New insights into orthostatic hypotension in multiple system atrophy : a European multicentre cohort study
Abstract: Objectives Orthostatic hypotension (OH) is a key feature of multiple system atrophy (MSA), a fatal progressive neurodegenerative disorder associated with autonomic failure, parkinsonism and ataxia. This study aims (1) to determine the clinical spectrum of OH in a large European cohort of patients with MSA and (2) to investigate whether a prolonged postural challenge increases the sensitivity to detect OH in MSA. Methods: Assessment of OH during a 10 min orthostatic test in 349 patients with MSA from seven centres of the European MSA-Study Group (age: 63.6±8.8 years; disease duration: 4.2±2.6 years). Assessment of a possible relationship between OH and MSA subtype (P with predominant parkinsonism or C with predominant cerebellar ataxia), Unified MSA Rating Scale (UMSARS) scores and drug intake. Results: 187 patients (54%) had moderate (>20 mm Hg (systolic blood pressure (SBP)) and/or >10 mm Hg (diastolic blood pressure (DBP)) or severe OH (>30 mm Hg (SBP) and/or >15 mm Hg (DBP)) within 3 min and 250 patients (72%) within 10 min. OH magnitude was significantly associated with disease severity (UMSARS I, II and IV), orthostatic symptoms (UMSARS I) and supine hypertension. OH severity was not associated with MSA subtype. Drug intake did not differ according to OH magnitude except for antihypertensive drugs being less frequently, and antihypotensive drugs more frequently, prescribed in severe OH. Conclusions: This is the largest study of OH in patients with MSA. Our data suggest that the sensitivity to pick up OH increases substantially by a prolonged 10 min orthostatic challenge. These results will help to improve OH management and the design of future clinical trials.
Main Authors: | , , , , , , , , , , , , , , , , , , , |
---|---|
Format: | Artículo biblioteca |
Language: | eng |
Published: |
BMJ Publishing Group
2016
|
Subjects: | COMORBILIDAD, TRASTORNOS DEL MOVIMIENTO, ATROFIA MULTISISTÉMICA, HIPOTENSION ORTOSTATICA, |
Online Access: | https://repositorio.uca.edu.ar/handle/123456789/14266 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
id |
oai:ucacris:123456789-14266 |
---|---|
record_format |
koha |
spelling |
oai:ucacris:123456789-142662024-03-21T11:57:15Z New insights into orthostatic hypotension in multiple system atrophy : a European multicentre cohort study Pavy-Le Traon, A. Piedvache, A. Pérez Lloret, Santiago Calandra-Buonaura, G. Cochen De Cock, Valérie Colosimo, C. Cortelli, P. Debs, R. Duerr, S. Fanciulli, A. Foubert Samier, Alexandra Gerdelat, A. Gurevich, T. Krismer, F. Poewe, W. Tison, F. Tranchant, C. Wenning, G. Rascol, O. Meissner, W. G. COMORBILIDAD TRASTORNOS DEL MOVIMIENTO ATROFIA MULTISISTÉMICA HIPOTENSION ORTOSTATICA Abstract: Objectives Orthostatic hypotension (OH) is a key feature of multiple system atrophy (MSA), a fatal progressive neurodegenerative disorder associated with autonomic failure, parkinsonism and ataxia. This study aims (1) to determine the clinical spectrum of OH in a large European cohort of patients with MSA and (2) to investigate whether a prolonged postural challenge increases the sensitivity to detect OH in MSA. Methods: Assessment of OH during a 10 min orthostatic test in 349 patients with MSA from seven centres of the European MSA-Study Group (age: 63.6±8.8 years; disease duration: 4.2±2.6 years). Assessment of a possible relationship between OH and MSA subtype (P with predominant parkinsonism or C with predominant cerebellar ataxia), Unified MSA Rating Scale (UMSARS) scores and drug intake. Results: 187 patients (54%) had moderate (>20 mm Hg (systolic blood pressure (SBP)) and/or >10 mm Hg (diastolic blood pressure (DBP)) or severe OH (>30 mm Hg (SBP) and/or >15 mm Hg (DBP)) within 3 min and 250 patients (72%) within 10 min. OH magnitude was significantly associated with disease severity (UMSARS I, II and IV), orthostatic symptoms (UMSARS I) and supine hypertension. OH severity was not associated with MSA subtype. Drug intake did not differ according to OH magnitude except for antihypertensive drugs being less frequently, and antihypotensive drugs more frequently, prescribed in severe OH. Conclusions: This is the largest study of OH in patients with MSA. Our data suggest that the sensitivity to pick up OH increases substantially by a prolonged 10 min orthostatic challenge. These results will help to improve OH management and the design of future clinical trials. 2022-06-27T13:22:18Z 2022-06-27T13:22:18Z 2016 Artículo Pavy-Le Traon, A., et al. New insights into orthostatic hypotension in multiple system atrophy : a European multicentre cohort study [en líena]. Journal of Neurology, Neurosurgery and Psychiatry. 2016, 87(5) doi:10.1136/jnnp-2014-309999 Disponible en: https://repositorio.uca.edu.ar/handle/123456789/14266 0022-3050 1468-330X (online) https://repositorio.uca.edu.ar/handle/123456789/14266 10.1136/jnnp-2014-309999 25977316 eng info:eu-repo/semantics/closedAccess http://creativecommons.org/licenses/by-nc-sa/4.0/ application/pdf BMJ Publishing Group Journal of Neurology, Neurosurgery and Psychiatry. 2016, 87(5) |
institution |
UCA |
collection |
DSpace |
country |
Argentina |
countrycode |
AR |
component |
Bibliográfico |
access |
En linea |
databasecode |
dig-uca |
tag |
biblioteca |
region |
America del Sur |
libraryname |
Sistema de bibliotecas de la UCA |
language |
eng |
topic |
COMORBILIDAD TRASTORNOS DEL MOVIMIENTO ATROFIA MULTISISTÉMICA HIPOTENSION ORTOSTATICA COMORBILIDAD TRASTORNOS DEL MOVIMIENTO ATROFIA MULTISISTÉMICA HIPOTENSION ORTOSTATICA |
spellingShingle |
COMORBILIDAD TRASTORNOS DEL MOVIMIENTO ATROFIA MULTISISTÉMICA HIPOTENSION ORTOSTATICA COMORBILIDAD TRASTORNOS DEL MOVIMIENTO ATROFIA MULTISISTÉMICA HIPOTENSION ORTOSTATICA Pavy-Le Traon, A. Piedvache, A. Pérez Lloret, Santiago Calandra-Buonaura, G. Cochen De Cock, Valérie Colosimo, C. Cortelli, P. Debs, R. Duerr, S. Fanciulli, A. Foubert Samier, Alexandra Gerdelat, A. Gurevich, T. Krismer, F. Poewe, W. Tison, F. Tranchant, C. Wenning, G. Rascol, O. Meissner, W. G. New insights into orthostatic hypotension in multiple system atrophy : a European multicentre cohort study |
description |
Abstract: Objectives Orthostatic hypotension (OH) is a key feature of multiple system atrophy (MSA), a fatal progressive neurodegenerative disorder associated with autonomic failure, parkinsonism and ataxia. This study aims (1) to determine the clinical spectrum of OH in a large European cohort of patients with MSA and (2) to investigate whether a prolonged postural challenge increases the sensitivity to detect OH in MSA.
Methods: Assessment of OH during a 10 min orthostatic test in 349 patients with MSA from seven centres of the European MSA-Study Group (age: 63.6±8.8 years; disease duration: 4.2±2.6 years). Assessment of a possible relationship between OH and MSA subtype (P with predominant parkinsonism or C with predominant cerebellar ataxia), Unified MSA Rating Scale (UMSARS) scores and drug intake.
Results: 187 patients (54%) had moderate (>20 mm Hg (systolic blood pressure (SBP)) and/or >10 mm Hg (diastolic blood pressure (DBP)) or severe OH (>30 mm Hg (SBP) and/or >15 mm Hg (DBP)) within 3 min and 250 patients (72%) within 10 min. OH magnitude was significantly associated with disease severity (UMSARS I, II and IV), orthostatic symptoms (UMSARS I) and supine hypertension. OH severity was not associated with MSA subtype. Drug intake did not differ according to OH magnitude except for antihypertensive drugs being less frequently, and antihypotensive drugs more frequently, prescribed in severe OH.
Conclusions: This is the largest study of OH in patients with MSA. Our data suggest that the sensitivity to pick up OH increases substantially by a prolonged 10 min orthostatic challenge. These results will help to improve OH management and the design of future clinical trials. |
format |
Artículo |
topic_facet |
COMORBILIDAD TRASTORNOS DEL MOVIMIENTO ATROFIA MULTISISTÉMICA HIPOTENSION ORTOSTATICA |
author |
Pavy-Le Traon, A. Piedvache, A. Pérez Lloret, Santiago Calandra-Buonaura, G. Cochen De Cock, Valérie Colosimo, C. Cortelli, P. Debs, R. Duerr, S. Fanciulli, A. Foubert Samier, Alexandra Gerdelat, A. Gurevich, T. Krismer, F. Poewe, W. Tison, F. Tranchant, C. Wenning, G. Rascol, O. Meissner, W. G. |
author_facet |
Pavy-Le Traon, A. Piedvache, A. Pérez Lloret, Santiago Calandra-Buonaura, G. Cochen De Cock, Valérie Colosimo, C. Cortelli, P. Debs, R. Duerr, S. Fanciulli, A. Foubert Samier, Alexandra Gerdelat, A. Gurevich, T. Krismer, F. Poewe, W. Tison, F. Tranchant, C. Wenning, G. Rascol, O. Meissner, W. G. |
author_sort |
Pavy-Le Traon, A. |
title |
New insights into orthostatic hypotension in multiple system atrophy : a European multicentre cohort study |
title_short |
New insights into orthostatic hypotension in multiple system atrophy : a European multicentre cohort study |
title_full |
New insights into orthostatic hypotension in multiple system atrophy : a European multicentre cohort study |
title_fullStr |
New insights into orthostatic hypotension in multiple system atrophy : a European multicentre cohort study |
title_full_unstemmed |
New insights into orthostatic hypotension in multiple system atrophy : a European multicentre cohort study |
title_sort |
new insights into orthostatic hypotension in multiple system atrophy : a european multicentre cohort study |
publisher |
BMJ Publishing Group |
publishDate |
2016 |
url |
https://repositorio.uca.edu.ar/handle/123456789/14266 |
work_keys_str_mv |
AT pavyletraona newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT piedvachea newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT perezlloretsantiago newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT calandrabuonaurag newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT cochendecockvalerie newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT colosimoc newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT cortellip newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT debsr newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT duerrs newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT fanciullia newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT foubertsamieralexandra newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT gerdelata newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT gurevicht newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT krismerf newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT poewew newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT tisonf newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT tranchantc newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT wenningg newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT rascolo newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy AT meissnerwg newinsightsintoorthostatichypotensioninmultiplesystematrophyaeuropeanmulticentrecohortstudy |
_version_ |
1794795132351938560 |