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Orthostatic Hypotension : Management of a Complex, But Common, Medical Problem

Fedorowski, Artur (author)
Karolinska Institutet,Lund University,Lunds universitet,Kardiovaskulär forskning - hypertoni,Forskargrupper vid Lunds universitet,Cardiovascular Research - Hypertension,Lund University Research Groups,Karolinska University Hospital
Ricci, Fabrizio (author)
Lund University,Lunds universitet,Kardiovaskulär forskning - hypertoni,Forskargrupper vid Lunds universitet,Cardiovascular Research - Hypertension,Lund University Research Groups,Casa di Cura Villa Serena di Città Sant'Angelo,University G.d'Annunzio of Chieti-Pescara
Hamrefors, Viktor (author)
Lund University,Lunds universitet,Kardiovaskulär forskning - hypertoni,Forskargrupper vid Lunds universitet,Cardiovascular Research - Hypertension,Lund University Research Groups,Skåne University Hospital
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Sandau, Kristin E (author)
Bethel University
Hwan Chung, Tae (author)
Johns Hopkins University
Muldowney, James A S (author)
Vanderbilt University
Gopinathannair, Rakesh (author)
Overland Park Regional Medical Center
Olshansky, Brian (author)
Iowa State University, College of Veterinary Medicine
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 (creator_code:org_t)
2022
2022
English.
In: Circulation: Arrhythmia and Electrophysiology. - 1941-3084. ; 15:3
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Orthostatic hypotension (OH), a common, often overlooked, disorder with many causes, is associated with debilitating symptoms, falls, syncope, cognitive impairment, and risk of death. Chronic OH, a cardinal sign of autonomic dysfunction, increases with advancing age and is commonly associated with neurodegenerative and autoimmune diseases, diabetes, hypertension, heart failure, and kidney failure. Management typically involves a multidisciplinary, patient-centered, approach to arrive at an appropriate underlying diagnosis that is causing OH, treating accompanying conditions, and providing individually tailored pharmacological and nonpharmacological treatment. We (1) propose a novel streamlined pathophysiological classification of OH; (2) review the relationship between the cardiovascular disease continuum and OH; (3) discuss OH-mediated end-organ damage; (4) provide diagnostic and therapeutic algorithms to guide clinical decision making and patient care; (5) identify current gaps in knowledge and try to define future research directions. Using a case-based learning approach, specific clinical scenarios are presented highlighting various presentations of OH to provide a practical guide to evaluate and manage patients who have OH.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

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