Diagnosis and treatment of orthostatic hypotension in Parkinson's disease

Abstract: Orthostatic hypotension (OH) is a frequent comorbidity affecting between 23 and 38% of Parkinson’s disease (PD) patients. Several pieces of evidence suggest that OH is related to faster cognitive decline and more frequent falls, and has been also connected to increased mortality. OH can be...

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Autores principales: Pérez Lloret, Santiago, Rey, Verónica, Pavy-Le Traon, Anne, Rascol, Olivier
Formato: Artículo
Lenguaje:Inglés
Inglés
Publicado: InTech 2019
Materias:
ENFERMEDADES NEUROGENERATIVAS
ENFERMEDAD DE PARKINSON
TRATAMIENTO
HIPOTENSION ORTOSTATICA
Acceso en línea:https://repositorio.uca.edu.ar/handle/123456789/1640
Aporte de:
Repositorio Institucional de la Universidad Católica Argentina (UCA) de Universidad Católica Argentina
id I33-R139123456789-1640
record_format dspace
institution Universidad Católica Argentina
institution_str I-33
repository_str R-139
collection Repositorio Institucional de la Universidad Católica Argentina (UCA)
language Inglés
Inglés
topic ENFERMEDADES NEUROGENERATIVAS
ENFERMEDAD DE PARKINSON
TRATAMIENTO
HIPOTENSION ORTOSTATICA
spellingShingle ENFERMEDADES NEUROGENERATIVAS
ENFERMEDAD DE PARKINSON
TRATAMIENTO
HIPOTENSION ORTOSTATICA
Pérez Lloret, Santiago
Rey, Verónica
Pavy-Le Traon, Anne
Rascol, Olivier
Diagnosis and treatment of orthostatic hypotension in Parkinson's disease
topic_facet ENFERMEDADES NEUROGENERATIVAS
ENFERMEDAD DE PARKINSON
TRATAMIENTO
HIPOTENSION ORTOSTATICA
description Abstract: Orthostatic hypotension (OH) is a frequent comorbidity affecting between 23 and 38% of Parkinson’s disease (PD) patients. Several pieces of evidence suggest that OH is related to faster cognitive decline and more frequent falls, and has been also connected to increased mortality. OH can be arbitrarily defined as a drop of systolic and/or diastolic blood pressure of 20 or 10 mmHg or more in the first three minutes after passing from decubitus to an upright position. Till test appears to be the most reliable tool for assessing the orthostatic response. On the other hand, the standing test and evaluation of orthostatic symptoms should be regarded as screening tests. The key physiopathological aspect of OH is an altered baroreflex function resulting from cardiac and vascular sympathetic denervation. Nonetheless, OH can be aggravated by heat, alcohol consumption or by drug treatments, such as antihypertensives, dopamine agonists or amantadine. Treatment should begin with re‐considering drug treatments. After treatment is optimized, nonpharmacological measures may be employed. Drugs treatment should be reserved for patients in whom other strategies have failed. Midodrine and fludrocortisone are the most frequently used treatments, even though evidence about their efficacy and safety is weak. Midodrine has a shorter duration of action and thus avoidance of evening dosing may help keep nocturnal blood pressure dipping intact. Promising alternatives may include droxidopa and fipamezole
format Artículo
author Pérez Lloret, Santiago
Rey, Verónica
Pavy-Le Traon, Anne
Rascol, Olivier
author_facet Pérez Lloret, Santiago
Rey, Verónica
Pavy-Le Traon, Anne
Rascol, Olivier
author_sort Pérez Lloret, Santiago
title Diagnosis and treatment of orthostatic hypotension in Parkinson's disease
title_short Diagnosis and treatment of orthostatic hypotension in Parkinson's disease
title_full Diagnosis and treatment of orthostatic hypotension in Parkinson's disease
title_fullStr Diagnosis and treatment of orthostatic hypotension in Parkinson's disease
title_full_unstemmed Diagnosis and treatment of orthostatic hypotension in Parkinson's disease
title_sort diagnosis and treatment of orthostatic hypotension in parkinson's disease
publisher InTech
publishDate 2019
url https://repositorio.uca.edu.ar/handle/123456789/1640
work_keys_str_mv AT perezlloretsantiago diagnosisandtreatmentoforthostatichypotensioninparkinsonsdisease
AT reyveronica diagnosisandtreatmentoforthostatichypotensioninparkinsonsdisease
AT pavyletraonanne diagnosisandtreatmentoforthostatichypotensioninparkinsonsdisease
AT rascololivier diagnosisandtreatmentoforthostatichypotensioninparkinsonsdisease
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