100 percentage

ALMOST ALL PATIENTS WITH PURE AUTONOMIC FAILURE EXPERIENCE SYMPTOMS ASSOCIATED WITH nOH

Nearly 100% of patients with pure autonomic failure will also experience symptoms of neurogenic orthostatic hypotension (nOH).1

PURE AUTONOMIC FAILURE IS A NEURODEGENERATIVE DISORDER THAT CAN DAMAGE A PATIENT’S AUTONOMIC NERVOUS SYSTEM

Pure autonomic failure, formerly known as Bradbury-Eggleston syndrome, is a disorder that is characterized by the degeneration of the autonomic nervous system.2 Consequently, most patients with pure autonomic failure may also experience symptoms associated with nOH as a result of a norepinephrine deficiency.1,3-6 Norepinephrine is the major neurotransmitter responsible for blood pressure maintenance following postural change.7 If your patients with pure autonomic failure are experiencing dizziness, lightheadedness, or any other symptoms that improve upon sitting, they may have nOH.3,4,8

 

PATIENTS WITH PURE AUTONOMIC FAILURE AND nOH MAY ALSO EXPERIENCE SUPINE HYPERTENSION

Up to 70% of patients with nOH will experience associated supine hypertension. This prevalence may be due to prolonged disease duration as well as decreased cardiovascular autonomic function.3,9,10 Supine hypertension may occur at any point during the day when a patient is in a recumbent position.10,11 Certain daily adjustments may help a patient manage his or her supine hypertension.3,11

Learn more about nOH and supine hypertension >>

OTHER NEURODEGENERATIVE DISORDERS HAVE BEEN LINKED TO nOH

Other disorders that have been identified to cause a norepinephrine deficiency and symptoms of nOH include12,13:

  • Lewy body dementia
  • Amyloidosis
  • Diabetic neuropathy
  • Guillian-Barré syndrome

References: 1. 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. 2. Gupta F, Kremens D, Vernino S, et al. Managing neurogenic orthostatic hypotension in a patient presenting with pure autonomic failure who later developed Parkinson disease. Clin Auton Res. 2017;27(suppl 1):s9-s11. 3. Kaufmann H, Norcliffe-Kaufmann L, Palma JA. Droxidopa in neurogenic orthostatic hypotension. Expert Rev Cardiovasc Ther. 2015;13(8):875-891. 4. Freeman R. Neurogenic orthostatic hypotension. N Engl J Med. 2008;358(6):615-624. 5. 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. 6. Kaufmann H, Norcliffe-Kaufmann L, Palma JA, et al. Natural history of pure autonomic failure: A United States prospective cohort. Ann Neurol. 2017;81(2):287-297. 7. Isaacson SH, Skettini J. Neurogenic orthostatic hypotension in Parkinson’s disease: evaluation, management, and emerging role of droxidopa. Vasc Health Risk Manag. 2014;10:169-176. 8. 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. 9. 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(7):1752-1756. 10. Stuebner E, Vichayanrat E, Low DA, et al. Twenty-four hour non-invasive ambulatory blood pressure and heart rate monitoring in Parkinson’s disease. Front Neurol. 2013;4:49.  11. Jordan J, Biaggioni I. Diagnosis and treatment of supine hypertension in autonomic failure patients with orthostatic hypotension. J Clin Hypertens. 2002;4(2):139-145.  12. Low PA. Neurogenic orthostatic hypotension: pathophysiology and diagnosis. Am J Manag Care. 2015;21(suppl 13):s248-s257. 13. Goldstein DS, Sharabi Y. Neurogenic orthostatic hypotension: a pathophysiological approach. Circulation. 2009;119(1):139-146.