Format

Send to

Choose Destination
Auton Neurosci. 2018 Sep;213:81-85. doi: 10.1016/j.autneu.2018.06.005. Epub 2018 Jun 28.

Delayed orthostatic hypotension: Severity of clinical symptoms and response to medical treatment.

Author information

1
Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Center for Medical Innovations, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Department of Neurology, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, Republic of Korea.
2
Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Center for Medical Innovations, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Neurosurgery, Seoul National University Seoul Hospital, Seoul, Republic of Korea.
3
Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Center for Medical Innovations, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
4
Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Center for Medical Innovations, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, Republic of Korea.
5
Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Center for Medical Innovations, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Department of Neurology, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
6
Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Center for Medical Innovations, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
7
Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Center for Medical Innovations, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Department of Neurology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea.
8
Department of Neurology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea.
9
Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Center for Medical Innovations, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, Republic of Korea; Neuroscience and Protein Metabolism Research Center, College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
10
Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Center for Medical Innovations, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: sangkun2923@gmail.com.
11
Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Center for Medical Innovations, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: stemcell.snu@gmail.com.

Abstract

INTRODUCTION:

Severity of orthostatic intolerance and the benefit of medical treatment in patients with delayed OH have not been elucidated. This study aimed to compare the symptom severity between classic and delayed OH and evaluate the efficacy of midodrine or pyridostigmine in patients with delayed OH.

METHODS:

This was an adjunctive study of previously reported randomized, open-label clinical trials evaluating the efficacy and safety of midodrine or pyridostigmine for classic OH. Seventeen patients with delayed OH were enrolled and also received midodrine (2.5 mg twice a day) or pyridostigmine (30 mg twice a day) alone or combined. Result of initial orthostatic vital sign and questionnaires were compared between the patients with delayed OH and previously reported 87 patients with classic OH. Delayed OH patients were followed up at 1 and 3 months post-treatment and the vital sign measurements and questionnaires were repeated during the follow-up period.

RESULTS:

Questionnaire scores regarding OH-related symptoms, depression and health-related quality of life (HRQOL) were comparable between the classic and delayed OH patients at baseline. OH-related symptoms and depression were significantly improved after 3 months of medical treatment.

CONCLUSION:

Patients with delayed OH exhibited orthostatic intolerance similar to that of classic OH. This study shows that these patients may benefit from medical treatment with either midodrine or pyridostigmine.

KEYWORDS:

Delayed orthostatic hypotension; Efficacy; Midodrine; Pyridostigmine; Treatment

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center