessments. We evaluated the associations of hypotensive episodes (defined as systolic BP drops of ≥20 mm Hg between 2 consecutive measurements that reached <100 mm Hg) and hypotensive duration (cumulative time of systolic BP <100 mm Hg) with subsequent cognitive function using adjusted linear mixed models.
Case report: Treatable immune-mediated severe orthostatic hypotension in SARS-CoV-2 infection.
Front Neurosci
January 2025
Service of Neurology, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
We report a patient with autonomic dysfunction following acute SARS-CoV-2 infection, presenting progressively worsening severe orthostatic hypotension to the point where she could no longer sit or stand. The patient experienced a delay in diagnosis after an initial misdiagnosis of a functional neurological disorder. Persistent orthostatic symptoms prompted us to re-examine the diagnosis and explore other diagnostic tools, which ultimately allowed us to identify and treat severe immune-mediated orthostatic hypotension (OH).
View Article and Find Full Text PDFBlood pressure targets, medication considerations and special concerns in elderly hypertension III: Focus on stroke and neurodegenerative disorders.
J Formos Med Assoc
January 2025
Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan. Electronic address:
Controlling hypertension has become an important issue in the elderly population in whom neurological comorbidities are highly prevalent. Most of the large-scale trials focusing on hypertension management in older populations have excluded patients with comorbid neurological disorders. However, this population requires special considerations, as the benefits of antihypertensive agents are mostly uncertain and there is a higher risk of adverse events.
View Article and Find Full Text PDFA Case of Severe Advanced Diabetic Cardiac Autonomic Neuropathy: Severe Orthostatic Hypotension Complicated With Episodes of Nocturnal Supine Hypertensive Emergency Episodes.
Cureus
December 2024
Internal Medicine, Meharry Medical College, Nashville, USA.
Diabetic cardiac autonomic neuropathy (CAN) is caused by damage to the autonomic nerve fibers that innervate the heart and blood vessels, leading to abnormalities in heart rate control and vascular dynamics. CAN encompasses symptoms such as exercise intolerance, orthostatic hypotension, cardiac denervation syndrome, and nocturnal hypertension. Neurogenic orthostatic hypotension (nOH), resulting from severe diabetic CAN, can cause symptomatic orthostatic hypotension.
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