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

Fedorowski, ArturKarolinska Institutet,Lund University,Lunds universitet,Kardiovaskulär forskning - hypertoni,Forskargrupper vid Lunds universitet,Cardiovascular Research - Hypertension,Lund University Research Groups,Karolinska University Hospital (author)

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.

Ricci, FabrizioLund 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(Swepub:lu)fa7062ri (author)
Hamrefors, ViktorLund University,Lunds universitet,Kardiovaskulär forskning - hypertoni,Forskargrupper vid Lunds universitet,Cardiovascular Research - Hypertension,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-vho (author)
Sandau, Kristin EBethel University (author)
Hwan Chung, TaeJohns Hopkins University (author)
Muldowney, James A SVanderbilt University (author)
Gopinathannair, RakeshOverland Park Regional Medical Center (author)
Olshansky, BrianIowa State University, College of Veterinary Medicine (author)
Kardiovaskulär forskning - hypertoniForskargrupper vid Lunds universitet (creator_code:org_t)

By the author/editor: Fedorowski, Artu ...; Ricci, Fabrizio; Hamrefors, Vikto ...; Sandau, Kristin ...; Hwan Chung, Tae; Muldowney, James ...; show more...; Gopinathannair, ...; Olshansky, Brian; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

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