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What do we really know about supine hypertension in patients with orthostatic hypotension

Jordan, J. and Tank, J. and Heusser, K. and Reuter, H. and Biaggioni, I. (2019) What do we really know about supine hypertension in patients with orthostatic hypotension. Current Opinion in Cardiology, 34 (4), pp. 384-389. Lippincott Williams & Wilkins Ltd.. DOI: 10.1097/HCO.0000000000000633 ISSN 0268-4705

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Official URL: http://www.co-cardiology.com

Abstract

Purpose of review Patients with severe orthostatic hypotension due to autonomic failure may be hypertensive in the supine position. Until recently, there were no internationally recognized diagnostic criteria for supine hypertension. This review covers diagnostic criteria, mechanisms, and management of supine hypertension in autonomic failure patients. Recent findings Recently, an international consensus group defined supine hypertension in patients with neurogenic orthostatic hypotension as brachial SBP at least 140 mmHg and/or DBP at least 90 mmHg while supine. Using these criteria, a large proportion of patients with orthostatic hypotension is diagnosed with supine hypertension. Recent research supports the concept that the hypertension can be mediated through residual sympathetic nervous system function and independently from sympathetic activity, for example via mineralocorticoid receptor activation. Summary The clear definition of supine hypertension is an important step that will hopefully foster clinical research in this area. Supine hypertension promotes renal sodium excretion, thus, worsening orthostatic hypotension the next morning. Supine hypertension may promote cardiovascular and renal disease. Yet, long-term benefits of treating supine hypertension be it through non pharmacological or pharmacological means have not been proven by sufficiently large clinical trials.

Item URL in elib:https://elib.dlr.de/129873/
Document Type:Article
Title:What do we really know about supine hypertension in patients with orthostatic hypotension
Authors:
AuthorsInstitution or Email of AuthorsAuthors ORCID iD
Jordan, J.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.UNSPECIFIED
Tank, J.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.UNSPECIFIED
Heusser, K.Institute of Aerospace Medicine, German Aerospace Center, Cologne, GermanyUNSPECIFIED
Reuter, H.University Hypertension Center, University of Cologne, Department of Internal Medicine and Cardiology, Ev. Klinikum Ko¨ ln-Weyertal, Department III of Internal Medicine, Heart Center of the University of Cologne, Cologne, GermanyUNSPECIFIED
Biaggioni, I.Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University School of Medicine, NashvilleUNSPECIFIED
Date:July 2019
Journal or Publication Title:Current Opinion in Cardiology
Refereed publication:Yes
Open Access:No
Gold Open Access:No
In SCOPUS:Yes
In ISI Web of Science:Yes
Volume:34
DOI :10.1097/HCO.0000000000000633
Page Range:pp. 384-389
Publisher:Lippincott Williams & Wilkins Ltd.
ISSN:0268-4705
Status:Published
Keywords:autonomic failure, autonomic nervous system, orthostatic hypotension, supine hypertension
HGF - Research field:Aeronautics, Space and Transport
HGF - Program:Space
HGF - Program Themes:Research under Space Conditions
DLR - Research area:Raumfahrt
DLR - Program:R FR - Forschung unter Weltraumbedingungen
DLR - Research theme (Project):R - Vorhaben Systemphysiologie
Location: Köln-Porz
Institutes and Institutions:Institute of Aerospace Medicine
Institute of Aerospace Medicine > Leitungsbereich ME
Institute of Aerospace Medicine > Cardiovascular Medicine in Aerospace
Deposited By: Schrage, Larissa
Deposited On:29 Oct 2019 15:22
Last Modified:29 Oct 2019 15:22

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