IDENTIFYING nOH IS THE FIRST STEP IN ADDRESSING SYMPTOMS

Once Jody received a neurogenic orthostatic hypotension (nOH) diagnosis, she was able to better manage her symptoms associated with nOH. Hear her firsthand account of life with nOH.

3 REASONS PATIENTS WITH nOH MAY GO UNDIAGNOSED:

1

Low awareness of nOH - nOH is considered an orphan disease, but affects many patients with Parkinson's disease, multiple system atrophy, and pure autonomic failure.1-4 Screening questions may help identify symptoms of nOH in these patients.5-7

2

Mistaken nOH symptoms - In some patients, symptoms of nOH may be mistaken as symptoms of their pre-existing neurodegenerative disorder.8

3

Delayed symptomatic episodes - nOH symptoms may not present immediately following postural changes. In some patients, symptomatic episodes may occur several minutes after standing.9 nOH may go undetected if blood pressure and heart rate monitoring are left incomplete. Measuring blood pressure and heart rate in both the supine and standing positions may help determine if your patient has nOH.2,7,10

References: 1. Freeman R. Neurogenic orthostatic hypotension. N Engl J Med. 2008;358(6):615-624. 2. Kaufmann H, Norcliffe-Kaufmann L, Palma JA. Droxidopa in neurogenic orthostatic hypotension. Expert Rev Cardiovasc Ther. 2015;13(8):875-891. 3. Ha AD, Brown CH, York MK, et al. The prevalence of symptomatic orthostatic hypotension in patients with Parkinson’s disease and atypical parkinsonism. Parkinsonism Relat Disord. 2011;17(8):625-628. 4. Kaufmann H. Consensus statement on the definition of orthostatic hypotension, pure autonomic failure and multiple system atrophy. Clin Auton Res. 1996;6(2):125-126. 5. Kaufmann H, Malamut R, Norcliffe-Kaufmann L, et al. The Orthostatic Hypotension Questionnaire (OHQ): validation of a novel symptom assessment scale. Clin Auton Res. 2012;22(2):79-90. 6. Low PA, Singer W. Management of neurogenic orthostatic hypotension: an update. Lancet Neurol. 2008;7(5):451-458. 7. 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. 8. Low PA. Neurogenic orthostatic hypotension: pathophysiology and diagnosis. Am J Manag Care. 2015;21(suppl 13):s248-s257. 9. Low PA, Opfer-Gehrking TL, McPhee BR, et al. Prospective evaluation of clinical characteristics of orthostatic hypotension. Mayo Clin Proc. 1995;70(7):617-622. 10. Shibao C, Lipsitz LA, Biaggioni I. Evaluation and treatment of orthostatic hypotension. J Am Soc Hypertens. 2013;7(4):317-324.