Podcast
Questions and Answers
What is the prevalence of nSH in patients with Parkinson's disease?
What is the prevalence of nSH in patients with Parkinson's disease?
- Unknown
- 48-70%
- 34-46% (correct)
- 37%
What is the prevalence of nSH in patients with pure autonomic failure (PAF)?
What is the prevalence of nSH in patients with pure autonomic failure (PAF)?
- 34-46%
- 37%
- 48-70% (correct)
- Unknown
What is a common feature in patients with Parkinson's disease and multiple system atrophy?
What is a common feature in patients with Parkinson's disease and multiple system atrophy?
- Increased heart rate variability
- Decreased baroreflex sensitivity
- Loss of nocturnal blood pressure dipping (correct)
- Elevated daytime blood pressure
What is the relationship between nOH and rising nocturnal BP profiles in patients with diabetes mellitus?
What is the relationship between nOH and rising nocturnal BP profiles in patients with diabetes mellitus?
What is the effect of anti-hypotensive drugs used for the treatment of nOH on nSH?
What is the effect of anti-hypotensive drugs used for the treatment of nOH on nSH?
What are the contributing factors to nSH?
What are the contributing factors to nSH?
What drives nSH in multiple system atrophy?
What drives nSH in multiple system atrophy?
What contributes to nSH in pure autonomic failure?
What contributes to nSH in pure autonomic failure?
How should patients with nOH be screened for nSH?
How should patients with nOH be screened for nSH?
How should office screening for nSH be performed?
How should office screening for nSH be performed?
What is recommended to gather further insights into circadian BP control?
What is recommended to gather further insights into circadian BP control?
How should a diagnosis of nSH be made in patients with cardiovascular autonomic failure?
How should a diagnosis of nSH be made in patients with cardiovascular autonomic failure?
What is the prevalence of nSH in patients with Parkinson's disease?
What is the prevalence of nSH in patients with Parkinson's disease?
What is the prevalence of nSH in patients with pure autonomic failure (PAF)?
What is the prevalence of nSH in patients with pure autonomic failure (PAF)?
What is a common feature in patients with Parkinson's disease and multiple system atrophy?
What is a common feature in patients with Parkinson's disease and multiple system atrophy?
What is the relationship between nOH and rising nocturnal BP profiles in patients with diabetes mellitus?
What is the relationship between nOH and rising nocturnal BP profiles in patients with diabetes mellitus?
What is the effect of anti-hypotensive drugs used for the treatment of nOH on nSH?
What is the effect of anti-hypotensive drugs used for the treatment of nOH on nSH?
What are the contributing factors to nSH?
What are the contributing factors to nSH?
What drives nSH in multiple system atrophy?
What drives nSH in multiple system atrophy?
What contributes to nSH in pure autonomic failure?
What contributes to nSH in pure autonomic failure?
How should patients with nOH be screened for nSH?
How should patients with nOH be screened for nSH?
How should office screening for nSH be performed?
How should office screening for nSH be performed?
What is recommended to gather further insights into circadian BP control?
What is recommended to gather further insights into circadian BP control?
How should a diagnosis of nSH be made in patients with cardiovascular autonomic failure?
How should a diagnosis of nSH be made in patients with cardiovascular autonomic failure?
What percentage of patients with Parkinson's disease have nocturnal supine hypertension (nSH)?
What percentage of patients with Parkinson's disease have nocturnal supine hypertension (nSH)?
What is the prevalence of nSH in pure autonomic failure (PAF)?
What is the prevalence of nSH in pure autonomic failure (PAF)?
What is a common feature of nocturnal blood pressure (BP) in patients with Parkinson's disease (PD) and multiple system atrophy (MSA)?
What is a common feature of nocturnal blood pressure (BP) in patients with Parkinson's disease (PD) and multiple system atrophy (MSA)?
What is the significant association between nOH and nocturnal BP profiles in patients with diabetes mellitus?
What is the significant association between nOH and nocturnal BP profiles in patients with diabetes mellitus?
What is the effect of anti-hypotensive drugs used for the treatment of nOH on nSH?
What is the effect of anti-hypotensive drugs used for the treatment of nOH on nSH?
What are the multiple factors that contribute to nSH?
What are the multiple factors that contribute to nSH?
What drives nSH in multiple system atrophy (MSA)?
What drives nSH in multiple system atrophy (MSA)?
How should office screening for nSH be performed?
How should office screening for nSH be performed?
What is recommended to gather further insights into circadian BP control?
What is recommended to gather further insights into circadian BP control?
How should a diagnosis of nSH be made in patients with cardiovascular autonomic failure?
How should a diagnosis of nSH be made in patients with cardiovascular autonomic failure?
What are the cut-offs for nSH diagnosis in the context of cardiovascular autonomic failure based on?
What are the cut-offs for nSH diagnosis in the context of cardiovascular autonomic failure based on?
What is the prevalence of nSH in patients with multiple system atrophy (MSA)?
What is the prevalence of nSH in patients with multiple system atrophy (MSA)?
Flashcards are hidden until you start studying
Study Notes
Diagnosis and Management of Nocturnal Supine Hypertension in Cardiovascular Autonomic Failure
- Nocturnal supine hypertension (nSH) is present in 34-46% of patients with Parkinson's disease (PD) and 37% of patients with multiple system atrophy (MSA).
- Loss of nocturnal blood pressure (BP) dipping is common in PD and MSA patients.
- The prevalence of nSH in pure autonomic failure (PAF) ranges from 48-70%.
- There is a significant association between the presence of nOH and rising nocturnal BP profiles in patients with type 1 and type 2 diabetes mellitus.
- Anti-hypotensive drugs used for the treatment of nOH may unmask or exacerbate nSH.
- Multiple factors contribute to nSH, including impairment of the afferent, central, and efferent pathways of the arterial baroreflex arch, disruption of the renin-angiotensin-aldosterone axis, and denervation supersensitivity at the level of the vascular adrenoceptors.
- Noradrenaline release from intact post-ganglionic sympathetic fibers drives nSH in MSA, while mechanisms independent of the sympathetic autonomic nervous system contribute to nSH in PAF.
- Patients with nOH should be screened for nSH at diagnosis and at regular intervals afterward.
- Office screening for nSH should be performed by measuring supine BP as soon as the patient assumes the supine position and then again after the patient has been resting supine for at least 5 minutes.
- Home BP recordings performed by patients themselves are recommended to gather further insights into circadian BP control.
- A diagnosis of nSH should be made independently from seated BP values, which may vary in patients with cardiovascular autonomic failure.
- Cut-offs for nSH diagnosis in the context of cardiovascular autonomic failure are based on the criteria for the diagnosis of essential hypertension and interpretation of 24-hour ambulatory BP monitoring recordings in the general population.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
