SUPINE HYPERTENSION AND ORTHOSTATIC HYPOTENSION – A MANAGEMENT CHALLENGE
SUPINE HYPERTENSION AND ORTHOSTATIC HYPOTENSION-A MANAGEMENT CHALLENGE (Abstract): We report the case of an 80-year-old patient, treated for hypertension (HT), with history of stroke, mesenteric artery thrombosis, ischemic coronary artery disease and lower limb peripheral artery disease, who was admitted to our department for dizziness and recurrent attacks of syncope. The patient also has a recent diagnosis of Parkinson’s disease. Cardiac and reflex syncope were excluded by specific tests. Syncope due to orthostatic hypotension (OH) was confirmed by active standing test. The major issue for clinician was the therapeutic approach for supine HT associated with OH. The optimal schedule for HT was established. Midodrine, the only available medication, was added with satisfactory effects on OH. Lifestyle modification was considered an essential step for achieving the therapeutic success.
2. Masuo K, Mikami H, Ogihara T, et al. Changes in frequency of orthostatic hypotension in elderly hypertensive patients under medications. Am J Hypertens 1996; 9: 263-268.
3. Shibao C, Lipsitz LA, Biaggioni I. ASH Position Paper: Evaluation and Treatment of Orthostatic Hypotension. J Clin Hypertens 2013; 15: 147-153.
4. Gibbons CH, Schmidt P, Biaggioni I, et al. The recommendations of a consensus panel for the screen-ing, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension. J Neurol 2017; 265: 1567-1582.
5. Goldstein DS, Pechnik S, Holmes C, et al. Association between supine hypertension and orthostatic hypotension in autonomic failure. Hypertension 2003; 42: 136-142.
6. Mader SL. Orthostatic hypotension. Med Clin North Am 1989; 73: 1337-1349.
7. Loew F, Gauthey L, Koerffy A, et al. Postprandial hypotension and orthostatic blood pressure re-sponses in elderly Parkinson's disease patients. J Hypertens 1995; 13: 1291-1297.
8. Engstrom JW, Aminoff MJ. Evaluation and treatment of orthostatic hypotension. Am Fam Physician 1997; 56: 1378-1384.
9. Dampney RA, Coleman MJ, Fontes MA, et al. Central mechanisms underlying short‐ and long‐term regulation of the cardiovascular system. Clin Exp Pharmacol Physiol 2002; 29: 261-268.
10. Robertson D, Wade D, Robertson R M. Postprandial alterations in cardiovascular hemodynamics in autonomic dysfunctional states. Am J Cardiol 1981; 48: 1048-1052.
11. Biaggioni I. Treatment: special conditions: orthostatic hypotension. J Am Soc Hypertens 2015; 9: 67-69.
12. Freeman R. Treatment of orthostatic hypotension. Semin Neurol 2003; 23: 435-442.
13. Aursulesei V, Girigan A, Cojocaru DC. Arterial hypertension in the elderly - the heart of the matter. Rev Med Chir Soc Med Nat Iasi 2015; 119 (3): 639-646.
14. Cojocaru DC, Aursulesei V. Rethinking Medical Practice in an Aging World. 6th LUMEN International Conference on Rethinking Social Action Core Values 2015; 323-328.
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