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Cited by 455Cardiovascular Syncope and Autonomic DisordersHeart Rate Variability and Autonomic ControlParkinson's Disease Mechanisms and Treatments

The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension

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Gibbons, Christopher H., Schmidt, Peter, Biaggioni, Italo, Frazier-Mills, Camille, Freeman, Roy, Isaacson, Stuart, Karabin, Beverly, Kuritzky, Louis +6 more·2017·Journal of Neurology
DOI 10.1007/s00415-016-8375-xPMC PMC5533816
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Abstract

Neurogenic orthostatic hypotension (nOH) is common in patients with neurodegenerative disorders such as Parkinson's disease, multiple system atrophy, pure autonomic failure, dementia with Lewy bodies, and peripheral neuropathies including amyloid or diabetic neuropathy. Due to the frequency of nOH in the aging population, clinicians need to be well informed about its diagnosis and management. To date, studies of nOH have used different outcome measures and various methods of diagnosis, thereby preventing the generation of evidence-based guidelines to direct clinicians towards 'best practices' when treating patients with nOH and associated supine hypertension. To address these issues, the American Autonomic Society and the National Parkinson Foundation initiated a project to develop a statement of recommendations beginning with a consensus panel meeting in Boston on November 7, 2015, with continued communications and contributions to the recommendations through October of 2016. This paper summarizes the panel members' discussions held during the initial meeting along with continued deliberations among the panel members and provides essential recommendations based upon best available evidence as well as expert opinion for the (1) screening, (2) diagnosis, (3) treatment of nOH, and (4) diagnosis and treatment of associated supine hypertension.

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  • The supine hypertension that accompanies NOH leads to increased nocturnal diuresis, which in turn worsens orthostatic intolerance, particularly in the morning.

    “the supine hypertension that accompanies NOH leads to increased nocturnal diuresis, which in turn worsens orthostatic intolerance, particularly in the morning.”

    From Postural Orthostatic Tachycardia Syndrome (2019) · cites this paper as [106]

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Authors
Gibbons, C. H., Schmidt, P., Biaggioni, I., Frazier-Mills, C., Freeman, R., Isaacson, S., Karabin, B., Kuritzky, L., Lew, M., Low, P., Mehdirad, A., Raj, S. R., Vernino, S., & Kaufmann, H.
Affiliations
  • Beth Israel Deaconess Medical Center (US)
  • National Parkinson's Foundation (US)
  • Vanderbilt University Medical Center (US)
  • University of Toledo Medical Center (US)
  • University of Florida Health (US)
  • University of Southern California (US)
  • Mayo Clinic (US)
  • Saint Louis University Hospital (US)
  • University of Calgary (CA)
  • The University of Texas Southwestern Medical Center (US)
  • NYU Langone Health (US)
Corresponding author
Gibbons, Christopher H.
ORCID
Venue
Journal of Neurology
Publisher
Springer Science and Business Media LLC
Published
2017-01-03
Volume
264
Issue
8
Pages
1567-1582
ISSN
  • 0012-1037 (ISSN-L)
  • 0340-5354
  • 1432-1459
DOI
10.1007/s00415-016-8375-x
PMC
PMC5533816
OpenAlex
W2567578155
Cited by
455
References
6
Citations by year
2026: 39 · 2025: 40 · 2024: 60 · 2023: 54 · 2022: 45 · 2021: 56 · 2020: 51 · 2019: 55 · 2018: 32 · 2017: 21 · 2016: 1
FWCI
44.56
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Neurology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders
  • National Parkinson Foundation
  • H. Lundbeck A/S
  • Parkinsonfonden
  • National Institute of Neurological Disorders and Stroke (U54NS065736)
Topics
  • Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
Keywords
neurogenic orthostatic hypotension, supine hypertension, Parkinson's disease, multiple system atrophy, pure autonomic failure, dementia with Lewy bodies, peripheral neuropathy, autonomic dysfunction, screening, diagnosis, treatment, clinical guidelines, consensus panel
MeSH terms
Humans, Hypertension, Hypotension, Orthostatic, Supine Position

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