The pathophysiology and diagnosis of orthostatic hypotension

Robertson, David

doi:10.1007/s10286-007-1004-0

Cited by 139 publications

(82 citation statements)

References 22 publications

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“…It is known that hypertension is associated with OH (4), particularly in elderly people. One of the most important mechanisms of OH is baroreflex dysfunction, which is in part caused by baroreceptor impairment due to aging or atherosclerosis (23,24). When we used the TUG test as a measure of physical function, we found that OH was associated with a shorter time on the TUG test, with whom physical function may be relatively preserved.…”

Section: Discussionmentioning

confidence: 88%

Orthostatic Hypotension Predicts a Poor Prognosis in Elderly People with Dementia

Oishi¹,

Sakata

Tsuchihashi

et al. 2016

Intern. Med.

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Objective The purpose of the present study was to assess the prevalence of orthostatic hypotension (OH) and elucidate its associations with the demographic characteristics and the prognosis in elderly subjects with dementia who visited a hospital for elderly daycare. Methods A total of 64 outpatients (44 females) with a mean age of 84 6 years who visited a hospital for daycare were enrolled in the study. The prevalence of OH and demographic characteristics were examined. Then, the subjects were followed up for 1 year. The blood pressure was measured in the supine position and immediately, 1, 3 and 5 minutes after standing. Poor outcome measures included death, hospitalization for any reason, and admission to a nursing home or geriatric facility.Results OH was present in 17 patients (26.6%). The presence of OH was associated with a higher supine systolic blood pressure. The increase in heart rate in the standing position was also reduced in subjects with OH compared with those without. The presence of OH was associated with faster time in the timed up-andgo test compared with those without OH. During the follow-up period, 22 patients (34.4%) had a poor prognosis, of which 8 (36.4%) had OH, which tended to be higher than those with a favorable prognosis. The event-free survival rate appeared to be lower in subjects with OH than in those without. Conclusion OH is relatively common in frail elderly patients with dementia, and it also appears to be associated with a poor prognosis.

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Section: Discussionmentioning

confidence: 88%

Orthostatic Hypotension Predicts a Poor Prognosis in Elderly People with Dementia

Oishi¹,

Sakata

Tsuchihashi

et al. 2016

Intern. Med.

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show abstract

“…Orthostatic hypotension (OH) is the most frequent symptom of cardiovascular autonomic dysfunction [44,50]. About 50% of PD patients with advanced disease and the majority of MSA patients complain about common symptoms of OH such as dizziness, lightheadedness, and nausea or pain during standing [7].…”

Section: Cardiovascular System: Orthostatic Hypotensionmentioning

confidence: 99%

Treatment of dysautonomia in extrapyramidal disorders

et al. 2011

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Although extrapyramidal diseases are commonly thought to solely affect the (extrapyramidal) motor system, non-motor symptoms such as behavioural abnormalities, dysautonomia, sleep disturbances and sensory dysfunctions are also frequently observed. Autonomic dysfunction is an important clinical component of extrapyramidal disease, but it is often not formally assessed, and thus frequently misdiagnosed. Symptoms of autonomic dysfunction can impact more on quality of life than motor symptoms. Appropriate symptom-oriented diagnosis and symptomatic treatment as part of an interdisciplinary approach can greatly benefit the patient. This review elaborates a limited overview on the treatment of cardiovascular, gastrointestinal, urogenital and sudomotor autonomic dysfunction in various extrapyramidal syndromes.

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“…Orthostatic hypotension is asymptomatic when the patient does not develop any symptoms, or is symptomatic when the patient experiences dizziness, weakness, nausea, pain or impaired vision in response to postural change. To account for symptomatic and asymptomatic orthostatic hypotension Robertson suggested the 'standing time' as practical clinical diagnostic parameter [Robertson, 2008]. Standing time is defined as the period from getting up until orthostatic symptoms occur.…”

Section: Pathophysiology Of Dysautonomiamentioning

confidence: 99%

“…Cardiovascular system: orthostatic hypotension Orthostatic hypotension is the most frequent symptom of cardiovascular autonomic dysfunction [Robertson, 2008;Peralta et al 2007]. About 50% of PD patients with advanced disease and the majority of MSA patients complain about common symptoms of orthostatic hypotension such as dizziness, lightheadedness, and nausea or pain during standing [Bleasdale-Barr and Mathias, 1998].…”

Section: Pathophysiology Of Dysautonomiamentioning

confidence: 99%

Review: Treatment of dysautonomia in extrapyramidal disorders

Ziemssen

Reichmann

2009

Ther Adv Neurol Disord

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Although extrapyramidal diseases are commonly thought to solely affect the extrapyramidal motor system, nonmotor symptoms such as behavioural abnormalities, dysautonomia, sleep disturbances and sensory dysfunctions are also frequently observed. Autonomic dysfunction as an important clinical component of extrapyramidal disease (idiopathic Parkinson's disease, multiple system atrophy, progressive supranuclear palsy, dementia with Lewy bodies) is often not formally assessed and thus frequently misdiagnosed. Symptoms of autonomic dysfunction in general impact more on quality of life than motor symptoms. Appropriate symptom-oriented diagnosis and symptomatic treatment as part of an interdisciplinary approach can greatly benefit the patient. Unfortunately, double-blind, randomized, controlled studies are scarce with the consequence that most recommendations are not based on the highest level of evidence. This review elaborates a limited overview on the treatment of cardiovascular, gastrointestinal, urogenital and sudomotor autonomic dysfunction in various extrapyramidal syndromes.

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The pathophysiology and diagnosis of orthostatic hypotension

Cited by 139 publications

References 22 publications

Orthostatic Hypotension Predicts a Poor Prognosis in Elderly People with Dementia

Orthostatic Hypotension Predicts a Poor Prognosis in Elderly People with Dementia

Treatment of dysautonomia in extrapyramidal disorders

Review: Treatment of dysautonomia in extrapyramidal disorders

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