Orthostatic Hypotension: Management of a Complex, But Common, Medical Problem, 2022, Artur Fedorowski et al

Abstract

Orthostatic hypotension (OH), a common, often overlooked, disorder with many causes, is associated with debilitating symptoms, falls, syncope, cognitive impairment, and risk of death. Chronic OH, a cardinal sign of autonomic dysfunction, increases with advancing age and is commonly associated with neurodegenerative and autoimmune diseases, diabetes, hypertension, heart failure, and kidney failure.

Management typically involves a multidisciplinary, patient-centered, approach to arrive at an appropriate underlying diagnosis that is causing OH, treating accompanying conditions, and providing individually tailored pharmacological and nonpharmacological treatment.

We (1) propose a novel streamlined pathophysiological classification of OH; (2) review the relationship between the cardiovascular disease continuum and OH; (3) discuss OH-mediated end-organ damage; (4) provide diagnostic and therapeutic algorithms to guide clinical decision making and patient care; (5) identify current gaps in knowledge and try to define future research directions.

Using a case-based learning approach, specific clinical scenarios are presented highlighting various presentations of OH to provide a practical guide to evaluate and manage patients who have OH.

https://www.ahajournals.org/doi/abs/10.1161/CIRCEP.121.010573

 

The whole "imagine unicorns and rainbows"-based medicine is seriously weird. Is what they hope is true? Or are they just saying that because it sounds nice? Why say something that is obviously false? Other than the fact that clearly nothing matters since this obviously false claim somehow makes it through peer review. Socially spread delusion, oh the irony.

 

Main drugs Orthostatic hypotension. Sorry for the blurriness:

 

Orthostatic hypotension Non pharmacological interventions. Can someone de-blurr this?

 

I've read a lot of good things in the Swedish groups on social media, written by some of dr Fedorowski's patients. They are actually getting proper medical investigations, are offered treatments that do seem to help a lot (including pharmaceutical ones), etc.

So it's not just empty words. At least dr Fedorowski seem to put his words into action in the clinic.

(ETA: If I were able to travel, his clinic is without a doubt the first one I'd ask for a referral to.)