SUPINE HYPERTENSION AND ORTHOSTATIC HYPOTENSION – A MANAGEMENT CHALLENGE
Abstract
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.
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