Orthostatic hypotension in neurodegeneration
Orthostatic hypotension, often referred to as postural hypotension, is a condition where blood pressure drops significantly when standing up from sitting or lying down. This drop in blood pressure can lead to symptoms such as dizziness, lightheadedness, and even fainting. In the context of neurodegeneration, orthostatic hypotension is particularly relevant because it often results from the failure of the autonomic nervous system to properly regulate blood pressure.
### What is Neurogenic Orthostatic Hypotension?
Neurogenic orthostatic hypotension (NOH) is a form of this condition that occurs due to neurodegenerative diseases. It is characterized by the autonomic nervous system’s inability to compensate for the normal drop in blood pressure that happens when changing positions. This failure is often linked to conditions like Parkinson’s disease and multiple system atrophy, where there is a loss of neurons that help regulate blood pressure.
### Symptoms of NOH
Symptoms of NOH can vary but commonly include dizziness, lightheadedness, weakness, and nausea. Some people may experience a temporary loss of consciousness, known as syncope. The symptoms can be exacerbated by factors such as hot weather, large meals, or alcohol consumption. A distinctive symptom is the “coat hanger” pain, which affects the back of the neck and shoulders.
### Causes and Diagnosis
NOH is often associated with neurodegenerative diseases that affect the autonomic nervous system. Diagnosis typically involves measuring blood pressure changes when moving from a lying to a standing position. Additional tests may include autonomic reflex testing to assess the function of the autonomic nervous system.
### Treatment and Management
Treatment for NOH focuses on managing symptoms without causing excessive blood pressure increases when lying down. Strategies include adjusting medications, increasing salt intake, and using physical maneuvers to improve blood flow when standing. Elevating the head of the bed and avoiding triggers like hot baths can also help. Exercise programs aimed at improving leg strength and overall conditioning are beneficial.
### Impact on Quality of Life
NOH can significantly impact an individual’s quality of life by limiting physical activity and increasing the risk of falls. It is essential to manage the condition effectively to prevent complications such as fractures and cardiovascular issues. By understanding the causes and symptoms of NOH, individuals can take proactive steps to manage their condition and maintain independence.
