Open AccessOrthostatic hypertension: From pathophysiology to clinical applications and therapeutic considerations
Author(s) -
Magkas Nikolaos,
Tsioufis Costas,
Thomopoulos Costas,
Dilaveris Polychronis,
Georgiopoulos Georgios,
Doumas Michael,
Papadopoulos Dimitris,
Tousoulis Dimitrios
Publication year - 2019
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.13491
Subject(s) - medicine , subclinical infection , pathophysiology , orthostatic vital signs , intensive care medicine , blood pressure , essential hypertension , clinical significance , cardiology
Orthostatic hypertension (OHT), that is, sustained increase in blood pressure after standing, is an increasingly recognized cardiovascular disorder having been examined in much fewer studies compared with orthostatic hypotension (OH). However, in both OHT and OH, dysfunction of the autonomous nervous system is considered to be the primary pathophysiological disturbance, while significant associations with essential hypertension have been observed. Although in many studies OHT has been related to subclinical or clinical target organ damage, there is also evidence denying such an association. Because OHT is defined variably across different studies, the comparison of relevant outcomes is at least problematic. Since evidence about OHT treatment is exclusively based on limited non‐randomized studies, no specific recommendations have been developed. Therefore, both the prognostic role and the clinical significance of OHT remain largely undefined. The aim of the present review is to summarize the available evidence regarding the definition, diagnosis, pathophysiology, prognostic role and treatment of OHT and highlight potential clinical implications of this underestimated condition.