Neurogenic Orthostatic Hypotension in Parkinson Disease: A Primer
AbstractAbstractParkinson disease (PD) is associated with a variety of motor and
non-motor clinical manifestations, including cardiovascular autonomic
dysfunction. Neurogenic orthostatic hypotension (nOH) is a potentially serious
manifestation of cardiovascular sympathetic failure that occurs in approximately
30% of patients with PD. Here we review the pathophysiology and effects of the
condition as well as treatment considerations for patients with PD and nOH.
Screening for nOH using orthostatic symptom questionnaires, orthostatic blood
pressure measurements, and specialized autonomic testing is beneficial for the
identification of symptomatic and asymptomatic cases because cardiac sympathetic
denervation and nOH can occur even at early (premotor) stages of PD. Symptoms of
nOH, such as orthostatic lightheadedness, in patients with PD, have been shown
to adversely affect patient safety (with increased risk of falls) and quality of
life and should prompt treatment with non-pharmacologic and, occasionally,
pharmacologic measures. Patients with nOH are also at increased risk of supine
hypertension, which requires balancing various management strategies.FundingLundbeck (Deerfield, IL).
Source: Neurology and Therapy - Category: Neurology Source Type: research
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