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. 2022 Nov;79(11):2385-2387.
doi: 10.1161/HYPERTENSIONAHA.122.19113. Epub 2022 Sep 16.

Management of Patients With Hypertension and Orthostatic Hypotension. Parallel Progress

Stephen P Juraschek  1 , Italo Biaggioni  2
Affiliations

Management of Patients With Hypertension and Orthostatic Hypotension. Parallel Progress

Stephen P Juraschek et al. Hypertension. 2022 Nov.
No abstract available

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Figures

Figure.
Figure.. Spectrum of orthostatic hypotension (OH).
Clinical development of OH requires the presence of autonomic impairment (due to aging, diabetes, and primary autonomic neuropathies) often in combination with aggravating factors that overwhelm or impair compensatory autonomic responses (volume depletion, infections, deconditioning, and medications). Evidence based on the SPRINT (Systolic Blood Pressure Intervention Trial) and ACCORD trials (Action to Control Cardiovascular Risk in Diabetes) indicate that effective hypertension control can be achieved without worsening of OH in patients in the mild end of the spectrum of OH. In parallel, medications that treat OH without significantly worsening supine hypertension have been developed (droxidopa trials,). Novel approaches are also being developed to selectively improve OH (Ampreloxetine, abdominal binder) and to treat supine hypertension in a way that may improve daytime OH (passive heat). There is, however, little if any overlap in the severity of OH in patients enrolled in these studies.
See this image and copyright information in PMC

References

    1. Denfeld QE, Turrise S, MacLaughlin EJ, Chang PS, Clair WK, Lewis EF, Forman DE, Goodlin SJ; American Heart Association Cardiovascular Disease in Older Populations Committee of the Council on Clinical Cardiology and Council on Cardiovascular and Stroke Nursing; Council on Lifestyle and Cardiometabolic Health; and Stroke Council. Preventing and managing falls in adults with cardiovascular disease: a scientific statement from the American Heart Association. Circ Cardiovasc Qual Outcomes. 2022;15:e000108. doi: 10.1161/HCQ.0000000000000108 - DOI - PubMed
    1. Gangavati A, Hajjar I, Quach L, Jones RN, Kiely DK, Gagnon P, Lipsitz LA. Hypertension, orthostatic hypotension, and the risk of falls in a community-dwelling elderly population: the maintenance of balance, independent living, intellect, and zest in the elderly of Boston study. J Am Geriatr Soc. 2011;59:383–389. doi: 10.1111/j.1532-5415.2011.03317.x - DOI - PMC - PubMed
    1. Juraschek SP, Taylor AA, Wright JT Jr, Evans GW, Miller ER 3rd, Plante TB, Cushman WC, Gure TR, Haley WE, Moinuddin I, et al.; SPRINT Research Group. Orthostatic hypotension, cardiovascular outcomes, and adverse events: results from SPRINT. Hypertension. 2020;75:660–667. doi: 10.1161/HYPERTENSIONAHA.119.14309 - DOI - PMC - PubMed
    1. Fleg JL, Evans GW, Margolis KL, Barzilay J, Basile JN, Bigger JT, Cutler JA, Grimm R, Pedley C, Peterson K, et al. Orthostatic Hypotension in the ACCORD (Action to Control Cardiovascular Risk in Diabetes) blood pressure trial: prevalence, incidence, and prognostic significance. Hypertension. 2016;68:888–895. doi: 10.1161/HYPERTENSIONAHA.116.07474 - DOI - PMC - PubMed
    1. Juraschek SP, Lipsitz LA, Beach JL, Mukamal KJ. Association of orthostatic hypotension timing with clinical events in adults with diabetes and hypertension: results from the ACCORD Trial. Am J Hypertens. 2019;32:684–694. doi: 10.1093/ajh/hpz015 - DOI - PMC - PubMed

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