Cardiovascular comorbidities complicate treatment decisions in nOH

Patients with neurogenic orthostatic hypotension (nOH) often have cardiovascular comorbidities that make treatment difficult, according to a study published in The American Journal of Cardiology. Management should be based on a patient’s cardiovascular profile.

According to the researchers, there is little evidence that nOH treatment will worsen other comorbid cardiovascular disease, although it can worsen supine hypertension. The limited amount of evidence that is available suggests that droxidopa may be less likely than midodrine to exacerbate supine hypertension, although further studies are needed to determine the safety profile of droxidopa treatment in patients with coronary artery disease or low left ventricular ejection fraction.

Reference
Olshansky B, Muldowney J. Cardiovascular Safety Considerations in the Treatment of Neurogenic Orthostatic Hypotension. Am J Cardiol. 2020;125(10):1582-1593. doi:10.1016/j.amjcard.2020.01.037