TY - JOUR
T1 - Management of neurogenic orthostatic hypotension
T2 - an update
AU - Low, Phillip A.
AU - Singer, Wolfgang
N1 - Funding Information:
This work was supported in part by the National Institutes of Health (NS 32352; NS 44233; NS 43364), Mayo CTSA (MO1 RR00585), and Mayo Funds.
PY - 2008/5
Y1 - 2008/5
N2 - Orthostatic hypotension (OH) is common in elderly people and in patients with disorders such as diabetes and Parkinson's disease. Grading of the severity of OH and its effect on the patient's quality of life are important. The symptoms vary with orthostatic stress, and subtle symptoms such as tiredness and cognitive impairment should be recognised. Standard drug treatment for OH is effective but worsens supine hypertension, whereas pyridostigmine can improve OH slightly but significantly without worsening of supine hypertension. Because orthostatic stress varies from moment to moment and drug treatment is suboptimal, drug treatment of OH needs to be combined with non-pharmacological approaches, such as compression of venous capacitance beds, use of physical counter-manoeuvres, and intermittent water-bolus treatment.
AB - Orthostatic hypotension (OH) is common in elderly people and in patients with disorders such as diabetes and Parkinson's disease. Grading of the severity of OH and its effect on the patient's quality of life are important. The symptoms vary with orthostatic stress, and subtle symptoms such as tiredness and cognitive impairment should be recognised. Standard drug treatment for OH is effective but worsens supine hypertension, whereas pyridostigmine can improve OH slightly but significantly without worsening of supine hypertension. Because orthostatic stress varies from moment to moment and drug treatment is suboptimal, drug treatment of OH needs to be combined with non-pharmacological approaches, such as compression of venous capacitance beds, use of physical counter-manoeuvres, and intermittent water-bolus treatment.
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U2 - 10.1016/S1474-4422(08)70088-7
DO - 10.1016/S1474-4422(08)70088-7
M3 - Review article
C2 - 18420158
AN - SCOPUS:41949090127
SN - 1474-4422
VL - 7
SP - 451
EP - 458
JO - The Lancet Neurology
JF - The Lancet Neurology
IS - 5
ER -