The Orthostatic Hypotension Questionnaire (OHQ): validation of a novel symptom assessment scale

Kaufmann, Horacio; Malamut, Richard; Norcliffe‐Kaufmann, Lucy; Rosa, Kathleen; Freeman, Roy

doi:10.1007/s10286-011-0146-2

Cited by 180 publications

(168 citation statements)

References 26 publications

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“…This contributes to a number of symptoms-lightheadedness, vision problems, weakness, fatigue, trouble concentrating, and head or neck discomfort, 41 which can increase the risk of falling.…”

Section: Discussionmentioning

confidence: 99%

Orthostatic Hypotension in Middle-Age and Risk of Falls

Juraschek

Daya

Appel

et al. 2016

AJHYPE

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Falls are a major cause of morbidity and mortality among older adults. 1,2 Nearly, one-third of persons aged 65 or older falls each year and the rate of falls in the United States is rising. 1,2 Moreover, falls are a significant reason for emergency room visits 3 and predispose to the risk of fracture, 4 posing a substantial burden on the US health system, estimated at approximately $23 billion yearly. 5 Given the aging US population, identifying risk factors for falls and tailoring interventions (e.g., physical therapy, prescription medication choices, or environment-based interventions like handrails) to prevent falls are recognized public health priorities.Orthostatic hypotension (OH) is a controversial risk factor for falls that has important implications for clinical guidelines on blood pressure management. The recently published SPRINT trial suggested that more intensive blood pressure management was associated with a lower risk of OH, but not a decreased risk of injurious falls. 6 OH has been traditionally thought to disproportionately impact older adults. The prevalence of OH increases with age, 7 reaching as high as 20% in adults age 75 years and older. 8 Furthermore, OH is associated with a history of falls as well as greater morbidity from falls in older adults. [8][9][10] Despite the focus in the literature on older adults, OH is also quite prevalent among middle-aged adults (as high as 15.9% in 1 study 11 ), who have a notably lower fall rate. While in the short-term, middle-aged OH may not be a major contributor to risk of serious falls, it is unknown whether it might be associated with risk of falls over time as people age.Thus, the aims of this prospective study were to: (i) determine whether OH in middle age was associated with risk of falls over the lifespan; (ii) characterize the continuous relationship between postural changes in systolic blood pressure (SBP) or diastolic blood pressure (DBP) and fall risk; and (iii) identify whether participant demographic characteristics or cardiovascular risk factors (obesity, hypertension, or diabetes) modified the association between OH and falls. We hypothesized that OH would be significantly associated with falls and this association would be more pronounced among older persons with cardiovascular risk factors. Orthostatic Hypotension in BACKGROUNDOne-third of older adults fall each year. Orthostatic hypotension (OH) has been hypothesized as an important risk factor for falls, but findings from prior studies have been inconsistent.

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Section: Discussionmentioning

confidence: 99%

Orthostatic Hypotension in Middle-Age and Risk of Falls

Juraschek

Daya

Appel

et al. 2016

AJHYPE

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“…Signs and symptoms of neurogenic bladder disturbance or erectile dysfunction can be assessed by direct questioning of the patient during a visit. Several rating scales that assess orthostatic hypotension are commonly used, including SCOPA-AUT [96], OHQ [97], and COMPASS [98], but these are relatively detailed and may take too long time to administer during routine office visits. The presence or absence of symptomatic orthostatic hypotension is assessed in UPDRS part IV.…”

Section: Assessment Of Autonomic Dysfunctionmentioning

confidence: 99%

Clinically meaningful parameters of progression and long-term outcome of Parkinson disease: An international consensus statement

Puschmann

Brighina

Μarkopoulou

et al. 2015

Parkinsonism & Related Disorders

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Parkinson disease (PD) is associated with a clinical course of variable duration, severity, and a combination of motor and non-motor features. Recent PD research has focused primarily on etiology rather than clinical progression and long-term outcomes. For the PD patient, caregivers, and clinicians, information on expected clinical progression and long-term outcomes is of great importance. Today, it remains largely unknown what factors influence long-term clinical progression and outcomes in PD; recent data indicate that the factors that increase the risk to develop PD differ, at least partly, from those that accelerate clinical progression and lead to worse outcomes. Prospective studies will be required to identify factors that influence progression and outcome. We suggest that data for such studies is collected during routine office visits in order to guarantee high external validity of such research. We report here the results of a consensus meeting of international movement disorder experts from the Genetic Epidemiology of Parkinson's Disease (GEO-PD) consortium, who convened to define which long-term outcomes are of interest to patients, caregivers and clinicians, and what is presently known about environmental or genetic factors influencing clinical progression or long-term outcomes in PD. We propose a panel of rating scales that collects a significant amount of phenotypic information, can be performed in the routine office visit and allows international standardization. Research into the progression and long-term outcomes of PD aims at providing individual prognostic information early, adapting treatment choices, and taking specific measures to provide care optimized to the individual patient's needs.

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“…Efficacy was evaluated using the composite score of the patient-rated Orthostatic Hypotension Questionnaire (OHQ) [11], which consists of the Orthostatic Hypotension Symptom Assessment (OHSA) and the Orthostatic Hypotension Daily Activity Scale (OHDAS). The OHQ composite score was the average of composite scores for the OHSA (ratings of 6 items: dizziness, problems with vision, weakness, fatigue, trouble concentrating, and head/neck discomfort) and the OHDAS (ratings of 4 items pertaining to activities requiring standing or walking for a short or long time).…”

Section: Efficacy Assessmentsmentioning

confidence: 99%

Safety and Durability of Effect with Long-Term, Open-Label Droxidopa Treatment in Patients with Symptomatic Neurogenic Orthostatic Hypotension (NOH303)

Isaacson

Shill

Vernino

et al. 2016

JPD

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Abstract.Background: Neurogenic orthostatic hypotension (nOH) is associated with insufficient norepinephrine release in response to postural change. Objective: The objective of this study was to evaluate the long-term safety and durability of efficacy of the norepinephrine precursor droxidopa in patients with symptomatic nOH. Methods: This multinational study consisted of 3 sequential phases: a 3-month open-label droxidopa treatment phase followed by a 2-week double-blind, placebo-controlled withdrawal phase, and a 9-month open-label extension phase in which all patients received droxidopa. Patients were adults diagnosed with symptomatic nOH associated with Parkinson's disease, multiple system atrophy, pure autonomic failure, dopamine ␤-hydroxylase deficiency, or nondiabetic autonomic neuropathy. Efficacy was evaluated using patient-and investigator-reported questionnaire responses and the orthostatic standing test. Safety was assessed through adverse event (AE) reports and vital signs. Results: A total of 102 patients received treatment with droxidopa. Initial improvements from baseline in patient-reported nOH symptom severity and impact on daily activities, evaluated using the Orthostatic Hypotension Questionnaire, exceeded 50% and were maintained throughout the 12-month study. Decreased nOH severity was also reflected in clinician and patient ratings on the Clinical Global Impression questionnaire. Standing systolic and diastolic blood pressures were increased from baseline throughout the study with droxidopa treatment. The most frequently reported AEs were falls, urinary tract infection, and headache. There was a low incidence (≤2%) of cardiac AEs (eg, first-degree atrioventricular block, supraventricular extrasystoles).

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The Orthostatic Hypotension Questionnaire (OHQ): validation of a novel symptom assessment scale

Abstract: These findings provide empirical evidence that the OHQ can accurately evaluate the severity of symptoms and the functional impact of NOH as well as assess the efficacy of treatment.

Cited by 180 publications

References 26 publications

Orthostatic Hypotension in Middle-Age and Risk of Falls

Orthostatic Hypotension in Middle-Age and Risk of Falls

Clinically meaningful parameters of progression and long-term outcome of Parkinson disease: An international consensus statement

Safety and Durability of Effect with Long-Term, Open-Label Droxidopa Treatment in Patients with Symptomatic Neurogenic Orthostatic Hypotension (NOH303)

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