Management of supine hypertension in patients with neurogenic orthostatic hypotension: scientific statement of the American Autonomic Society, European Federation of Autonomic Societies, and the European Society of Hypertension

Jens Jordan, Alessandra Fanciulli, Jens Tank, Giovanna Calandra-Buonaura, William P. Cheshire, Pietro Cortelli, Sabine Eschlboeck, Guido Grassi, Max J. Hilz, Horacio Kaufmann, Heinz Lahrmann, Giuseppe Mancia, Gert Mayer, Lucy Norcliffe-Kaufmann, Anne Pavy-Le Traon, Satish R. Raj, David Robertson, Isabel Rocha, Hannes Reuter, Walter StruhalRoland D. Thijs, Konstantinos P. Tsioufis, J. Gert van Dijk, Gregor K. Wenning, Italo Biaggioni

Research output: Contribution to journalArticle

Abstract

Supine hypertension commonly occurs in patients with neurogenic orthostatic hypotension due to autonomic failure. Supine hypertension promotes nocturnal sodium excretion and orthostatic hypotension, thus, interfering with quality of life. Perusal of the literature on essential hypertension and smaller scale investigations in autonomic failure patients also suggest that supine hypertension may predispose to cardiovascular and renal disease. These reasons provide a rationale for treating supine hypertension. Yet, treatment of supine hypertension, be it through nonpharmacological or pharmacological approaches, may exacerbate orthostatic hypotension when patients get up during the night. Fall-related complications may occur. More research is needed to define the magnitude of the deleterious effects of supine hypertension on cardiovascular, cerebrovascular, and renal morbidity and mortality. Integration of more precise cardiovascular risk assessment, efficacy, and safety data, and the prognosis of the underlying condition causing autonomic failure is required for individualized management recommendations.

Original languageEnglish
Pages (from-to)1541-1546
Number of pages6
JournalJournal of Hypertension
Volume37
Issue number8
DOIs
Publication statusPublished - Aug 1 2019

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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    Jordan, J., Fanciulli, A., Tank, J., Calandra-Buonaura, G., Cheshire, W. P., Cortelli, P., Eschlboeck, S., Grassi, G., Hilz, M. J., Kaufmann, H., Lahrmann, H., Mancia, G., Mayer, G., Norcliffe-Kaufmann, L., Pavy-Le Traon, A., Raj, S. R., Robertson, D., Rocha, I., Reuter, H., ... Biaggioni, I. (2019). Management of supine hypertension in patients with neurogenic orthostatic hypotension: scientific statement of the American Autonomic Society, European Federation of Autonomic Societies, and the European Society of Hypertension. Journal of Hypertension, 37(8), 1541-1546. https://doi.org/10.1097/HJH.0000000000002078