Sequeira QCM, Casares FDA

Language: Spanish
References: 25
Page: 11-20
PDF size: 257.98 Kb.

ABSTRACT

The nervous system is divided in a central nervous system, a peripheral nervous system and an autonomic nervous system. The autonomous system has functions related to homeostasis, adaptation and other multiple autoregulatory tasks. The autonomic nervous system is divided in a sympathic and a parasympathic branch, both conformed by a preganglionic and a postganglionic neuron and both regulated upwards by central centers. The patologies affecting this system can manifest themselves in a myriad of ways and can be classified in structural and functional disorders depending on whether or not they have a defined anatomic injury. Supine hypertension is characterized by an elevated blood pressure in the aforementioned position and eventhough unlike chronic elevated blood pressure end organ damage has not been fully documented, its importance lies on its high incidence in dysautonomic patients and moreso if they receive medications for ortosthatic hypotension. Treatment for supine hypertension consists in a series of non-medical and pharmacologic measures with the goal of balancing the risk of falls, syncope, and orthostatic intolerance against the possible end organ damage produced by the elevated blood pressure levels.

REFERENCES

1. Boron W, Boulpaep E. Medical Physiology. Second edition Updated edition. Chapter 10: Organization of the Nervous System. Elsevier Saunders. 2012: 267-270.

2. Goldstein D, Low P. Clinical Evaluation of the Autonomic Nervous System. Continuum Lifelong Learning Neurol 2007;13(6):33–49.

3. Benarroch E. The Autonomic Nervous System: Basic Anatomy and Phisiology. Continuum Lifelong Learning Neurol 2007;13(6):13–32.

4. Daroff R, Jankovic J, Mazziotta J et al. Bradley’s Neurology in Clinical Practice. Seventh Edition. Chapter 108: Disorders of the Autonomic Nervous System. Elsevier. 2016; 1867-1895.

5. Mtui E, Gruener G, Dockery P. Fitzgerald’s Clinical Neuroanatomy and Neuroscience. 7th edition. Chapter 13: Autonomic Nervous System. Elsevier 2016:136-150.

6. Benarroch E. The central autonomic network: functional organization, dysfunction, and perspective. Mayo Clin Proc 1993;68(10):988–1001.

7. Saper C. The central autonomic nervous system: conscious visceral perception and autonomic pattern generation. Annu Rev Neurosci 2002;25: 433–469.

8. Toni R, Malaguti A, Benfenati F, Martini L. The human hypothalamus:a morpho- functional perspective. J Endocrinol Invest 2004;27(6 suppl):73–94.

9. Fanciulli A, Wenning A, Gregor K. Multiple-System Atrophy. New England Journal of Medicine 2015: 249-263.

10. Freeman R. Neurogenic Orthostatic Hypotension. New England Journal of Medicine. 2008: 615-624.

11. Goldstein D, Pechnik S, Holmes C et al. Association between supine hypertension and orthostatic hypotension in autonomic failure. Hypertension 2003; 42: 136-42.

12. Jordan J, Shannon J, Pohar B et al. Contrasting effects of vasodilators on blood pressure and sodium balance in the hypertension of autonomic failure. J Am Soc Nephrol 1999;10-35.

13. Kotchen T. Vasculopatía hipertensiva. McGraw-Hill 2016.

14. Whelton P, Carey R, Aronow W et al. Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults. Hypertension. 2017; 1-481.

15. Freeman R, Kaufmann H. Disorders of Orthostatic Tolerance- Orthostatic Hypotension, Postural Tachycardia Syndrome, and Syncope. Continuum Lifelong Learning Neurol 2007;13(6):50– 88.

16. Kanjwal K, George A, Figueredo VM, Grubb BP. Orthostatic hypotension: definition, diagnosis and management. J Cardiovasc Med (Hagerstown). 2015;16(2):75–81.

17. Naschitz JE, Slobodin G, Elias N, Rosner I. The patient with supine hypertension and orthostatic hypotension: a clinical dilemma. Postgrad Med J. 2006;82(966):246–253

18. Lamarre-Cliche M. Orthostatic hypotension and supine hypertension in the patient with autonomic failure. Can J Gen Intern Med. 2014;9(3):91–95.

19. Vagaonescu T, Saadia D, Tuhrim S et al. Hypertensive cardiovascular damage in patients with primary autonomic failure. Lancet 2000:725-726.

20. Kaufmann H, Goldstein D. Autonomic Failure in Neurodegenerative Disorders. Continuum Lifelong Learning Neurol 2007;13(6):111–142.

21. Singer W, Sandroni P, Opfer-Gehrking T et al. Pyridostigmine Treatment Trial in Neurogenic Orthostatic Hypotension. Arch Neurol. 2006; 63(4):513– 518.

22. Ahmed A, Grubb B, Zaman L et al. Syndrome of Supine Hypertension with Orthostatic Hypotension. A nightmare for Physicians. The Journal of Innovations in Cardiac Rhythm Management 2016; 7: 2285-2288.

23. Nwazue V, Raj S. Confounders of vasovagal syncope: orthostatic hypotension. Cardiol Clin 2013; 31:89.

24. Shannon J, Jordan J, Costa F et al. The hypertension of autonomic failure and its treatment. Hypertension 1997;30:1062.

25. Shannon J, Jordan J, Dietrich A et al. Sympathetically mediated hypertension in autonomic failure. Circulation 2000; 101 (23), 2710–2715.