Supine hypertension: A state of the art

Mantovani, Giacomo; Marozzi, Irene; Rafanelli, Martina; Rivasi, Giulia; Volpato, Stefano; Ungar, Andrea

doi:10.1016/j.autneu.2022.102988

Cited by 5 publications

(5 citation statements)

References 33 publications

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“…If medication is needed, we start a low dose at night (5 mg nifedipine/25 mg losartan) but are cautious of hypotension, particularly if patients need to mobilise at night for nocturia. Other pharmacological options include clonidine (0.1–0.2 mg) or glyceryl trinitrate patches (0.1–0.2 mg/hour) 30…”

Section: Diagnosing Msamentioning

confidence: 99%

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Multiple system atrophy

et al. 2023

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This is a practical guide to diagnosing and managing multiple system atrophy (MSA). We explain the newly published Movement Disorders Society Consensus Diagnostic Criteria, which include new ‘Clinically Established MSA’ and ‘Possible Prodromal MSA’ categories, hopefully reducing time to diagnosis. We then highlight the key clinical features of MSA to aid diagnosis. We include a list of MSA mimics with suggested methods of differentiation from MSA. Lastly, we discuss practical symptom management in people living with MSA, including balancing side effects, with the ultimate aim of improving quality of life.

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Section: Diagnosing Msamentioning

confidence: 99%

“…Other pharmacological options include clonidine (0.1–0.2 mg) or glyceryl trinitrate patches (0.1–0.2 mg/hour). 30 …”

Section: Diagnosing Msamentioning

confidence: 99%

Multiple system atrophy

et al. 2023

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“…Approximately half of the patients with N-OH experience supine hypertension. 10,44 Also, 30.0% of patients with PD and MSA have mild to severe supine hypertension, regardless of their age, disease duration, or stage. 45 Supine hypertension is largely asymptomatic especially during daytime.…”

Section: Supine Hypertensionmentioning

confidence: 99%

“…Due to the forced natriuresis, OH can get worse the following morning with more severe symptoms. 44,46 Supine hypertension increases the risks of cardiovascular diseases and renal failure as longterm complications. Therefore, patients with N-OH should be regularly screened for supine hypertension, especially when starting a long-acting medication for N-OH or when reporting possibly related symptoms such as frequent awakening and nocturia.…”

Section: Supine Hypertensionmentioning

confidence: 99%

“…Therefore, patients with N-OH should be regularly screened for supine hypertension, especially when starting a long-acting medication for N-OH or when reporting possibly related symptoms such as frequent awakening and nocturia. 44,47 The long-term benefits of the management of supine hypertension are still under a matter of investigation. Its managements are discussed in detail on the scientific statement of the professional societies.…”

Section: Supine Hypertensionmentioning

confidence: 99%

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Diagnosis and management of neurogenic orthostatic hypotension

Ju,

Sinn

2023

ACN

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Orthostatic hypotension is a sustained and pathological drop in blood pressure upon standing. Orthostatic hypotension can be due to non-neurogenic conditions or autonomic disorders. Impaired baroreflex-mediated vasoconstriction and insufficient release of norepinephrine play key roles in the pathophysiology of neurogenic orthostatic hypotension. Its common symptoms mainly related to inadequate cerebral blood flow include dizziness, lightheadedness, and syncope. It is crucial to differentiate neurogenic orthostatic hypotension from non-neurogenic orthostatic hypotension. For the management of neurogenic orthostatic hypotension, physicians should implement non-pharmacological methods and, if possible, reverse combined non-neurological conditions. Depending on severity of symptoms, pharmacological intervention may be tried after or with non-pharmacological methods. Its management should be individualized based on intensity of symptoms, comorbid conditions, drug side effects, and etiology. In this review, we discuss the definition, pathophysiology, clinical approach, and management of neurogenic orthostatic hypotension.

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