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Orthostatic hypotension

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https://www.readbyqxmd.com/read/28444110/the-association-of-orthostatic-hypotension-with-falls-an-end-to-the-debate
#1
James Frith
No abstract text is available yet for this article.
April 24, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28439398/a-practical-approach-to-the-pharmacological-management-of-hypertension-in-older-people
#2
REVIEW
Nikesh Parekh, Amy Page, Khalid Ali, Kevin Davies, Chakravarthi Rajkumar
Hypertension is the leading cause of cardiovascular (CV) morbidity and mortality in adults over the age of 65. The first part of this paper is an overview, summarizing the current guidelines on the pharmacological management of hypertension in older adults in Europe and the USA, and evidence from key trials that contributed to the guidelines. In the second part of the paper, we will discuss the major challenges of managing hypertension in the context of multimorbidity, including frailty, orthostatic hypotension (OH), falls and cognitive impairment that are associated with ageing...
April 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28428900/asymptomatic-severe-vagal-and-sympathetic-cardiac-denervation-in-holmes-adie-s-syndrome
#3
B Estañol, R C Callejas-Rojas, S Cortés, R Martínez-Memije, O Infante-Vázquez, G Delgado-García
A 40-year-old woman was found to have bilateral Adie's pupils and generalized muscle stretch areflexia. She did not have orthostatic hypotension but, in an ECG strip in the office, she appeared to have an almost fixed heart rate. We thus studied the heart rate variability (HRV) and the systolic blood pressure variability (SBPV) in supine and standing position and also during rhythmic breathing. We found a decreased HRV in the time domain with very low standard deviation in supine and standing position and during rhythmic breathing...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28421033/orthostatic-hypotension-predicts-cognitive-impairment-in-the-elderly-findings-from-a-cohort-study
#4
Haixia Huang, Tianheng Zheng, Fang Liu, Zhuoli Wu, Huazheng Liang, Shaoshi Wang
BACKGROUND: Orthostatic hypotension (OH) is a known risk factor for cerebral ischemia, but its correlation with cognitive impairment (CI) is not well established. OBJECTIVE: The aim of this study is to explore the relationship between OH and CI in the elderly. METHODS: The study group consisted of 44 OH patients who presented with drowsiness, vertigo, and fatigue between January 2009 and December 2011 (OH group). Eighty-eight healthy elderly were paired with those in the OH group in a 1:2 based on their education levels (NOH group)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28408809/assessment-of-effects-of-differences-in-trunk-posture-during-fowler-s-position-on-hemodynamics-and-cardiovascular-regulation-in-older-and-younger-subjects
#5
Satoshi Kubota, Yutaka Endo, Mitsue Kubota, Tomohiko Shigemasa
BACKGROUND: Downward shifts in blood volume with changing position generally cause tachycardic responses. Age-related decreases in vagal nerve activity could contribute to orthostatic hypotension in older individuals. Fowler's position is a reclined position with the back between 30° and 60°, used to facilitate breathing, eating, and other routine daily activities in frail and elderly patients. OBJECTIVE: This study examined whether stroke volume (SV) was higher and heart rate (HR) lower in Fowler's position with an upright upper trunk than in Fowler's position with the whole trunk upright in both older and younger subjects, based on the assumption that lower HR would result from reduced sympathetic activation in older individuals...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28401995/orthostatic-dizziness-in-parkinson-s-disease-is-attributed-to-cerebral-hypoperfusion-a-transcranial-doppler-study
#6
Jinse Park, Hee-Tae Kim, Kang Min Park, Sam Yeol Ha, Sung Eun Kim, Kyong Jin Shin, Si Eun Kim, Wooyoung Jang, Ji Sun Kim, Jinyoung Youn, Engsoek Oh, Suyeon Park
OBJECTIVES: Orthostatic hypotension (OH) is controversially regarded as the cause of orthostatic dizziness in Parkinson's disease (PD). We sought to evaluate whether cerebral autoregulation is an alternative cause for orthostatic dizziness in PD patients, using transcranial Doppler monitoring during head-up tilting. METHODS: Forty-five PD patients with dizziness, 13 PD patients without dizziness, and 10 age-matched healthy controls were enrolled. Participants were divided into the following four groups: patients with dizziness and OH (group 1, n = 22), patients with dizziness but no OH (n = 23, group 2), patients without dizziness (n = 11, group 3), and age-matched healthy controls (n = 10, group 4)...
April 12, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28398981/effectiveness-of-non-pharmacological-interventions-in-treating-orthostatic-hypotension-in-the-elderly-and-people-with-a-neurological-condition-a-systematic-review-protocol
#7
Angela Logan, Jonathan Marsden, Jennifer Freeman, Bridie Kent
The objectives of the review are to determine:Specifically, the review question is:What is the evidence base for non-pharmacological interventions in treating orthostatic hypotension (OH) in elderly people and people with a neurological condition?
April 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28398383/-right-atrial-appendage-thrombosis-during-atrial-fibrillation-an-element-to-look-for
#8
Giovanni Barbati, Renato De Domenico, Stefania Rossi, Elena Vecchiato, Roberto Zeppellini
Oral anticoagulant therapy (OAT) is a mainstay of atrial fibrillation (AF) pharmacological treatment. Left atrial appendage closure is a possible treatment, when feasible, in patients with intracerebral hemorrhage during OAT. We report a case of right atrial appendage thrombosis in a patient with chronic AF admitted for syncope due to diuretic-induced orthostatic hypotension. Two years previously, he had undergone left atrial appendage closure with the Amplatzer Cardiac Plug device because of intracerebral hemorrhage during OAT...
March 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28389156/response-of-non-motor-symptoms-to-levodopa-in-late-stage-parkinson-s-disease-results-of-a-levodopa-challenge-test
#9
Margherita Fabbri, Miguel Coelho, Leonor Correia Guedes, Ines Chendo, Catarina Sousa, Mario M Rosa, Daisy Abreu, Nilza Costa, Catarina Godinho, Angelo Antonini, Joaquim J Ferreira
BACKGROUND: Non-motor symptoms (NMS) are extremely common among late-stage Parkinson's disease (LSPD) patients. Levodopa (L-dopa) responsiveness seems to decrease with disease progression but its effect on NMS in LSPD still needs to be investigated. OBJECTIVE: To assess the response of blood pressure (BP), pain, fatigue and anxiety to L-dopa in LSPD patients. METHODS: 20 LSPD patients, defined as Schwab and England ADL Scale <50 or Hoehn Yahr Stage >3 (MED ON) and 22 PD patients treated with subthalamic deep brain stimulation (advanced PD group) underwent an L-dopa challenge...
February 7, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28385881/quantitative-measurement-of-csf-in-patients-with-spontaneous-intracranial-hypotension
#10
H-C Chen, P-L Chen, Y-H Tsai, C-H Chen, C C-C Chen, J-W Chai
BACKGROUND AND PURPOSE: CSF hypovolemia is a core feature of spontaneous intracranial hypotension. Spontaneous intracranial hypotension is characterized by orthostatic headache and radiologic manifestations, including CSF along the neural sleeves, diffuse pachymeningeal enhancement, and/or venous engorgement. However, these characteristics are only qualitative. Quantifying intraspinal CSF volumes could improve spontaneous intracranial hypotension diagnosis and evaluation of hypovolemic statuses in patients with spontaneous intracranial hypotension...
April 6, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28383399/poststroke-alterations-in-heart-rate-variability-during-orthostatic-challenge
#11
Joel Rodriguez, Andrew Philip Blaber, Markus Kneihsl, Irhad Trozic, Rebecca Ruedl, David A Green, James Broadbent, Da Xu, Andreas Rössler, Helmut Hinghofer-Szalkay, Franz Fazekas, Nandu Goswami
Older adults following recovery from ischemic stroke have a higher incidence of orthostatic hypotension, syncope, and fall risk, which may be related to impaired autonomic responses limiting the ability to maintain cerebral blood flow. Thus, we investigated cerebrovascular and cardiovascular regulation in 23 adults ≥55 years of age, 10 diagnosed with ischemic stroke, and 13 age-matched healthy controls when sitting at rest and upon standing to compare differences of autonomic variables at ∼7 months (218 ± 41 days) poststroke...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28373993/efficacy-of-administration-of-an-angiotensin-converting-enzyme-inhibitor-for-two-years-on-autonomic-and-peripheral-neuropathy-in-patients-with-diabetes-mellitus
#12
Triantafyllos Didangelos, Konstantinos Tziomalos, Charalambos Margaritidis, Zisis Kontoninas, Ioannis Stergiou, Stefanos Tsotoulidis, Eleni Karlafti, Alexandros Mourouglakis, Apostolos I Hatzitolios
Aim. To evaluate the effect of quinapril on diabetic cardiovascular autonomic neuropathy (CAN) and peripheral neuropathy (DPN). Patients and Methods. Sixty-three consecutive patients with diabetes mellitus [43% males, 27 with type 1 DM, mean age 52 years (range 22-65)], definite DCAN [abnormal results in 2 cardiovascular autonomic reflex tests (CARTs)], and DPN were randomized to quinapril 20 mg/day (group A, n = 31) or placebo (group B, n = 32) for 2 years. Patients with hypertension or coronary heart disease were excluded...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28353545/orthostatic-hypotension-new-views-for-an-old-problem
#13
Edoardo Casiglia, Jens Jordan
No abstract text is available yet for this article.
May 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28351846/postural-heart-rate-changes-in-young-patients-with-vasovagal-syncope
#14
Marvin S Medow, Sana Merchant, Melissa Suggs, Courtney Terilli, Breige O'Donnell-Smith, Julian M Stewart
BACKGROUND AND OBJECTIVES: Recurrent postural vasovagal syncope (VVS) is caused by transient cerebral hypoperfusion from episodic hypotension and bradycardia; diagnosis is made by medical history. VVS contrasts with postural tachycardia syndrome (POTS), defined by chronic daily symptoms of orthostatic intolerance with excessive upright tachycardia without hypotension. POTS has recently been conflated with VVS when excessive tachycardia is succeeded by hypotension during tilt testing. We hypothesize that excessive tachycardia preceding hypotension and bradycardia is part of the vasovagal response during tilt testing of patients with VVS...
March 28, 2017: Pediatrics
https://www.readbyqxmd.com/read/28349278/clinical-classification-of-orthostatic-hypotensions
#15
EDITORIAL
William P Cheshire
No abstract text is available yet for this article.
March 27, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28338807/is-orthostatic-hypotension-related-to-falling-a-meta-analysis-of-individual-patient-data-of-prospective-observational-studies
#16
Laura Caroline Hartog, Dennis Schrijnders, G W D Landman, Klaas Groenier, Nanne Kleefstra, Henk J G Bilo, Kornelis Johannes Jongers van Hateren
Background: orthostatic hypotension (OH) is one out of many risk factors believed to contribute to an increased fall risk in elderly subjects but it is unclear whether an independent association between OH and falling exists. Objectives: to perform an individual patient data (IPD) meta-analysis of prospective observational studies investigating the relationship between OH and falling. Design: MEDLINE, EMBASE, the Cochrane Library and the abstracts of annual meetings of selected hypertension societies were searched...
February 25, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28331633/office-orthostatic-blood-pressure-measurements-and-ambulatory-blood-pressure-monitoring-in-the-prediction-of-autonomic-dysfunction
#17
Kawther F Alquadan, Girish Singhania, Abhilash Koratala, Abutaleb A Ejaz
BACKGROUND: In this retrospective analysis we investigated the predictive performance of orthostatic hypotension (OH) and ambulatory blood pressure monitoring (ABP) to predict autonomic dysfunction. METHODS: Statistical associations among the candidate variables were investigated and comparisons of predictive performances were performed using Receiver Operating Characteristics (ROC) curves. RESULTS: Ninety-four patients were included for analysis...
2017: Clinical Hypertension
https://www.readbyqxmd.com/read/28327122/midodrine-as-adjunctive-support-for-treatment-of-refractory-hypotension-in-the-intensive-care-unit-a-multicenter-randomized-placebo-controlled-trial-the-midas-trial
#18
Matthew H Anstey, Bradley Wibrow, Tharusan Thevathasan, Brigit Roberts, Khushi Chhangani, Pauline Yeung Ng, Alexander Levine, Alan DiBiasio, Todd Sarge, Matthias Eikermann
BACKGROUND: Patients admitted to intensive care units (ICU) are often treated with intravenous (IV) vasopressors. Persistent hypotension and dependence on IV vasopressors in otherwise resuscitated patients lead to delay in discharge from ICU. Midodrine is an oral alpha-1 adrenergic agonist approved for treatment of symptomatic orthostatic hypotension. This trial aims to evaluate whether oral administration of midodrine is an effective adjunct to standard therapy to reduce the duration of IV vasopressor treatment, and allow earlier discharge from ICU and hospital...
March 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28319594/long-term-cardiovascular-autonomic-and-clinical-changes-after-immunoglobulin-g-immunoadsorption-therapy-in-autoimmune-autonomic-ganglionopathy
#19
Franca Barbic, Franca Dipaola, Francesca Andreetta, Enrico Brunetta, Laura Dalla Vecchia, Renato Mantegazza, Raffaello Furlan, Carlo Antozzi
A 63-year-old male was diagnosed with autoimmune autonomic ganglionopathy based on the finding of plasma antibodies to the nicotinic acetylcholine receptor (nAChR) of autonomic ganglia. He complained of mouth and eye dryness, dysphagia, severe constipation, erectile dysfunction, urgency, frequent urination, habitual orthostatic syncope and presyncope. A remarkable symptomatic orthostatic hypotension without changes in heart rate was present. We here describe the 3-year time course of the changes in spectral indices of cardiovascular autonomic control LF/HF and LFSAP, dysautonomia symptoms intensity and anti-nAChR antibodies following repetitive selective immunoadsorptions...
March 17, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28306636/blood-pressure-lowering-efficacy-and-safety-of-perindopril-indapamide-amlodipine-single-pill-combination-in-patients-with-uncontrolled-essential-hypertension-a-multicenter-randomized-double-blind-controlled-trial
#20
Jean-Jacques Mourad, Celso Amodeo, Martine de Champvallins, Romualda Brzozowska-Villatte, Roland Asmar
OBJECTIVES: This 4-month, double-blind, randomized, controlled trial was designed to demonstrate the superiority of perindopril/indapamide/amlodipine single pill over perindopril/indapamide after 1 month and to determine further up-titration efficacy and safety in patients with mild-to-moderate hypertension. METHODS: After a 1-month run-in period on perindopril/indapamide 5/1.25 mg, patients with SBP/DBP at least 150/95 mmHg and no diabetes or renal insufficiency received perindopril/indapamide/amlodipine 5/1...
March 16, 2017: Journal of Hypertension
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