Universität zu Köln

Jordan, Jens, Tank, Jens, Heusser, Karsten, Reuter, Hannes and Biaggioni, Italo (2019). What do we really know about supine hypertension in patients with orthostatic hypotension. Curr. Opin. Cardiol., 34 (4). S. 384 - 390. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1531-7080

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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 Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Jordan, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Tank, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Heusser, Karsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Reuter, Hannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Biaggioni, Italo UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-135939
DOI:	10.1097/HCO.0000000000000633
Journal or Publication Title:	Curr. Opin. Cardiol.
Volume:	34
Number:	4
Page Range:	S. 384 - 390
Date:	2019
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1531-7080
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BLOOD-PRESSURE; AUTONOMIC FAILURE; ANGIOTENSIN-II Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13593