Current Orthostatic Hypotension Trials @ The Neuro Center
Neurogenic Orthostatic Hypotension Trial
We are looking for participants that meet the following criteria:
Do you think you qualify or have questions? Give us a call at 678-961-0733 opt. 6 or email at neurocenterresearch@gmail.com
We are looking for participants that meet the following criteria:
- 18 years or older and able to stand (with or without limited assistance)
- Clinical diagnosis of symptomatic orthostatic hypotension associated with Parkinson's Disease (PD), Multiple System Atrophy (MSA), Pure Autonomic Failure (PAF), Non-Diabetic Autonomic Neuropathy (NDAN) or Dopamine Beta Hydroxylase (DBH) Deficiency
- Have been previously stabilized with droxidopa therapy for symptoms of neurogenic orthostatic hypotension (NOH) (dizziness, light-headedness, or feelings that they are about to black out)
- No history of cancer within the past 2 years other than a successfully treated, non-metastatic cutaneous squamous cell or basal cell carcinoma or cervical cancer in situ
Do you think you qualify or have questions? Give us a call at 678-961-0733 opt. 6 or email at neurocenterresearch@gmail.com
What is neurogenic orthostatic hypotension?
Neurogenic orthostatic hypotension (nOH) is a condition that is part of a larger category called orthostatic hypotension (OH), which is also known as postural hypotension. nOH is caused by dysfunction in the autonomic nervous system and causes people to feel faint when they stand or sit up.
WHAT ARE THE SYMPTOMS?
nOH can appear with or without symptoms. The typical symptoms of nOH are lightheadedness, dizziness, blurry vision and, when there’s a significant drop in blood pressure upon standing up, fainting. Symptoms almost always occur when standing up, less frequently when moving from standing to sitting and abate when lying down. People with nOH may also experience weakness, fatigue, leg buckling, headaches, neck and shoulder discomfort and shortness of breath. Severity of symptoms varies from day to day and fluctuates throughout the day. Often, mornings tend to be most difficult since nOH symptoms are aggravated by overnight urination, which is common in people with Parkinson’s. Meals, particularly those rich in carbohydrates and sugars, also cause drops in blood pressure.
Not all people with nOH have symptoms. Symptoms emerge only when blood pressure when standing falls below a certain limit. In people living with Parkinson’s, this usually occurs when your mean blood pressure upon standing falls below approximately 90/60 mmHg (systolic/diastolic) as measured with a blood pressure cuff on the arm. Symptoms of nOH typically disappear upon sitting or lying down, because gravity restores blood flow to the brain.
Indeed, people with nOH are frequently able to tolerate wide swings in blood pressures and often remain conscious at pressures that would otherwise induce fainting in healthy people. Fainting can still occur, however, especially after a large meal, consuming alcohol, in very warm weather, if dehydrated or if taking medications to lower blood pressure.
In people with Parkinson’s, symptoms of nOH can also be non-specific, including fatigue and difficultly concentrating, and may sometimes mimic a levodopa off state. It’s easy to miss nOH unless your physician measures your blood pressure while you are in a standing position. Conversely, it is important to realize people with Parkinson’s can experience lightheadedness that mimics nOH, but may instead be caused by balance problems or other issues. For this reason, careful evaluation of your symptoms by a movement disorder specialist is strongly advised.
Not all people with nOH have symptoms. Symptoms emerge only when blood pressure when standing falls below a certain limit. In people living with Parkinson’s, this usually occurs when your mean blood pressure upon standing falls below approximately 90/60 mmHg (systolic/diastolic) as measured with a blood pressure cuff on the arm. Symptoms of nOH typically disappear upon sitting or lying down, because gravity restores blood flow to the brain.
Indeed, people with nOH are frequently able to tolerate wide swings in blood pressures and often remain conscious at pressures that would otherwise induce fainting in healthy people. Fainting can still occur, however, especially after a large meal, consuming alcohol, in very warm weather, if dehydrated or if taking medications to lower blood pressure.
In people with Parkinson’s, symptoms of nOH can also be non-specific, including fatigue and difficultly concentrating, and may sometimes mimic a levodopa off state. It’s easy to miss nOH unless your physician measures your blood pressure while you are in a standing position. Conversely, it is important to realize people with Parkinson’s can experience lightheadedness that mimics nOH, but may instead be caused by balance problems or other issues. For this reason, careful evaluation of your symptoms by a movement disorder specialist is strongly advised.
DIAGNOSIS OF NEUROGENIC ORTHOSTATIC HYPOTENSION
Diagnosis of nOH requires blood pressure readings taken while lying flat as well as while standing up. At least a 20 mmHg drop in your systolic blood pressure and a 10 mmHg drop in your diastolic blood pressure when you stand up is required to make the diagnosis.
Some people with Parkinson’s don’t experience a drop in blood pressure every time they stand up. In these cases, a doctor may use a monitor to measure the person’s blood pressure every 30 minutes for an entire day to assist in diagnosis and subsequent management of nOH.
Some people with Parkinson’s don’t experience a drop in blood pressure every time they stand up. In these cases, a doctor may use a monitor to measure the person’s blood pressure every 30 minutes for an entire day to assist in diagnosis and subsequent management of nOH.
TREATMENT OPTIONS FOR NEUROGENIC ORTHOSTATIC HYPOTENSION
- Correcting aggravating factors
- Lifestyle changes
- Medication