RESEARCH: Treating supine hypertension in autonomic failure patients with orthostatic hypotension.

[Guest guest]

I believe some people were asking about this problem before where blood

pressure spikes upward when lying down. The last few lines state:

" The recent observation that patients with supine hypertension develop left

ventricular hypertrophy suggests they should be treated. During the day,

avoiding the supine position is often all that is required. Short-acting

vasodilators (e.g., transdermal nitroglycerin) can be used during the

night. "

Regards,

Pam

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J Clin Hypertens (Greenwich) 2002 Mar-Apr;4(2):139-45 R

How to Diagnose, How to Treat: Diagnosis and treatment of supine

hypertension in autonomic failure patients with orthostatic hypotension.

Jordan J, Biaggioni I.

Hypotension and Syncope Unit, Clinical Research Center, Franz Volhard

Clinic, Medical Faculty of the Charite, Humboldt University, Berlin,

Germany.

Orthostatic hypotension is seen in various medical conditions. It can be

secondary to medications or volume depletion. It can also be due to

autonomic neuropathy secondary to other diseases, such as diabetes mellitus,

or to primary degenerative processes of the autonomic nervous system.

Orthostatic hypotension dominates the clinical picture of patients suffering

from autonomic failure. Paradoxically, about one half of these patients also

suffer from supine hypertension, which induces pressure natriuresis,

worsening orthostatic hypotension. It also complicates the treatment of

orthostatic hypotension. Supine hypertension is mediated by an increase in

peripheral vascular resistance. This is due to residual sympathetic tone in

patients with multiple system atrophy (Shy-Drager syndrome), but the cause

is not known in patients with pure autonomic failure, who have increased

vascular resistance despite very low levels or plasma norepinephrine and

renin activity. The recent observation that patients with supine

hypertension develop left ventricular hypertrophy suggests they should be

treated. During the day, avoiding the supine position is often all that is

required. Short-acting vasodilators (e.g., transdermal nitroglycerin) can be

used during the night. ©2002 Le Jacq Communications, Inc.

PMID: 11927799 [PubMed - in process]