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11-12-2023 | View point

Asymptomatic orthostatic hypotension in synucleinopathies: to treat or not to treat?

Authors: Abhishek Lenka, Guillaume Lamotte, Paul Beach

Published in: Clinical Autonomic Research | Issue 1/2024

Excerpt

Orthostatic hypotension (OH) is a debilitating non-motor manifestation of synucleinopathies such as Parkinson’s disease (PD), multiple system atrophy (MSA), dementia with Lewy bodies (DLB), and pure autonomic failure (PAF) [1]. Classical OH is defined as a sustained drop in systolic blood pressure (SBP) > 20 mm Hg and/or diastolic blood pressure (DBP) > 10 mm Hg within 3 min of upright posture [1]. The prevalence of OH varies among the synucleinopathies, with up to half of PD and DLB patients and approximately 80% of patients with MSA presenting with this condition, and is a defining feature of PAF [2]. In general, the prevalence of OH in synucleinopathies increases with age and disease duration [2]. ‘Typical’ symptoms associated with OH may be reported as postural lightheadedness, dizziness, vision changes (tunnel or blurred), syncope, or near-syncope. Some patients report ‘atypical’ postural symptoms upon prompting, such as fatigue or cognitive dysfunction, pain in the shoulders and neck (also known as “coat hanger” pain), or even dyspnea [1]. In PD, OH is associated with more rapid disease progression, shorter survival time, dementia, falls, hospitalization, and institutionalization [3, 4]. …

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Title: Asymptomatic orthostatic hypotension in synucleinopathies: to treat or not to treat?
Authors: Abhishek Lenka
Guillaume Lamotte
Paul Beach
Publication date: 11-12-2023
Publisher: Springer Berlin Heidelberg
Published in: Clinical Autonomic Research / Issue 1/2024
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI: https://doi.org/10.1007/s10286-023-01006-z

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Asymptomatic orthostatic hypotension in synucleinopathies: to treat or not to treat?

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