Syndrome of Orthostatic Hypotension with Supine Hypertension: A Therapeutic Dilemma for Cardiologists
M. Naaim *
Autonomic Nervous Systems Exploration Unit, Cardiology Department, ARRAZI Hospital, Mohammed VI University Hospital, Marrakech, Morocco.
N. Malhabi
Autonomic Nervous Systems Exploration Unit, Cardiology Department, ARRAZI Hospital, Mohammed VI University Hospital, Marrakech, Morocco.
M. Ztati
Autonomic Nervous Systems Exploration Unit, Cardiology Department, ARRAZI Hospital, Mohammed VI University Hospital, Marrakech, Morocco.
M. Eljamili
Autonomic Nervous Systems Exploration Unit, Cardiology Department, ARRAZI Hospital, Mohammed VI University Hospital, Marrakech, Morocco.
S. El Karimi
Autonomic Nervous Systems Exploration Unit, Cardiology Department, ARRAZI Hospital, Mohammed VI University Hospital, Marrakech, Morocco.
M. El Hattaoui
Autonomic Nervous Systems Exploration Unit, Cardiology Department, ARRAZI Hospital, Mohammed VI University Hospital, Marrakech, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Orthostatic hypotension (OH) and supine hypertension (SH) are two cardiovascular symptoms of autonomic failure that frequently coexist in the same patient.
Clinicians are faced with a dilemma because aggressive orthostatic intolerance treatment can exacerbate supine hypertension, and vice versa for supine hypertension management.
The objective of our article is to provide a better framework for the clinical evaluation, the right choice of therapeutic options and the improvement of the quality of life of patients with OH-SH syndrome. For these reasons, we report three observations, whose etiologies, clinical presentation, and treatment are different, namely diabetes, multiple system atrophy type C (MSA) and Parkinson's disease.
Keywords: Orthostatic hypotension, supine hypertension, cardiovascular symptoms