2017
DOI: 10.1177/1060028016689264
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The Treatment of Primary Orthostatic Hypotension

Abstract: Midodrine and droxidopa possess the most evidence with respect to increasing blood pressure and alleviating symptoms. Pyridostigmine and fludrocortisone can be used in patients who fail to respond to these agents. Emerging evidence with low-dose atomoxetine is promising, especially in those with central autonomic failure, and may prove to be a viable alternative treatment option. Data surrounding other therapies such as sympathomimetic agents or octreotide are minimal. Medication management of primary OH shoul… Show more

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Cited by 37 publications
(50 citation statements)
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“…nOH accounts for up to 15% of syncope in general population cohorts, and approximately 24% of syncope-related cases in emergency room settings. 12, 34, 35 nOH is more prevalent with advanced age, and is a common cause of hospitalization in patients >65 years of age. 36 Importantly, nOH is a significant predictor of cardiovascular events and is associated with all-cause mortality.…”
Section: Neurogenic Orthostatic Hypotensionmentioning
confidence: 99%
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“…nOH accounts for up to 15% of syncope in general population cohorts, and approximately 24% of syncope-related cases in emergency room settings. 12, 34, 35 nOH is more prevalent with advanced age, and is a common cause of hospitalization in patients >65 years of age. 36 Importantly, nOH is a significant predictor of cardiovascular events and is associated with all-cause mortality.…”
Section: Neurogenic Orthostatic Hypotensionmentioning
confidence: 99%
“…8, 35 In patients with cardiovascular disease, short-acting pressor agents are preferred such as midodrine (2.5–10.0 mg PO Q4H x3; α1-adrenergic agonist) and droxidopa (100–600 mg PO, TID; synthetic norepinephrine precursor). In nOH patients without cardiovascular disease, volume expansion with fludrocortisone (0.2 mg/day; mineralocorticoid agonist) can be considered, either alone or in combination with midodrine or droxidopa.…”
Section: Neurogenic Orthostatic Hypotensionmentioning
confidence: 99%
“…Orthostatic hypotension (OH) is a common condition characterized by a reduction in systolic blood pressure (SBP) of at least 20 mm Hg and/or in diastolic blood pressure (BP) of at least 10 mm Hg within 3 minutes of standing . It is often accompanied by symptoms of dizziness/lightheadedness, fatigue, vision disturbance, and loss of concentration, which can greatly hinder quality of life .…”
Section: Introductionmentioning
confidence: 99%
“…It is often accompanied by symptoms of dizziness/lightheadedness, fatigue, vision disturbance, and loss of concentration, which can greatly hinder quality of life . The prevalence of OH increases with age, affecting approximately 5% of patients younger than 50 years, 30% of patients older than 70 years, and up to 50% of nursing home patients older than 80 years . Generally, OH is a result of autonomic failure and abnormal BP regulatory mechanisms.…”
Section: Introductionmentioning
confidence: 99%
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