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2015 ; 13
(11
): 1263-76
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Orthostatic hypotension: managing a difficult problem
#MMPMID26427904
Jones PK
; Shaw BH
; Raj SR
Expert Rev Cardiovasc Ther
2015[Nov]; 13
(11
): 1263-76
PMID26427904
show ga
Orthostatic hypotension (OH) leads to a significant number of hospitalizations
each year, and is associated with significant morbidity and mortality among
affected individuals. Given the increased risk for cardiovascular events and
falls, it is important to identify the underlying etiology of OH and to choose
appropriate therapeutic agents. OH can be non-neurogenic or neurogenic (arising
from a central or peripheral lesion). The initial evaluation includes orthostatic
vital signs, complete history and a physical examination. Patients should also be
evaluated for concomitant symptoms of post-prandial hypotension and supine
hypertension. Non-pharmacologic interventions are the first step for treatment of
OH. The appropriate selection of medications can also help with symptomatic
relief. This review highlights the pathophysiology, clinical features, diagnostic
work-up and treatment of patients with neurogenic OH.