TY - JOUR
T1 - The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension
AU - Gibbons, Christopher H.
AU - Schmidt, Peter
AU - Biaggioni, Italo
AU - Frazier-Mills, Camille
AU - Freeman, Roy
AU - Isaacson, Stuart
AU - Karabin, Beverly
AU - Kuritzky, Louis
AU - Lew, Mark
AU - Low, Phillip
AU - Mehdirad, Ali
AU - Raj, Satish R.
AU - Vernino, Steven
AU - Kaufmann, Horacio
N1 - Publisher Copyright:
© 2016, The Author(s).
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Neurogenic orthostatic hypotension (nOH) is common in patients with neurodegenerative disorders such as Parkinson’s disease, multiple system atrophy, pure autonomic failure, dementia with Lewy bodies, and peripheral neuropathies including amyloid or diabetic neuropathy. Due to the frequency of nOH in the aging population, clinicians need to be well informed about its diagnosis and management. To date, studies of nOH have used different outcome measures and various methods of diagnosis, thereby preventing the generation of evidence-based guidelines to direct clinicians towards ‘best practices’ when treating patients with nOH and associated supine hypertension. To address these issues, the American Autonomic Society and the National Parkinson Foundation initiated a project to develop a statement of recommendations beginning with a consensus panel meeting in Boston on November 7, 2015, with continued communications and contributions to the recommendations through October of 2016. This paper summarizes the panel members’ discussions held during the initial meeting along with continued deliberations among the panel members and provides essential recommendations based upon best available evidence as well as expert opinion for the (1) screening, (2) diagnosis, (3) treatment of nOH, and (4) diagnosis and treatment of associated supine hypertension.
AB - Neurogenic orthostatic hypotension (nOH) is common in patients with neurodegenerative disorders such as Parkinson’s disease, multiple system atrophy, pure autonomic failure, dementia with Lewy bodies, and peripheral neuropathies including amyloid or diabetic neuropathy. Due to the frequency of nOH in the aging population, clinicians need to be well informed about its diagnosis and management. To date, studies of nOH have used different outcome measures and various methods of diagnosis, thereby preventing the generation of evidence-based guidelines to direct clinicians towards ‘best practices’ when treating patients with nOH and associated supine hypertension. To address these issues, the American Autonomic Society and the National Parkinson Foundation initiated a project to develop a statement of recommendations beginning with a consensus panel meeting in Boston on November 7, 2015, with continued communications and contributions to the recommendations through October of 2016. This paper summarizes the panel members’ discussions held during the initial meeting along with continued deliberations among the panel members and provides essential recommendations based upon best available evidence as well as expert opinion for the (1) screening, (2) diagnosis, (3) treatment of nOH, and (4) diagnosis and treatment of associated supine hypertension.
KW - Autonomic dysfunction
KW - Droxidopa
KW - Fludrocortisone
KW - Midodrine
KW - Neurogenic orthostatic hypotension
KW - Supine hypertension
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U2 - 10.1007/s00415-016-8375-x
DO - 10.1007/s00415-016-8375-x
M3 - Review article
C2 - 28050656
AN - SCOPUS:85008219651
SN - 0340-5354
VL - 264
SP - 1567
EP - 1582
JO - Journal of Neurology
JF - Journal of Neurology
IS - 8
ER -