The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension

Christopher H. Gibbons, Peter Schmidt, Italo Biaggioni, Camille Frazier-Mills, Roy Freeman, Stuart Isaacson, Beverly Karabin, Louis Kuritzky, Mark Lew, Phillip Anson Low, Ali Mehdirad, Satish R. Raj, Steven Vernino, Horacio Kaufmann

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1-16
Number of pages16
JournalJournal of Neurology
DOIs
StateAccepted/In press - Jan 3 2017

Fingerprint

Orthostatic Hypotension
Consensus
Hypertension
Amyloid Neuropathies
Pure Autonomic Failure
Multiple System Atrophy
Therapeutics
Lewy Body Disease
Diabetic Neuropathies
Expert Testimony
Peripheral Nervous System Diseases
Practice Guidelines
Neurodegenerative Diseases
Parkinson Disease
Communication
Outcome Assessment (Health Care)
Guidelines
Population

Keywords

  • Autonomic dysfunction
  • Droxidopa
  • Fludrocortisone
  • Midodrine
  • Neurogenic orthostatic hypotension
  • Supine hypertension

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension. / Gibbons, Christopher H.; Schmidt, Peter; Biaggioni, Italo; Frazier-Mills, Camille; Freeman, Roy; Isaacson, Stuart; Karabin, Beverly; Kuritzky, Louis; Lew, Mark; Low, Phillip Anson; Mehdirad, Ali; Raj, Satish R.; Vernino, Steven; Kaufmann, Horacio.

In: Journal of Neurology, 03.01.2017, p. 1-16.

Research output: Contribution to journalArticle

Gibbons, CH, Schmidt, P, Biaggioni, I, Frazier-Mills, C, Freeman, R, Isaacson, S, Karabin, B, Kuritzky, L, Lew, M, Low, PA, Mehdirad, A, Raj, SR, Vernino, S & Kaufmann, H 2017, 'The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension', Journal of Neurology, pp. 1-16. https://doi.org/10.1007/s00415-016-8375-x
Gibbons, Christopher H. ; Schmidt, Peter ; Biaggioni, Italo ; Frazier-Mills, Camille ; Freeman, Roy ; Isaacson, Stuart ; Karabin, Beverly ; Kuritzky, Louis ; Lew, Mark ; Low, Phillip Anson ; Mehdirad, Ali ; Raj, Satish R. ; Vernino, Steven ; Kaufmann, Horacio. / The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension. In: Journal of Neurology. 2017 ; pp. 1-16.
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