Orthostatic Hypotension: Epidemiology, Prognosis, and Treatment.
Orthostatic hypotension (OH) is a common cardiovascular disorder, with or without signs of underlying neurodegenerative disease. OH is diagnosed on the basis of an orthostatic challenge and implies a persistent systolic/diastolic blood pressure decrease of at least 20/10 mm Hg upon standing. Its prevalence is age dependent, ranging from 5% in patients <50 years of age to 30% in those >70 years of age. OH may complicate treatment of hypertension, heart failure, and coronary heart disease; cause disabling symptoms, faints, and traumatic injuries; and substantially reduce quality of life. Despite being largely asymptomatic or with minimal symptoms, the presence of OH independently increases mortality and the incidence of myocardial infarction, stroke, heart failure, and atrial fibrillation. In this review, we outline the etiology and prevalence of OH in the general population, summarize its relationship with morbidity and mortality, propose a diagnostic and therapeutic algorithm, and delineate current challenges and future perspectives.
Institute of Cardiology "G. d'Annunzio" University and Center of Excellence on Aging, Chieti, Italy.
Fabrizio
F
Ricci
Institute of Cardiology "G. d'Annunzio" University and Center of Excellence on Aging, Chieti, Italy. Electronic address: rdecater@unich.it.
Raffaele
R
De Caterina
Department of Clinical Sciences, Lund University, Clinical Research Center, Skåne University Hospital, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden.
Artur
A
Fedorowski
D001794:Blood Pressure / Q000502:physiology; D015103:Droxidopa / Q000627:therapeutic use; D018475:Head-Down Tilt / Q000502:physiology; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D011187:Posture / Q000502:physiology; D011379:Prognosis; D016896:Treatment Outcome
D015103:Droxidopa
autonomic dysfunction; cardiovascular events; orthostatic hypotension; postural homeostasis