Hipotensão ortostática: o estado da arte

Autores

  • José Luís Ducla-Soares Chefe de Serviço de Medicina Interna; Professor Agregado de Medicina Interna Clínica Universitária de Medicina I, Hospital de Santa Maria, Lisboa

Palavras-chave:

baroreflexo, sistema nervoso simpático, receptores adrenérgicos, hipotensão ortostática

Resumo

Define-se hipotensão ortostática e analisa-se a sua
relevância clínica em termos epidemiológicos e
clínicos. Descreve-se a fisiologia da adaptação
tensional ao ortostatismo, com base na qual se
categorizam as hipotensões ortostática em hipo e
normoadrenérgicas, sendo os seus mecanismos
fisiopatológicos analisados. Definem-se os objectivos
terapêuticos e analisam-se as várias metodologias ao dispor.

Downloads

Não há dados estatísticos.

Referências

The Consensus Committe of the American Autonomic Society and the American Academy of Neurology. Concensus statement on the

definition of orthostatic hypotension, pure autonomic failure, and multiple system athrophy. Neurology 1996;46:1470.

Streeten DHP, Anderson GH: Delayed orthostatic intolerance. Arch Intern Med 1992;152:1066-1072.

Caird FI, Andrews GR, Kennedy RD. Effect of posture on blood pressure in the elderly. Br Heart J 1973;35:527-530.

Mader SL, Josephson KR, Rubenstein LZ. Low prevalence of postural hypotension among community-dwelling elderly. JAMA

;258:1511-1514.

Kapoor WN, Karpf M, Wienand S, Peterson JR, Levey GS. A prospective evaluation and follow-up of patients with syncope. N

Engl J Med 1983;309:197-204.

Witzleb E. Functions of the vascular system. In Schmidt RF, Thews G (Eds) Human physiology 2nd edition. Berlin, Spinger-Verlag, 1989:

-542.

Guyton AC, Hall JE. Nervous regulation of the circulation, and rapid control of arterial pressure, In: Guyton AC, Hall JE Textbook

of medical physiology 9th edition, Philadelphia, W.B Saunders Company, 1996: 209-220.

Insel PA. Adrenergic receptors – evolving concepts and clinical implications. N Engl J Med 1996;334:580-585.

Esler M, Jennings G, Lambert G, Meredith I, Horne M, Eisenhofer G. Overflow of cathecolamine neurotransmitters to the circulation:

source, fate, functions. Physiol Rev 1990;70:963-985.

Borst C, van Brederode JFM, Wieling W. Mechanisms of initial blood pressure response to postural change. Clin Sci 1984;67:321-

Ewing DJ. Cardiovascular reflexes and autonomic neuropathy. Clin Sci Mol Med 1978;55:321-327.

Ewing DJ. Practical bedside investigation of diabetic autonomic failure. In Bannister R (editor). Autonomic failure: a textbook of

clinical disorders of the autonomic nervous system. Oxford, Oxford University Press 1983:371-405.

Ducla-Soares JL. Contribuição para o estudo da disautonomia da polineuropatia amiloidótica familiar. Tese de Doutoramento.

Edição do autor 1991.

Low PA, Suarez GA, Benarroch EE. Clinical autonomic disorders: classification and clinical evaluation. In Low PA (editor) Clinical

autonomic disorders, 2nd edition, by Mayo Foundation, edited by Lippincott-Raven Publishers, Philadelphia 1997:3-15.

Bradbury S, Egglestone C. Postural hypotension; report of three cases. Am Heart J 1925;1:73-86.

Bannister R: Clinical features and investigation of the primary autonomic failure syndromes. In: Bannister R, Mathias CJ.

Autonomic failure: a textbook of clinical disorders of the autonomic nervous system, 3th edition, Oxford, Oxford University

Press 1992: 531-548.

Johnson RH, Lee GJ, Oppenheimer DR, Spalding JMK. Autonomic failure with orthostatic hypotension due to intermediolateral

column degeneration. Q Jl Med 1966;35:276-292.

Low PA, Bannister R: Multiple system atrophy and pure autonomic failure. In Low PA (editor): Clinical autonomic disorders, 2nd edition,

by Mayo Foundation, published by Lippincot-Raven, Philadelphia 1997:555-576.

Linden RJ. Atrial reflexes and renal function. American Journal of Cardiology 1979;44:879-883.

Wilcox CS, Penn W. The basis of the nocturnal polyuria in Neurosurgery and Psychiatry 1975;37:677-684.

Wilcox CS. Body fluids and renal function in autonomic failure. In Bannister R (Editor): Autonomic failure. A textbook of clinical

disorders of the autonomic nervous system, Oxford University Press, Oxford 1983: 115-154,

Mathias CJ, da Costa DF, Fosbraey P, Bannister R, Christensen NJ. In The sympathoadrenal system, Alfred Benzon Symposium

(edited by Christansen NJ, Hendrikcksen O, Lassen NA). Munksgaard, Copenhaga: 402406.

Mathias CJ, Fosbraey P, da Costa D, Thornley A, Bannister R. The effect of desmopressin on nocturnal polyuria, overnight

weight loss, and morning postural hypotension in patients with autonomic failure. Br Med J 1986;293:353.

Magrini M, Ibrahim MM, Tarazi RC. Abnormalities of supine hemodynamics in idiopathic orthostatic hypotension. Cardiology

;61:125-135.

Kafka MS. Alpha adrenergic receptors in orthostatic hypotension. Neurology 1984;34:1121-1125.

Streeten DHP: Orthostatic disorders of blood pressure control-clinical features. In: Streeten DHP. Orthostatic disorders of the

circulation. Mechanisms, manifestations and treatment. New York, Plenum Medical Book Company 1987:173-188.

Ducla-Soares JL, Sousa Guerreiro A, Póvoa P, Álvares E, Guerreiro L, Carrilho F, Santos M, Figueirinhas J, Carvalho M. Falência

autonómica pura. Acta Médica Portuguesa 1993;6:533-538.

Hines S, Houston M, Robertson D. The clinical spectrum of autonomic dysfunction. Am J Med 1981;70:1091-1096.

Bannister R. Clinical features of progressive autonomic failure. In: Autonomic failure: a textbook of clinical disorders of the

autonomic nervous system. Oxford, Oxford University Press 1983: 67-73.

Craig GM. Clinical presentation of orthostatic hypotension in the elderly. Postgrad Med J 1994;70:638-642.

Robertson D, Kincaid DW, Haile V, Robertson RM. The head and neck discomfort of autonomic failure: an unrecognised aetiology

of headache. Clinical Autonomic Research 1994;4:99-103.

Rowe PC, Bou-Holaigah I, Kan JS, Calkins H. Is neurally mediated hypotension un unrecognised cause of chronic fatigue? Lancet

;345:623-624.

Rosen SG, Cryer PE. Postural tachycardia syndrome. Reversal of sympathetic hyperresponsiveness and clinical improvement during

sal loading. Am J Med 1982;72:847-850.

Ducla-Soares JL, Póvoa P, Meneses Santos J. Orthostatic tachycardia due to hypovolemia and ß-adrenergic hypersensitivity

– clinical case. European Heart Journal 1996;16:2009-20010.

Holdtke RD, Dworkin GE, Gaspar SR, Israel BC. Sympathotonic orthostatic hypotension: a report of four cases. Neurology

;39:34-40.

Streeten DH. Pathogenesis of hyperadrenergic orthostatic hypotension. Evidence of disordered venous innervation

exclusively in the lower limbs. J Clin Invest 1990;86:1582-1588.

Jacob G, Costa F, Shannon JR, Robertson RM, Wathen M, Stein M, Biaggioni I, Black B, Robertson D. The neuropatic postural

tachycardia syndrome N Engl J Med 2000;343:1008-1012.

Neville BGR, Sladen GE. Acute autonomic neuropathy following primary herpes simplex infectioon. J Neurol Neurosur Psych

;47:648-650.

Vassalo M, Camillieri M, Caron BL, Low PA. Gastrointestinal and motor dysfunction in acquired selective cholinergic dysautonomia

associated with infectious mononucleosis. Gastrenterology 1991;100:252-256.

Park DM, Johnson RH, Crean GP, Robinson JF. Orthostatic hypotension in bronchial carcinoma. Br Med Jour 1972;3:510-

Appenzeller O, Kornfeld M. Acute pandysautonomia. Clinical and morphologic study. Arch Neurol 1973;29:334-339.

Low PA, Dyck PJ, Lambert EH, Brimijoin WS, Tratmann JC, Malagelada JR, Fealey RD, Barret DM. Acute panautonomic

neuropathy. Ann Neuro 1983;13:412-417.

Crespo M, Correia L, Ferreira F, Ducla-Soares JL. Disautonomia aguda associada a Linfoma de Hodgkin. Acta Médica Portuguesa,

in press

Robertson D, Robertsone RM. Causes of chronic orthostatic hypotension. Arch Intern Med 1994;154:1620-1624.

Streeten HP, Kerr LP, Kerr CB. Hyperbradykininism: a new orthostatic syndrome. Lancet 1972;2:1048-1053.

Frohlich ED, Dustan HP, Page IH. Hyperdynamic beta-adrenergic circulatory state. Arch Intern Med 1966;117:614-619.

Frohlich ED, Tarazi RC, Dustan HP. Arch Intern Med 1969;123:1-7.

Davies AO, Mares A, Pool JL, Taylor AA. Mitral valve prolapse with symptoms of beta-sdrenergic hypersensitivity. Beta2 - adrenergic receptor supercoupling with desensitization on isoproterenol exposure. Am J Med 1987;82:193-201.

Polinsky RJ, Kopin IJ, Ebert MH, Weise V. Pharmacologic distinction of different orthostatic hypotension syndromes.

Neurology 1981;31:1-7.

Robinson BJ, Stowell LI, Johnson RH, Palmer KT. Is orthostatic hypotension in the elderly due to autonomic failure? Age and

Ageing 1990;19:288-296.

Bannister R. Treatment of progressive autonomic failure. In: Bannister R (ed): Autonomic failure. Oxford, Oxford University

Press 1983:316-334.

Sheps SG. Use of an elastic garment in the treatment of orthostatic hypotension. Cardiology 1976;61:271-279.

Wieling W, van Lieshout JJ, van Leeuwen AM. Physical manoeuvres that reduce postural hypotension in autonomic failure.

Clinical Autonomic Research 1993;3:57-65.

Polinsky RJ, Samaras GM, Kopin IJ. Sympathetic neural prosthesis for managing orthostatic hypotension. Lancet 1983;1:901-904.

Diamond MA, Murray RH, Scmid PG. Idiopathic postural hypotension; physiologic observations and report of a new mode of therapy. J Clin Invest 1970;49:1341-1348.

Nanda RN, Johnson RH, Keogh HJ. Treatment of neurogenic orthostatic hypotension with a monoamine oxidase inhibitor and

tyramine. Lancet 1976;2:1164-1167.

Schwartz GL, Schirger A. Orthostatic hypotension. Curr Ther Endocrinol Metab 1994;5:178-183.

Robertson D, Perry SE, Hollister As. Dopamine-hydroxylase deficiency: a genetic disorder of cardiovascular regulation.

Hypertension 1991;18:1-8.

Robertson D, Goldberg MR, Hollister AS. Clonidine raises blood pressure in severe idiopathic orthostatic hypotension. AM J Med

;74:193-200.

Schirger A, Sheps SG, Thomas JE, Fealey RD. Midodrine. A new agent in the management of idiopathic orthostatic hypotension

and Shy-Drager syndrome. Mayo Clin Proc 1981;56:429-433.

Jankovic J, Gilden JL, Hiner BC, Kaufmann H, Brown DC, Coghlan CH, Rubin M, Fouad-Tarazi FM. Neurogenic orthostatic

hypotension: a double-blind, placebo controlled study with midodrine. Am J Med 1993;95(1):38-48.

Onrot J: Hemodynamic and humoral effects of caffeine in human autonomic failure. N Engl J Med 1985;313:549-554.

Wagner HN Jr, Braunwald E. The pressor effect of the antidiuretic principle of the posterior pituitary in orthostatic hypotension. J

Clin Invest 1956;35:1412-1418.

De Paula RB: Contribution of vasopressin to orthostatic blood pressure maintenance in essential hypertension. Am J Hypertens

;6:794-798.

Jennings G, Esler M, Holmes R. Treatment of orthostatic hypotension with dihydroergotamine. Br Med J 1979;2:307.

Schatz IJ, Miller MJ, Frame B. Corticosteroids in the management of orthostatic hypotension. Cardiology 1976;61:280-289.

Hoeldtke RD, Streeten DHP. Treatment of orthostatic hypotension with erythropoietin. N Engl J Med 1993;329:611-

Kuchel O, BUU NT, Gutkowska J. Treatment of severe orthostatic hypotension by metoclopramide. Ann Intern Med 1980;93:841-

Chobanian AV, Volicer L, Liang CS. Use of propranolol in the treatment of idiopathic orthostatic hypotension. Trans Assoc

Am Physicians 1977;90:324-334.

Kochar MS, Itskovitz HD. Treatment of idiopathic orthostatic hypotension (Shy-Drager syndrome) with indomethacin. Lancet

;1:1011-1014.

Stackpoole PW, Robertson D. Combination H-1 and H-2 receptor antagonist therapy in diabetic autonomic neuropathy. South Med

J 1982;75:634-635.

Raimbach SJ: Prevention of glucose-induced hypotension by the somatostatin analogue octreotide (SMS-201-995) in chronic

autonomic failure: haemodynamic and hormonal changes: Clin Sci 1989;77:623-628.

Man in’t Veld AJ, Schalekamp MADH: Pindolol acts as a ßadrenoceptor agonist in orthostatic hypotension: therapeutic implications. Br Med J 1981;282:929-931.

Moss AJ, Glaser W, Topol E. Atrial tachypacing in the treatment of a patient with primary orthostatic hypotension. N Engl J Med

;302:1456-1457.

Heseltine D, Thomas T, Wilkinson R, James OFW, Potter. Potassium supplementation in the treatment of idiopathic postural

hypotension. Age and Ageing 1990;19:409-414

Ficheiros Adicionais

Publicado

29-06-2001

Como Citar

1.
Ducla-Soares JL. Hipotensão ortostática: o estado da arte. RPMI [Internet]. 29 de Junho de 2001 [citado 16 de Novembro de 2024];8(2):80-8. Disponível em: https://revista.spmi.pt/index.php/rpmi/article/view/1948

Edição

Secção

Artigos de Revisão

Artigos Similares

Também poderá iniciar uma pesquisa avançada de similaridade para este artigo.