Top

Published in:

19-07-2023 | Hypotension | Editorial

All orthostatic hypotension is neurogenic

Author: Italo Biaggioni

Published in: Clinical Autonomic Research | Issue 4/2023

Excerpt

Absolutes are almost never true in clinical medicine, and it is likely that anecdotal cases of orthostatic hypotension (OH) in patients without autonomic failure will be reported in response to this article. Nevertheless, the purpose of this commentary, and its provocative title is to make the point that virtually all cases of OH have a neurogenic component. The term “neurogenic OH” has been used to denote OH that is primarily due to autonomic failure, and even though this classification is useful in the evaluation and management of patients with OH, it is important to understand that this is an oversimplification. …

El-Bedawi KM, Hainsworth R (1994) Combined head-up tilt and lower body suction: a test of orthostatic tolerance. Clin Auton Res 4(1–2):41–47CrossRefPubMed

Gamboa A et al (2008) Excessive nitric oxide function and blood pressure regulation in patients with autonomic failure. Hypertension 51(6):1531–1536CrossRefPubMed

Okamoto LE et al (2021) Local passive heat for the treatment of hypertension in autonomic failure. J Am Heart Assoc 10(7):e018979CrossRefPubMedPubMedCentral

Vogel ER, Sandroni P, Low PA (2005) Blood pressure recovery from Valsalva maneuver in patients with autonomic failure. Neurology 65(10):1533–1537CrossRefPubMed

Low P, Singer W (2023) The arterial baroreflex in neurogenic orthostatic hypotension. Clin Auton Res 33(2):81–82CrossRefPubMed

Norcliffe-Kaufmann L et al (2018) Orthostatic heart rate changes in patients with autonomic failure caused by neurodegenerative synucleinopathies. Ann Neurol 83(3):522–531CrossRefPubMedPubMedCentral

Juraschek SP et al (2020) Orthostatic hypotension, cardiovascular outcomes, and adverse events: results from SPRINT. Hypertension 75(3):660–667CrossRefPubMed

Kaufmann H et al (2014) Droxidopa for neurogenic orthostatic hypotension: a randomized, placebo-controlled, phase 3 trial. Neurology 83(4):328–335CrossRefPubMedPubMedCentral

Singer W et al (2006) Pyridostigmine treatment trial in neurogenic orthostatic hypotension. Arch Neurol 63(4):513–518CrossRefPubMed

10.

Mar PL et al (2015) Neurogenic hyperadrenergic orthostatic hypotension: a newly recognized variant of orthostatic hypotension in older adults with elevated norepinephrine (noradrenaline). Clin Sci (Lond) 129(2):107–116CrossRefPubMed

11.

Shibao C et al (2013) Early discontinuation of treatment in patients with orthostatic hypotension. Auton Neurosci 177(2):291–296CrossRefPubMedPubMedCentral

12.

Shibao CA et al (2020) Congenital absence of norepinephrine due to CYB561 mutations. Neurology 94(2):e200–e204CrossRefPubMedPubMedCentral

13.

Wahba A et al (2022) Management of orthostatic hypotension in the hospitalized patient: a narrative review. Am J Med 135(1):24–31CrossRefPubMed

Title: All orthostatic hypotension is neurogenic
Author: Italo Biaggioni
Publication date: 19-07-2023
Publisher: Springer Berlin Heidelberg
Keywords: Hypotension
Hypotension
Published in: Clinical Autonomic Research / Issue 4/2023
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI: https://doi.org/10.1007/s10286-023-00966-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

All orthostatic hypotension is neurogenic

Excerpt

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 4/2023

Poor health-related quality of life in postural orthostatic tachycardia syndrome in comparison with a sex- and age-matched normative population

Cognitive functioning in postural orthostatic tachycardia syndrome among different body positions: a prospective pilot study (POTSKog study)

Autonomic control of ventricular function in health and disease: current state of the art

Quality of life in individuals with primary hyperhidrosis: a systematic review and meta-analysis

A case showing how hyperventilation may decrease blood pressure in neurogenic orthostatic hypotension

Orthostatic hypertension—too much of a good thing