The most common cause of orthostatic hypotension is poor postural adjustment. The most severe form of orthostatic hypotension is of unknown etiology; the primary disorder is a degeneration of the peripheral autonomic nervous system, resulting in a decrease in production of catecholamine. Physiologically, there is a failure of arteriolar and venous vasoconstriction and a lack of cardiac response, both in rate and in contractility to sympathetic stimulation. Total and central cardiopulmonary blood volumes are contracted. The application of hydrostatic counterpressure by the use of an elasticized garment is helpful in the management of orthostatic hypotension, especially when used with sodium-retaining steroids to increase intravascular volume.
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http://dx.doi.org/10.1159/000169820 | DOI Listing |
Europace
January 2025
Department of Clinical Sciences, Lund University, Malmö, Sweden.
Background: Orthostatic hypotension (OH) is an important differential diagnosis in unexplained syncope. Neurogenic OH (nOH) has been postulated to differ from non-neurogenic OH (non-nOH), yet pathophysiological differences are largely unexplored. We aimed to investigate etiology and tilt table test (TTT)-induced hemodynamic responses in symptomatic OH patients.
View Article and Find Full Text PDFJ 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 PDFMov Disord Clin Pract
January 2025
TSE/Prion Biochemistry Section, DIR, National Institute of Allergy and Infectious Diseases (NIAID), Hamilton, Montana, USA.
Background: Cerebrospinal fluid (CSF) α-synuclein seeding activity (SSA) via a seed amplification assay might predict central Lewy body diseases (LBD) in at-risk individuals.
Objective: The aim was to assess CSF SSA in a prospective, longitudinal study.
Methods: Participants self-reported risk factors were genetics, olfactory dysfunction, dream enactment behavior, orthostatic intolerance, or hypotension; individuals who had ≥3 confirmed risk factors underwent CSF sampling and were followed for up to 7.
Eur J Prev Cardiol
January 2025
CH Saint Joseph et Saint Luc. Lyon, France.
Due to the aging population, focusing on healthy aging has become a global priority. Cardiovascular diseases (CVDs) and frailty, characterized by increased vulnerability to adverse stress and health events, interact synergistically in advanced age. In older adults, hip fractures are a frequent dramatic "life-transition" event.
View Article and Find Full Text PDFClin Neuropharmacol
January 2025
MedStar Georgetown University Hospital, Washington, DC.
Introduction: Adjunctive therapies to treat OFF episodes resulting from long-term levodopa treatment in Parkinson disease (PD) are hampered by safety and tolerability issues. Istradefylline offers an alternative mechanism (adenosine A2A receptor antagonist) and therefore potentially improved tolerability.
Methods: A systematic review of PD adjuncts published in 2011 was updated to include randomized controlled trials published from January 1, 2010-April 15, 2019.
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