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Marie R Griffin - One of the best experts on this subject based on the ideXlab platform.
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orthostatic Hypotension related hospitalizations in the united states
The American Journal of Medicine, 2007Co-Authors: Cyndya A Shibao, Carlos G. Grijalva, Italo Biaggioni, Marie R GriffinAbstract:BACKGROUND: Orthostatic Hypotension has been commonly described in elderly persons and is associated with an increased risk of falls, syncope, and cerebrovascular events. Nevertheless, the precise burden of this condition in the US is currently unknown. METHODS: We analyzed discharge data from the Nationwide Inpatient Sample to identify orthostatic Hypotension-related hospitalizations and associated comorbidities after excluding acute causes of this condition. National hospitalization rates were estimated using US census population estimates, and the medical conditions most frequently associated with orthostatic Hypotension were assessed. RESULTS: In 2004, there were an estimated 80,095 orthostatic Hypotension-related hospitalizations, yielding an overall rate of 36 (95% confidence interval, 34 to 38) hospitalizations per 100,000 US adults. Orthostatic Hypotension was the primary diagnosis in 35% of these hospitalizations. The number of orthostatic Hypotension-related hospitalizations increased steadily with age, and patients aged 75 years or older had the highest annual hospitalization rate, 233 per 100,000 (95% confidence interval, 217 to 249). The median length of hospital stay was 3 days (IQR 2-6) and the overall in-hospital mortality was 0.9%. Caucasian males were most likely to be hospitalized with orthostatic Hypotension. Syncope was the most common comorbid condition reported among orthostatic Hypotension patients. CONCLUSIONS: Orthostatic Hypotension is a relatively common condition among hospitalized US elderly patients. In light of the progressive aging of the US population, the contribution of orthostatic Hypotension to morbidity and mortality is likely to increase, and deserves further scrutiny.
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Orthostatic Hypotension-Related Hospitalizations in the
2007Co-Authors: Cyndya A Shibao, Carlos G. Grijalva, Italo Biaggioni, Satish R. Raj, Marie R GriffinAbstract:BACKGROUND: Orthostatic Hypotension has been commonly described in elderly persons and is associated with an increased risk of falls, syncope, and cerebrovascular events. Nevertheless, the precise burden of this condition in the US is currently unknown. METHODS: We analyzed discharge data from the Nationwide Inpatient Sample to identify orthostatic Hypotension-related hospitalizations and associated comorbidities after excluding acute causes of this condition. National hospitalization rates were estimated using US census population estimates, and the medical conditions most frequently associated with orthostatic Hypotension were assessed. RESULTS: In 2004, there were an estimated 80,095 orthostatic Hypotension-related hospitalizations, yielding an overall rate of 36 (95% confidence interval, 34 to 38) hospitalizations per 100,000 US adults. Orthostatic Hypotension was the primary diagnosis in 35% of these hospitalizations. The number of orthostatic Hypotension-related hospitalizations increased steadily with age, and patients aged 75 years or older had the highest annual hospitalization rate, 233 per 100,000 (95% confidence interval, 217 to 249). The median length of hospital stay was 3 days (IQR 2-6) and the overall in-hospital mortality was 0.9%. Caucasian males were most likely to be hospitalized with orthostatic Hypotension. Syncope was the most common comorbid condition reported among orthostatic Hypotension patients. CONCLUSIONS: Orthostatic Hypotension is a relatively common condition among hospitalized US elderly patients. In light of the progressive aging of the US population, the contribution of orthostatic Hypotension to morbidity and mortality is likely to increase, and deserves further scrutiny. © 2007 Elsevier Inc. All rights reserved.
Cyndya A Shibao - One of the best experts on this subject based on the ideXlab platform.
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Management of Orthostatic Hypotension, Postprandial Hypotension, and Supine Hypertension.
Seminars in neurology, 2020Co-Authors: Cyndya A Shibao, Italo BiaggioniAbstract:This review provides recommendations for the treatment of neurogenic orthostatic Hypotension (nOH), postprandial Hypotension, and supine hypertension. It focuses on novel treatment strategies and new insights into the mechanism underlying these conditions. Our goal is to provide practical advice for clinicians on how to screen, diagnose, and treat these conditions with nonpharmacological and pharmacological approaches. For each disorder, we offered a stepwise recommendation on how to apply these new concepts to successfully ameliorate the symptoms associated with OH to prevent syncope and falls. The management of OH in patients who also have supine hypertension requires special considerations and pharmacotherapy. It is noteworthy that there are few therapeutic options for OH and only two Food and Drug Administration-approved drugs for the treatment of OH and nOH based on randomized clinical trials. We will use these studies to develop evidence-based guidelines for OH. The research is limited for postprandial Hypotension and supine hypertension, and therefore the recommendations will be based on small studies, clinical expertise, and, above all, an understanding of the underlying pathophysiology.
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orthostatic Hypotension related hospitalizations in the united states
The American Journal of Medicine, 2007Co-Authors: Cyndya A Shibao, Carlos G. Grijalva, Italo Biaggioni, Marie R GriffinAbstract:BACKGROUND: Orthostatic Hypotension has been commonly described in elderly persons and is associated with an increased risk of falls, syncope, and cerebrovascular events. Nevertheless, the precise burden of this condition in the US is currently unknown. METHODS: We analyzed discharge data from the Nationwide Inpatient Sample to identify orthostatic Hypotension-related hospitalizations and associated comorbidities after excluding acute causes of this condition. National hospitalization rates were estimated using US census population estimates, and the medical conditions most frequently associated with orthostatic Hypotension were assessed. RESULTS: In 2004, there were an estimated 80,095 orthostatic Hypotension-related hospitalizations, yielding an overall rate of 36 (95% confidence interval, 34 to 38) hospitalizations per 100,000 US adults. Orthostatic Hypotension was the primary diagnosis in 35% of these hospitalizations. The number of orthostatic Hypotension-related hospitalizations increased steadily with age, and patients aged 75 years or older had the highest annual hospitalization rate, 233 per 100,000 (95% confidence interval, 217 to 249). The median length of hospital stay was 3 days (IQR 2-6) and the overall in-hospital mortality was 0.9%. Caucasian males were most likely to be hospitalized with orthostatic Hypotension. Syncope was the most common comorbid condition reported among orthostatic Hypotension patients. CONCLUSIONS: Orthostatic Hypotension is a relatively common condition among hospitalized US elderly patients. In light of the progressive aging of the US population, the contribution of orthostatic Hypotension to morbidity and mortality is likely to increase, and deserves further scrutiny.
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Orthostatic Hypotension-Related Hospitalizations in the
2007Co-Authors: Cyndya A Shibao, Carlos G. Grijalva, Italo Biaggioni, Satish R. Raj, Marie R GriffinAbstract:BACKGROUND: Orthostatic Hypotension has been commonly described in elderly persons and is associated with an increased risk of falls, syncope, and cerebrovascular events. Nevertheless, the precise burden of this condition in the US is currently unknown. METHODS: We analyzed discharge data from the Nationwide Inpatient Sample to identify orthostatic Hypotension-related hospitalizations and associated comorbidities after excluding acute causes of this condition. National hospitalization rates were estimated using US census population estimates, and the medical conditions most frequently associated with orthostatic Hypotension were assessed. RESULTS: In 2004, there were an estimated 80,095 orthostatic Hypotension-related hospitalizations, yielding an overall rate of 36 (95% confidence interval, 34 to 38) hospitalizations per 100,000 US adults. Orthostatic Hypotension was the primary diagnosis in 35% of these hospitalizations. The number of orthostatic Hypotension-related hospitalizations increased steadily with age, and patients aged 75 years or older had the highest annual hospitalization rate, 233 per 100,000 (95% confidence interval, 217 to 249). The median length of hospital stay was 3 days (IQR 2-6) and the overall in-hospital mortality was 0.9%. Caucasian males were most likely to be hospitalized with orthostatic Hypotension. Syncope was the most common comorbid condition reported among orthostatic Hypotension patients. CONCLUSIONS: Orthostatic Hypotension is a relatively common condition among hospitalized US elderly patients. In light of the progressive aging of the US population, the contribution of orthostatic Hypotension to morbidity and mortality is likely to increase, and deserves further scrutiny. © 2007 Elsevier Inc. All rights reserved.
L. Nelson Hopkins - One of the best experts on this subject based on the ideXlab platform.
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Postoperative Hypotension after carotid angioplasty and stenting: report of three cases
Neurosurgery, 1999Co-Authors: Adnan I. Qureshi, Giuseppe Lanzino, Andreas R. Luft, Demetrius K. Lopes, Richard D. Fessler, Mudit Sharma, Lee R. Guterman, L. Nelson HopkinsAbstract:OBJECTIVE AND IMPORTANCE: Hemodynamic instability after carotid angioplasty and stenting is not well recognized. We report three patients who developed sustained Hypotension in the postoperative period after successful carotid angioplasty and stent placement for internal carotid artery stenosis in the carotid sinus region. CLINICAL PRESENTATION: In two patients, Hypotension was initially induced by inflation of the angioplasty balloon. The third patient developed Hypotension after completion of the procedure. In all cases, the Hypotension persisted for 18 to 33 hours after the procedure. During the postoperative period, two of these patients also developed sinus bradycardia, which, in one patient, was further complicated by a third-degree atrioventricular block. INTERVENTION: The Hypotension was successfully treated by intravenous vasopressors or inotropic agents. No permanent neurological or cardiac sequelae were observed. CONCLUSION: Sustained Hypotension with or without bradycardia may develop after carotid angioplasty and stent placement, presumably as a result of carotid sinus dysfunction. During the postoperative period, patients should be monitored in settings suited to expeditious management of cardiovascular emergencies.
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Postoperative Hypotension after carotid angioplasty and stenting : Report of three cases. Commentaries
Neurosurgery, 1999Co-Authors: Adnan I. Qureshi, Giuseppe Lanzino, Andreas R. Luft, Demetrius K. Lopes, Richard D. Fessler, Mudit Sharma, Lee R. Guterman, L. Nelson Hopkins, C. M. Loftus, Robert H. RosenwasserAbstract:OBJECTIVE AND IMPORTANCE: Hemodynamic instability after carotid angioplasty and stenting is not well recognized. We report three patients who developed sustained Hypotension in the postoperative period after successful carotid angioplasty and stent placement for internal carotid artery stenosis in the carotid sinus region. CLINICAL PRESENTATION: In two patients, Hypotension was initially induced by inflation of the angioplasty balloon. The third patient developed Hypotension after completion of the procedure. In all cases, the Hypotension persisted for 18 to 33 hours after the procedure. During the postoperative period, two of these patients also developed sinus bradycardia, which, in one patient, was further complicated by a third-degree atrioventricular block. INTERVENTION: The Hypotension was successfully treated by intravenous vasopressors or inotropic agents. No permanent neurological or cardiac sequelae were observed. CONCLUSION: Sustained Hypotension with or without bradycardia may develop after carotid angioplasty and stent placement, presumably as a result of carotid sinus dysfunction. During the postoperative period, patients should be monitored in settings suited to expeditious management of cardiovascular emergencies.
Adnan I. Qureshi - One of the best experts on this subject based on the ideXlab platform.
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Postoperative Hypotension after carotid angioplasty and stenting: report of three cases
Neurosurgery, 1999Co-Authors: Adnan I. Qureshi, Giuseppe Lanzino, Andreas R. Luft, Demetrius K. Lopes, Richard D. Fessler, Mudit Sharma, Lee R. Guterman, L. Nelson HopkinsAbstract:OBJECTIVE AND IMPORTANCE: Hemodynamic instability after carotid angioplasty and stenting is not well recognized. We report three patients who developed sustained Hypotension in the postoperative period after successful carotid angioplasty and stent placement for internal carotid artery stenosis in the carotid sinus region. CLINICAL PRESENTATION: In two patients, Hypotension was initially induced by inflation of the angioplasty balloon. The third patient developed Hypotension after completion of the procedure. In all cases, the Hypotension persisted for 18 to 33 hours after the procedure. During the postoperative period, two of these patients also developed sinus bradycardia, which, in one patient, was further complicated by a third-degree atrioventricular block. INTERVENTION: The Hypotension was successfully treated by intravenous vasopressors or inotropic agents. No permanent neurological or cardiac sequelae were observed. CONCLUSION: Sustained Hypotension with or without bradycardia may develop after carotid angioplasty and stent placement, presumably as a result of carotid sinus dysfunction. During the postoperative period, patients should be monitored in settings suited to expeditious management of cardiovascular emergencies.
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Postoperative Hypotension after carotid angioplasty and stenting : Report of three cases. Commentaries
Neurosurgery, 1999Co-Authors: Adnan I. Qureshi, Giuseppe Lanzino, Andreas R. Luft, Demetrius K. Lopes, Richard D. Fessler, Mudit Sharma, Lee R. Guterman, L. Nelson Hopkins, C. M. Loftus, Robert H. RosenwasserAbstract:OBJECTIVE AND IMPORTANCE: Hemodynamic instability after carotid angioplasty and stenting is not well recognized. We report three patients who developed sustained Hypotension in the postoperative period after successful carotid angioplasty and stent placement for internal carotid artery stenosis in the carotid sinus region. CLINICAL PRESENTATION: In two patients, Hypotension was initially induced by inflation of the angioplasty balloon. The third patient developed Hypotension after completion of the procedure. In all cases, the Hypotension persisted for 18 to 33 hours after the procedure. During the postoperative period, two of these patients also developed sinus bradycardia, which, in one patient, was further complicated by a third-degree atrioventricular block. INTERVENTION: The Hypotension was successfully treated by intravenous vasopressors or inotropic agents. No permanent neurological or cardiac sequelae were observed. CONCLUSION: Sustained Hypotension with or without bradycardia may develop after carotid angioplasty and stent placement, presumably as a result of carotid sinus dysfunction. During the postoperative period, patients should be monitored in settings suited to expeditious management of cardiovascular emergencies.
Italo Biaggioni - One of the best experts on this subject based on the ideXlab platform.
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Management of Orthostatic Hypotension, Postprandial Hypotension, and Supine Hypertension.
Seminars in neurology, 2020Co-Authors: Cyndya A Shibao, Italo BiaggioniAbstract:This review provides recommendations for the treatment of neurogenic orthostatic Hypotension (nOH), postprandial Hypotension, and supine hypertension. It focuses on novel treatment strategies and new insights into the mechanism underlying these conditions. Our goal is to provide practical advice for clinicians on how to screen, diagnose, and treat these conditions with nonpharmacological and pharmacological approaches. For each disorder, we offered a stepwise recommendation on how to apply these new concepts to successfully ameliorate the symptoms associated with OH to prevent syncope and falls. The management of OH in patients who also have supine hypertension requires special considerations and pharmacotherapy. It is noteworthy that there are few therapeutic options for OH and only two Food and Drug Administration-approved drugs for the treatment of OH and nOH based on randomized clinical trials. We will use these studies to develop evidence-based guidelines for OH. The research is limited for postprandial Hypotension and supine hypertension, and therefore the recommendations will be based on small studies, clinical expertise, and, above all, an understanding of the underlying pathophysiology.
-
orthostatic Hypotension related hospitalizations in the united states
The American Journal of Medicine, 2007Co-Authors: Cyndya A Shibao, Carlos G. Grijalva, Italo Biaggioni, Marie R GriffinAbstract:BACKGROUND: Orthostatic Hypotension has been commonly described in elderly persons and is associated with an increased risk of falls, syncope, and cerebrovascular events. Nevertheless, the precise burden of this condition in the US is currently unknown. METHODS: We analyzed discharge data from the Nationwide Inpatient Sample to identify orthostatic Hypotension-related hospitalizations and associated comorbidities after excluding acute causes of this condition. National hospitalization rates were estimated using US census population estimates, and the medical conditions most frequently associated with orthostatic Hypotension were assessed. RESULTS: In 2004, there were an estimated 80,095 orthostatic Hypotension-related hospitalizations, yielding an overall rate of 36 (95% confidence interval, 34 to 38) hospitalizations per 100,000 US adults. Orthostatic Hypotension was the primary diagnosis in 35% of these hospitalizations. The number of orthostatic Hypotension-related hospitalizations increased steadily with age, and patients aged 75 years or older had the highest annual hospitalization rate, 233 per 100,000 (95% confidence interval, 217 to 249). The median length of hospital stay was 3 days (IQR 2-6) and the overall in-hospital mortality was 0.9%. Caucasian males were most likely to be hospitalized with orthostatic Hypotension. Syncope was the most common comorbid condition reported among orthostatic Hypotension patients. CONCLUSIONS: Orthostatic Hypotension is a relatively common condition among hospitalized US elderly patients. In light of the progressive aging of the US population, the contribution of orthostatic Hypotension to morbidity and mortality is likely to increase, and deserves further scrutiny.
-
Orthostatic Hypotension-Related Hospitalizations in the
2007Co-Authors: Cyndya A Shibao, Carlos G. Grijalva, Italo Biaggioni, Satish R. Raj, Marie R GriffinAbstract:BACKGROUND: Orthostatic Hypotension has been commonly described in elderly persons and is associated with an increased risk of falls, syncope, and cerebrovascular events. Nevertheless, the precise burden of this condition in the US is currently unknown. METHODS: We analyzed discharge data from the Nationwide Inpatient Sample to identify orthostatic Hypotension-related hospitalizations and associated comorbidities after excluding acute causes of this condition. National hospitalization rates were estimated using US census population estimates, and the medical conditions most frequently associated with orthostatic Hypotension were assessed. RESULTS: In 2004, there were an estimated 80,095 orthostatic Hypotension-related hospitalizations, yielding an overall rate of 36 (95% confidence interval, 34 to 38) hospitalizations per 100,000 US adults. Orthostatic Hypotension was the primary diagnosis in 35% of these hospitalizations. The number of orthostatic Hypotension-related hospitalizations increased steadily with age, and patients aged 75 years or older had the highest annual hospitalization rate, 233 per 100,000 (95% confidence interval, 217 to 249). The median length of hospital stay was 3 days (IQR 2-6) and the overall in-hospital mortality was 0.9%. Caucasian males were most likely to be hospitalized with orthostatic Hypotension. Syncope was the most common comorbid condition reported among orthostatic Hypotension patients. CONCLUSIONS: Orthostatic Hypotension is a relatively common condition among hospitalized US elderly patients. In light of the progressive aging of the US population, the contribution of orthostatic Hypotension to morbidity and mortality is likely to increase, and deserves further scrutiny. © 2007 Elsevier Inc. All rights reserved.
