nOH CAN OCCUR WHEN THE NEUROLOGIC FUNCTIONS THAT REGULATE BLOOD PRESSURE ARE DISRUPTED

A patient may suffer from symptoms of nOH if he or she has a neurodegenerative disorder that disrupts the autonomic nervous system's ability to release norepinephrine.2,4

DIAGNOSTICS CONSIDERATIONS

Orthostatic measurements, at-home blood pressure monitoring, excluding other causes, and specialty tests may help identify patients with nOH.1,4,6

CONSIDER FOCUSING ON REDUCTION OF SYMPTOMS

Patients with nOH have a dysfunctional autonomic nervous system.1,4 Rather than attempting to normalize blood pressure, consider management options that aim to reduce symptoms associated with nOH.6,7

MANY PATIENTS WITH nOH ALSO EXPERIENCE SUPINE HYPERTENSION

Up to 70% of patients with nOH experience supine hypertension.8 Certain lifestyle adjustments may help manage the risks of associated supine hypertension.1,6

REFERENCES
  1. Freeman R. Neurogenic orthostatic hypotension. N Engl J Med. 2008;358:615-624.
  2. Freeman R, Wieling W, Axelrod FB, et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res. 2011;21(2):69-72.
  3. Palma JA, Kaufmann H. Epidemiology, diagnosis, and management of neurogenic orthostatic hypotension. Mov Disord Clin Pract. 2017;4(3):298-308.
  4. Low PA. Neurogenic orthostatic hypotension: pathophysiology and diagnosis. Am J Manag Care. 2015;21(suppl 13):s248-s257.
  5. Rascol O, Perez-Lloret S, Damier P, et al. Falls in ambulatory non-demented patients with Parkinson's disease. J Neural Transm (Vienna). 2015;122(10):1447-1455.
  6. Gibbons CH, Schmidt P, Biaggioni I, et al. The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension. J Neurol. 2017;264(8):1567-1582.
  7. Isaacson SH. Managed care approach to the treatment of neurogenic orthostatic hypotension. Am J Manag Care. 2015;21(suppl 13):s258-s268.
  8. Berganzo K, Diez-Arrola B, Tijero B, et al. Nocturnal hypertension and dysautonomia in patients with Parkinson's disease: are they related? J Neurol. 2013;260:1752-1756.