Orthostatic hypotension: managing a difficult problem #MMPMID26427904
Jones PK; Shaw B; Raj SR
Expert Rev Cardiovasc Ther 2015[Nov]; 13 (11): 1263-76 PMID26427904show 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. Orthostatic hypotension 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. 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 workup and treatment of patients with neurogenic OH.