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Orthostatic Tolerance, Cerebral Oxygenation, and Blood Velocity in Humans With Sympathetic Failure

M.P.M. Harms, W.N.J.M. Colier, W. Wieling, J.W.M. Lenders, N.H. Secher, J.J. van Lieshout
2000 Stroke  
and Purpose-Patients with orthostatic hypotension due to sympathetic failure become symptomatic when standing, although their capability to maintain cerebral blood flow is reported to be preserved.  ...  We tested the hypothesis that in patients with sympathetic failure, orthostatic symptoms reflect reduced cerebral perfusion with insufficient oxygen supply.  ...  higher, suggesting a shift in the relationship between cerebral perfusion pressure and blood velocity comparable to that in chronic hypertensive patients. 48 The differences in MCA V mean between symptomatic  ... 
doi:10.1161/01.str.31.7.1608 pmid:10884461 fatcat:docespjfb5cj7d72iw4exmlnam

Orthostatic hypotension following spinal cord injury: understanding clinical pathophysiology

V E Claydon, J D Steeves, A Krassioukov
2005 Spinal Cord  
Possible alterations in cerebral autoregulation following SCI, and the impact of these changes upon cerebral perfusion are also examined.  ...  Finally, the management of orthostatic hypotension will be considered.  ...  Since a reduction in cerebral perfusion is the ultimate cause of presyncopal symptoms associated with orthostatic hypotension, an understanding of the control of cerebral autoregulation in SCI is crucial  ... 
doi:10.1038/sj.sc.3101855 pmid:16304564 fatcat:co3nyth6wbeoxkiq2tkwkwpm44

Neurogenic orthostatic hypotension in Parkinson's disease: evaluation, management, and emerging role of droxidopa

Stuart Isaacson, Julia Skettini
2014 Vascular Health and Risk Management  
to orthostatic hypotension and supine hypertension. nOH is common in Parkinson's disease (PD).  ...  Neurogenic orthostatic hypotension (nOH) is due to failure of the autonomic nervous system to regulate blood pressure in response to postural changes due to an inadequate release of norepinephrine, leading  ...  maintain adequate cerebral perfusion upon standing, often in response to orthostatic stress.  ... 
doi:10.2147/vhrm.s53983 pmid:24729712 pmcid:PMC3979788 fatcat:u66rtbddwrghlnzpn5fa6qfwri

Orthostatic Hypotension in Parkinson Disease: How Much You Fall or How Low You Go?

Jose-Alberto Palma, Juan Carlos Gomez-Esteban, Lucy Norcliffe-Kaufmann, Jose Martinez, Beatriz Tijero, Koldo Berganzo, Horacio Kaufmann
2015 Movement Disorders  
Background-Orthostatic hypotension (OH) is frequent in patients with Parkinson disease (PD) and can occur with or without symptoms.  ...  Symptomatic OH was associated with an upright mean blood pressure below 75 mmHg.  ...  Acknowledgments Funding source for this work: National Institutes of Health and the Dysautonomia Foundation, Inc.  ... 
doi:10.1002/mds.26079 pmid:25678194 pmcid:PMC4397106 fatcat:nxq2elqjgzah7egl62kvbiivdu

Positional Brain Ischemia with MCA Occlusion Successfully Treated with Extra-Intracranial Bypass

A. Albanese, G. Esposito, A. Puca, A. Tuttolomondo, B. Tirpakova, D. Di Giuda, G. Maira, V. Di Lazzaro
2010 Cerebrovascular Diseases  
We report a case of PCI associated with middle cerebral artery (MCA) occlusion and without orthostatic hypotension treated by lowflow extra-intracranial bypass.  ...  Because PCI is generally associated with orthostatic hypotension [2, 3] , a hemodynamic mechanism has been proposed [4] .  ...  We report a case of PCI associated with middle cerebral artery (MCA) occlusion and without orthostatic hypotension treated by lowflow extra-intracranial bypass.  ... 
doi:10.1159/000288055 pmid:20185907 fatcat:jinvea3vkbhf3pcfq4swefpdye

Initial orthostatic hypotension and orthostatic intolerance symptom prevalence in older adults: a systematic review

Elena M. Christopoulos, Jennifer Tran, Sarah L. Hillebrand, Peter W. Lange, Rebecca K. Iseli, Carel G.M. Meskers, Andrea B. Maier
2020 International Journal of Cardiology Hypertension  
Initial orthostatic hypotension is a clinically relevant syndrome in older adults which has been associated with symptoms of orthostatic intolerance.  ...  Where orthostatic intolerance symptoms were reported, a large proportion of older adults with a diagnosis of initial orthostatic hypotension were symptomatic.  ...  Acknowledgements We kindly acknowledge Arjen Mol (researcher, Vrije Universiteit) for his advice and Lindy Cochrane (senior librarian, University of Melbourne) for assisting with the search of the literature  ... 
doi:10.1016/j.ijchy.2020.100071 pmid:33884364 pmcid:PMC7803043 fatcat:wtdcibhnkzazrn63clmndo4vyu

Orthostatic and Supine Blood Pressures Are Associated with White Matter Hyperintensities in Parkinson Disease

Yoon-Sang Oh, Joong-Seok Kim, Kwang-Soo Lee
2013 Journal of Movement Disorders  
Results: The presence of orthostatic hypotension was associated with increasing tendency of WMH score and the blood pressure changes during tilting and supine blood pressure were positively correlated  ...  and Purpose: Several reports on the elderly population have suggested that orthostatic hypotension is associated with white matter hyperintensities (WMH); however, little information is available on patients  ...  contribute myriad episodes of cerebral hypo-and hyper-perfusion to white matter injuries.  ... 
doi:10.14802/jmd.13006 pmid:24868422 pmcid:PMC4027644 fatcat:6nbcbwahpjalrkubvlsoo3rpvi

Initial orthostatic hypotension is unrelated to orthostatic tolerance in healthy young subjects

Kate N. Thomas, James D. Cotter, Sean D. Galvin, Michael J. A. Williams, Chris K. Willie, Philip N. Ainslie
2009 Journal of applied physiology  
It is not known, however, if initial orthostatic hypotension (IOH) and related symptoms associated with standing are related to the occurrence of syncope.  ...  Initial orthostatic hypotension is unrelated to orthostatic tolerance in healthy young subjects.  ...  GRANTS This study received funding from the Otago Health Care Trust and the Dept. of Physiology, Univ. of Otago, Dunedin, New Zealand.  ... 
doi:10.1152/japplphysiol.91650.2008 pmid:19541730 fatcat:xgv24tuqo5hsnhl6qqtryn65fa

Postprandial Hypotension: Simple Treatment But Difficulties With the Diagnosis

R. W. M. M. Jansen
2005 The journals of gerontology. Series A, Biological sciences and medical sciences  
Postprandial hypotension occurs both in the sitting and supine position and can be found at all meal times.  ...  In 85 consecutive frail geriatric patients, 67% had postprandial hypotension and 52% were diagnosed with orthostatic hypotension (9).  ...  Another factor might be that the cerebral symptoms depend on the extent to which cerebral perfusion is compromised, regardless of whether it is caused by orthostatic or postprandial hypotension.  ... 
doi:10.1093/gerona/60.10.1268 pmid:16282557 fatcat:l55ecuiit5dijjqvbnmooocpu4

Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome

Roy Freeman, Wouter Wieling, Felicia B. Axelrod, David G. Benditt, Eduardo Benarroch, Italo Biaggioni, William P. Cheshire, Thomas Chelimsky, Pietro Cortelli, Christopher H. Gibbons, David S. Goldstein, Roger Hainsworth (+15 others)
2011 Clinical Autonomic Research  
cerebral perfusion.  ...  Orthostatic hypotension is a clinical sign and may be symptomatic or asymptomatic.  ... 
doi:10.1007/s10286-011-0119-5 pmid:21431947 fatcat:77gxqlurfnbefdagmbeg6pxlzm

Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome

Roy Freeman, Wouter Wieling, Felicia B. Axelrod, David G. Benditt, Eduardo Benarroch, Italo Biaggioni, William P. Cheshire, Thomas Chelimsky, Pietro Cortelli, Christopher H. Gibbons, David S. Goldstein, Roger Hainsworth (+15 others)
2011 Autonomic Neuroscience: Basic & Clinical  
cerebral perfusion.  ...  Orthostatic hypotension is a clinical sign and may be symptomatic or asymptomatic.  ... 
doi:10.1016/j.autneu.2011.02.004 pmid:21393070 fatcat:ukpri75rcjgbnlpicvchywv5ma

Management Strategies for Comorbid Supine Hypertension in Patients with Neurogenic Orthostatic Hypotension

Stuart H Isaacson, Khashayar Dashtipour, Ali A Mehdirad, Amanda C Peltier
2021 Current Neurology and Neuroscience Reports  
In autonomic failure, neurogenic orthostatic hypotension (nOH) and neurogenic supine hypertension (nSH) are interrelated conditions characterized by postural blood pressure (BP) dysregulation. nOH results  ...  in a sustained BP drop upon standing, which can lead to symptoms that include lightheadedness, orthostatic dizziness, presyncope, and syncope. nSH is characterized by elevated BP when supine and, although  ...  Patients with nOH can be asymptomatic despite a substantial drop in orthostatic BP if standing BP remains within the range of cerebral perfusion pressure and cerebral autoregulation.  ... 
doi:10.1007/s11910-021-01104-3 pmid:33687577 fatcat:746pdphazze25pvmejmhaxvali

Central and cerebrovascular effects of leg crossing in humans with sympathetic failure

Mark P.M. Harms, Wouter Wieling, Willy N.J.M. Colier, Jacques W.M. Lenders, Niels H. Secher, Johannes J. van Lieshout
2010 Clinical Science  
Leg crossing increases arterial pressure and combats symptomatic orthostatic hypotension in patients with sympathetic failure.  ...  However, in healthy subjects, cerebral perfusion and oxygenation were improved by a rise in CO without significant changes in TPR or MAP, whereas in patients with sympathetic failure, cerebral perfusion  ...  Both patients with sympathetic dysfunction [5] and recurrent vasovagal syncope [6] can combat symptomatic orthostatic hypotension by crossing one leg against the other (leg crossing).  ... 
doi:10.1042/cs20090038 pmid:19832700 pmcid:PMC2825733 fatcat:hwsovmp4tna6ze5ejrcahce3sq

Lower standing systolic blood pressure as a predictor of falls in the elderly: a community-based prospective study

Kazuomi Kario, Jonathan N Tobin, Leslie I Wolfson, Robert Whipple, Carol A Derby, Devender Singh, Paul R Marantz, Sylvia Wassertheil-Smoller
2001 Journal of the American College of Cardiology  
OBJECTIVES We investigated prospectively the relationships among falls, physical balance, and standing and supine blood pressure (BP) in elderly persons.  ...  Loss of balance, as detected by DPG, did not predict future falls and was also not associated with baseline BP levels.  ...  Donald Blaufox, MD, PhD, for providing access to SHEP screening data, Zirel Sweezy and Sara Pressel for standardized blood pressure training and certification assistance, and to Thomas G.  ... 
doi:10.1016/s0735-1097(01)01327-4 pmid:11451282 fatcat:pg6l475abnbrdpqpaqr4pvby5m

Mechanisms of orthostatic intolerance following very prolonged exercise

Samuel J. E. Lucas, James D. Cotter, Carissa Murrell, Luke Wilson, J. Greg Anson, David Gaze, Keith P. George, Philip N. Ainslie
2008 Journal of applied physiology  
During prolonged exercise, posturalinduced hypotension and hypocapnia exacerbate cerebral hypoperfusion and facilitate syncope.  ...  Within testing sessions, participants lay supine and then stood for 6 min, while heart rate variability (spectral analysis of ECG), middle cerebral artery perfusion velocity (MCAv), mean arterial pressure  ...  Second, hypotension and hypocapnia occurred while supine and were further exaggerated during postural change, during all testing sessions within the exercise trial, but reductions in cerebral perfusion  ... 
doi:10.1152/japplphysiol.00175.2008 pmid:18483169 fatcat:3tzjav3bfbek5nvqp7raavlgma
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