Highlights
- •Heart failure and neurogenic orthostatic hypotension have disparate treatment strategies.
- •Stepwise strategies are: Undoing modifying CHF treatments, using conservative measures, then adding nOH treatments
Abstract
Neurogenic orthostatic hypotension (nOH) is a common comorbidity in patients with
neurodegenerative diseases. It is associated with an increased risk of falls, incident
cardiovascular disease, and all-cause mortality. There are over 5 million individuals
in the U.S. with heart failure (HF) with an associated 50% mortality rate at 5 years.
The prevalence of nOH and HF increase with age and, as the population continues to
age, will be increasingly common comorbid conditions. Thus, the effective management
of these conditions has important implications for public health. The management of
orthostatic hypotension in the context of congestive heart failure is challenging
due to the fact that the fundamental principles of management of these disease states
are in opposition to each other. In this review, we will discuss the principles of
management of nOH and HF and outline strategies for the effective treatment of these
comorbid conditions.
Abbreviations:
ACEi (Angiotensin converting enzyme inhibitor), ANRI (angiotensin-neprilysin inhibitor), ARB (Angiotensin receptor blockers), BB (Beta-blocker), BP (Blood pressure), HF (Heart failure), HFpEF (Heart failure with preserved ejection fraction), HFrEF (Heart failure with reduced ejection fraction), HTN (Hypertension), nOH (Neurogenic orthostatic hypotension), OH (Orthostatic hypotension)Keywords
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Article info
Publication history
Published online: June 05, 2020
Accepted:
May 19,
2020
Received in revised form:
March 25,
2020
Received:
November 6,
2019
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
