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行动呼吁:医疗服务提供者在减轻与神经源性直立性低血压相关负担中的作用

A Call to Action: The Role of Healthcare Providers in Reducing the Burden Associated with Neurogenic Orthostatic Hypotension.

作者信息

Gibson Jessie S, Hunter Christine B, Hewitt L Arthur

机构信息

Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.

Parkinson's Disease Center and Movement Disorders Center, Baylor College of Medicine, Houston, TX, USA.

出版信息

Neurol Ther. 2020 Dec;9(2):205-211. doi: 10.1007/s40120-020-00203-6. Epub 2020 Jul 27.

Abstract

Neurogenic orthostatic hypotension (nOH) is a sustained fall in blood pressure upon standing that frequently affects patients with neurodegenerative diseases (e.g., Parkinson disease) and manifests with symptoms such as lightheadedness and dizziness upon standing. nOH can severely affect patients by increasing the risk of falls and injuries and by decreasing functionality, independence, and quality of life. However, the condition is often under-recognized because of many factors, including the nonspecific nature of the symptoms, patient comorbidities, and patients' reluctance to discuss their symptoms with their healthcare providers. Increased awareness of the burden of nOH and recognition of potential barriers to efficient diagnosis may lead to improved clinical outcomes and better quality of life for patients. To better understand the manifestations and real-life impact of living with nOH symptoms, perspectives from a patient with nOH and his caregiver (wife) are provided, along with key findings from a published survey of patients and caregivers on the burden of nOH. In addition, insights and advice on a practical approach for diagnosing, educating, and treating patients with nOH are outlined.

摘要

神经源性直立性低血压(nOH)是指站立时血压持续下降,常影响神经退行性疾病(如帕金森病)患者,表现为站立时头晕目眩等症状。nOH会增加跌倒和受伤风险,降低功能、独立性及生活质量,从而严重影响患者。然而,由于诸多因素,包括症状的非特异性、患者合并症以及患者不愿与医护人员讨论症状等,该病症常未得到充分认识。提高对nOH负担的认识以及认识到有效诊断的潜在障碍,可能会改善临床结局并提高患者生活质量。为了更好地理解nOH症状的表现及对现实生活的影响,本文提供了一位nOH患者及其照顾者(妻子)的观点,以及一项已发表的关于nOH患者及照顾者负担的调查的主要发现。此外,还概述了关于诊断、教育和治疗nOH患者的实用方法的见解和建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32c1/7606417/c6d7de8743c6/40120_2020_203_Fig1_HTML.jpg

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