PRIORITIZE nOH SYMPTOM RELIEF IN DIAGNOSED PATIENTS

Patients with neurogenic orthostatic hypotension (nOH) often have a pre-existing neurodegenerative disorder, such as Parkinson’s disease.1-3 Due to the high degree of hemodynamic variability in nOH patients, restoring normal blood pressure may not be a realistic goal.1,4,5 Instead, consider management methods that work to reduce symptoms of nOH in patients, including lifestyle adjustments.1,3-5

ADJUSTMENTS IN A PATIENT’S DAILY ROUTINE MAY HELP RELIEVE nOH SYMPTOMS IN SOME PATIENTS

For patients feeling dizzy, experiencing syncope, or having other symptoms that improve upon sitting, the following lifestyle adjustments may help patients find relief1,3,4:

CHANGES IN DIET

  • Drinking a minimum of 2L of water daily
  • Increasing salt intake
  • Eating smaller meals, low in carbohydrates

PHYSICAL ADJUSTMENTS

  • Exercising in the recumbent position (eg, stationary bicycle, rowing machine)
  • Avoiding increased core body temperature
  • Elevating head of bed 6 to 9 inches
  • Wearing compression stockings or abdominal binder

References: 1. Freeman R. Neurogenic orthostatic hypotension. N Engl J Med. 2008;358(6):615-624. 2. 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. 3. Kaufmann H, Norcliffe-Kaufmann L, Palma JA. Droxidopa in neurogenic orthostatic hypotension. Expert Rev Cardiovasc Ther. 2015;13(8):875-891. 4. 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. 5. Isaacson SH. Managed care approach to the treatment of neurogenic orthostatic hypotension. Am J Manag Care. 2015;21(suppl 13):s258-s268.