Diagnosis and treatment of orthostatic hypotension in Parkinson's disease

Autores
Pérez Lloret, Santiago; Rey, Verónica; Pavy-Le Traon, Anne; Rascol, Olivier
Año de publicación
2013
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Fil: Pérez Lloret, Santiago. Pontificia Universidad Católica Argentina. Laboratorio de Farmacología Clínica y Epidemiología; Argentina
Fil: Pérez Lloret, Santiago. Universidad de Toulouse III. Hospital Universitario. Departamento de Investigación Clínica; Francia
Fil: Pérez Lloret, Santiago. Universidad de Toulouse III. Hospital Universitario. Departamento de Farmacología Clínica y Neurociencias; Francia
Fil: Pérez Lloret, Santiago. Institut national de la santé et de la recherche médicale; Francia
Fil: Rey, Verónica. Pontificia Universidad Católica Argentina. Laboratorio de Farmacología Clínica y Epidemiología; Argentina
Fil: Rey, Verónica. Universidad de Toulouse III. Hospital Universitario. Departamento de Investigación Clínica; Francia
Fil: Rey, Verónica. Universidad de Toulouse III. Hospital Universitario. Departamento de Farmacología Clínica y Neurociencias; Francia
Fil: Rey, Verónica. Institut national de la santé et de la recherche médicale; Francia
Fil: Pavy-Le Traon, Anne. Universidad de Toulouse III. Hospital Universitario. Departamento de Investigación Clínica; Francia
Fil: Pavy-Le Traon, Anne. Universidad de Toulouse III. Hospital Universitario. Departamento de Farmacología Clínica y Neurociencias; Francia
Fil: Pavy-Le Traon, Anne. Institut national de la santé et de la recherche médicale; Francia
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
Fuente
Journal of Integrative Medicine, Vol. 1, Nro. 27, 2013
Materia
ENFERMEDADES NEUROGENERATIVAS
ENFERMEDAD DE PARKINSON
TRATAMIENTO
HIPOTENSION ORTOSTATICA
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/4.0/
Repositorio
Repositorio Institucional (UCA)
Institución
Pontificia Universidad Católica Argentina
OAI Identificador
oai:ucacris:123456789/1640
Acceder
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oai_identifier_str oai:ucacris:123456789/1640
network_acronym_str RIUCA
repository_id_str 2585
network_name_str Repositorio Institucional (UCA)
spelling Diagnosis and treatment of orthostatic hypotension in Parkinson's diseasePérez Lloret, SantiagoRey, VerónicaPavy-Le Traon, AnneRascol, OlivierENFERMEDADES NEUROGENERATIVASENFERMEDAD DE PARKINSONTRATAMIENTOHIPOTENSION ORTOSTATICAFil: Pérez Lloret, Santiago. Pontificia Universidad Católica Argentina. Laboratorio de Farmacología Clínica y Epidemiología; ArgentinaFil: Pérez Lloret, Santiago. Universidad de Toulouse III. Hospital Universitario. Departamento de Investigación Clínica; FranciaFil: Pérez Lloret, Santiago. Universidad de Toulouse III. Hospital Universitario. Departamento de Farmacología Clínica y Neurociencias; FranciaFil: Pérez Lloret, Santiago. Institut national de la santé et de la recherche médicale; FranciaFil: Rey, Verónica. Pontificia Universidad Católica Argentina. Laboratorio de Farmacología Clínica y Epidemiología; ArgentinaFil: Rey, Verónica. Universidad de Toulouse III. Hospital Universitario. Departamento de Investigación Clínica; FranciaFil: Rey, Verónica. Universidad de Toulouse III. Hospital Universitario. Departamento de Farmacología Clínica y Neurociencias; FranciaFil: Rey, Verónica. Institut national de la santé et de la recherche médicale; FranciaFil: Pavy-Le Traon, Anne. Universidad de Toulouse III. Hospital Universitario. Departamento de Investigación Clínica; FranciaFil: Pavy-Le Traon, Anne. Universidad de Toulouse III. Hospital Universitario. Departamento de Farmacología Clínica y Neurociencias; FranciaFil: Pavy-Le Traon, Anne. Institut national de la santé et de la recherche médicale; FranciaAbstract: 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 fipamezoleInTech2013info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfhttps://repositorio.uca.edu.ar/handle/123456789/16401848-884610.5772/56924Pérez Lloret, S., Rey M.V., Pavy-Le Traon, A., Rascol, O. Diagnosis and treatment of orthostatic hypotension in Parkinson's disease [en línea]. International Journal of Integrative Medicine. 2013, 1 (27). doi: 10.5772/56924. Disponible en: https://repositorio.uca.edu.ar/handle/123456789/1640Journal of Integrative Medicine, Vol. 1, Nro. 27, 2013reponame:Repositorio Institucional (UCA)instname:Pontificia Universidad Católica Argentinaengenginfo:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/4.0/2025-07-03T10:55:21Zoai:ucacris:123456789/1640instacron:UCAInstitucionalhttps://repositorio.uca.edu.ar/Universidad privadaNo correspondehttps://repositorio.uca.edu.ar/oaiclaudia_fernandez@uca.edu.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:25852025-07-03 10:55:21.821Repositorio Institucional (UCA) - Pontificia Universidad Católica Argentinafalse
dc.title.none.fl_str_mv Diagnosis and treatment of orthostatic hypotension in Parkinson's disease
title Diagnosis and treatment of orthostatic hypotension in Parkinson's disease
spellingShingle Diagnosis and treatment of orthostatic hypotension in Parkinson's disease
Pérez Lloret, Santiago
ENFERMEDADES NEUROGENERATIVAS
ENFERMEDAD DE PARKINSON
TRATAMIENTO
HIPOTENSION ORTOSTATICA
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
dc.creator.none.fl_str_mv Pérez Lloret, Santiago
Rey, Verónica
Pavy-Le Traon, Anne
Rascol, Olivier
author Pérez Lloret, Santiago
author_facet Pérez Lloret, Santiago
Rey, Verónica
Pavy-Le Traon, Anne
Rascol, Olivier
author_role author
author2 Rey, Verónica
Pavy-Le Traon, Anne
Rascol, Olivier
author2_role author
author
author
dc.subject.none.fl_str_mv ENFERMEDADES NEUROGENERATIVAS
ENFERMEDAD DE PARKINSON
TRATAMIENTO
HIPOTENSION ORTOSTATICA
topic ENFERMEDADES NEUROGENERATIVAS
ENFERMEDAD DE PARKINSON
TRATAMIENTO
HIPOTENSION ORTOSTATICA
dc.description.none.fl_txt_mv Fil: Pérez Lloret, Santiago. Pontificia Universidad Católica Argentina. Laboratorio de Farmacología Clínica y Epidemiología; Argentina
Fil: Pérez Lloret, Santiago. Universidad de Toulouse III. Hospital Universitario. Departamento de Investigación Clínica; Francia
Fil: Pérez Lloret, Santiago. Universidad de Toulouse III. Hospital Universitario. Departamento de Farmacología Clínica y Neurociencias; Francia
Fil: Pérez Lloret, Santiago. Institut national de la santé et de la recherche médicale; Francia
Fil: Rey, Verónica. Pontificia Universidad Católica Argentina. Laboratorio de Farmacología Clínica y Epidemiología; Argentina
Fil: Rey, Verónica. Universidad de Toulouse III. Hospital Universitario. Departamento de Investigación Clínica; Francia
Fil: Rey, Verónica. Universidad de Toulouse III. Hospital Universitario. Departamento de Farmacología Clínica y Neurociencias; Francia
Fil: Rey, Verónica. Institut national de la santé et de la recherche médicale; Francia
Fil: Pavy-Le Traon, Anne. Universidad de Toulouse III. Hospital Universitario. Departamento de Investigación Clínica; Francia
Fil: Pavy-Le Traon, Anne. Universidad de Toulouse III. Hospital Universitario. Departamento de Farmacología Clínica y Neurociencias; Francia
Fil: Pavy-Le Traon, Anne. Institut national de la santé et de la recherche médicale; Francia
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
description Fil: Pérez Lloret, Santiago. Pontificia Universidad Católica Argentina. Laboratorio de Farmacología Clínica y Epidemiología; Argentina
publishDate 2013
dc.date.none.fl_str_mv 2013
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://repositorio.uca.edu.ar/handle/123456789/1640
1848-8846
10.5772/56924
Pérez Lloret, S., Rey M.V., Pavy-Le Traon, A., Rascol, O. Diagnosis and treatment of orthostatic hypotension in Parkinson's disease [en línea]. International Journal of Integrative Medicine. 2013, 1 (27). doi: 10.5772/56924. Disponible en: https://repositorio.uca.edu.ar/handle/123456789/1640
url https://repositorio.uca.edu.ar/handle/123456789/1640
identifier_str_mv 1848-8846
10.5772/56924
Pérez Lloret, S., Rey M.V., Pavy-Le Traon, A., Rascol, O. Diagnosis and treatment of orthostatic hypotension in Parkinson's disease [en línea]. International Journal of Integrative Medicine. 2013, 1 (27). doi: 10.5772/56924. Disponible en: https://repositorio.uca.edu.ar/handle/123456789/1640
dc.language.none.fl_str_mv eng
eng
language eng
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/4.0/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/4.0/
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv InTech
publisher.none.fl_str_mv InTech
dc.source.none.fl_str_mv Journal of Integrative Medicine, Vol. 1, Nro. 27, 2013
reponame:Repositorio Institucional (UCA)
instname:Pontificia Universidad Católica Argentina
reponame_str Repositorio Institucional (UCA)
collection Repositorio Institucional (UCA)
instname_str Pontificia Universidad Católica Argentina
repository.name.fl_str_mv Repositorio Institucional (UCA) - Pontificia Universidad Católica Argentina
repository.mail.fl_str_mv claudia_fernandez@uca.edu.ar
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score 13.13397

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