Display options
Cite
Shibao C, Gamboa A, Diedrich A, et al. Management of hypertension in the setting of autonomic dysfunction. Curr Treat Options Cardiovasc Med. 2006;8(2):105-9doi: 10.1007/s11936-006-0002-1.
Shibao, C., Gamboa, A., Diedrich, A., & Biaggioni, I. (2006). Management of hypertension in the setting of autonomic dysfunction. Current treatment options in cardiovascular medicine, 8(2), 105-9. https://doi.org/10.1007/s11936-006-0002-1
Shibao, Cyndya, et al. "Management of hypertension in the setting of autonomic dysfunction." Current treatment options in cardiovascular medicine vol. 8,2 (2006): 105-9. doi: https://doi.org/10.1007/s11936-006-0002-1
Shibao C, Gamboa A, Diedrich A, Biaggioni I. Management of hypertension in the setting of autonomic dysfunction. Curr Treat Options Cardiovasc Med. 2006 Apr;8(2):105-9. doi: 10.1007/s11936-006-0002-1. PMID: 16533484.
Copy Download .nbib Format: NLM
Share it on

Curr Treat Options Cardiovasc Med. 2006 Apr;8(2):105-9. doi: 10.1007/s11936-006-0002-1.

Management of hypertension in the setting of autonomic dysfunction.

Current treatment options in cardiovascular medicine

Cyndya Shibao, Alfredo Gamboa, André Diedrich, Italo Biaggioni

Affiliations

  1. 1500 21st Avenue South, Suite 3500, Clinical Trials Center, Vanderbilt University, Nashville, TN 37212, USA.

PMID: 16533484 DOI: 10.1007/s11936-006-0002-1

Abstract

Supine hypertension is a common finding in patients with autonomic failure; it is associated with end-organ damage and produces nighttime pressure diuresis with worsening of orthostatic hypotension. During the daytime, it is best treated by avoiding the supine posture. At night, simple measures such as raising the head of the bed by 6 to 9 inches can be effective, but most patients require pharmacologic treatment. Transdermal nitroglycerin (0.1 to 0.2 mg/h) or nifedipine (30 mg, orally) has proved to be effective. Hydralazine and minoxidil are usually less effective but may be useful in a given patient. One key therapeutic concept is the hypersensitivity of these patients to depressor agents, requiring a careful titration of the doses on an individual basis. For those patients with proven residual sympathetic tone, as in multiple system atrophy, central sympatholytics such as clonidine may provide an alternative.

References

  1. Circulation. 2000 Jun 13;101(23):2710-5 - PubMed
  2. Am J Med. 2002 Apr 1;112(5):355-60 - PubMed
  3. J Hypertens. 2003 Sep;21(9):1677-86 - PubMed
  4. Semin Neurol. 2003 Dec;23(4):435-42 - PubMed
  5. Clin Sci (Lond). 1998 Jan;94(1):5 - PubMed
  6. Lancet. 2000 Feb 26;355(9205):725-6 - PubMed
  7. Hypertension. 1997 Nov;30(5):1062-7 - PubMed
  8. Neurology. 1996 May;46(5):1470 - PubMed
  9. Cardiol Clin. 2002 May;20(2):291-301, vii - PubMed
  10. Clin Exp Hypertens. 1994 Mar;16(2):147-61 - PubMed
  11. Am J Med. 1998 Aug;105(2):116-24 - PubMed
  12. J Am Coll Cardiol. 1990 May;15(6):1334-42 - PubMed
  13. J Hypertens Suppl. 2003 Jul;21(6):S25-30 - PubMed
  14. J Am Soc Nephrol. 1999 Jan;10(1):35-42 - PubMed
  15. Circulation. 2001 Jul 3;104(1):52-7 - PubMed
  16. Clin Sci (Lond). 2001 Dec;101(6):609-18 - PubMed

Publication Types